A Chiropractor’s Approach To Neck Pain in Sebastopol
As a chiropractor in Sebastopol and an upper cervical chiropractic specialist for more than 20 years, I have seen many people in my office with neck pain and neck related problems. Problems in the neck can refer to the upper back, shoulders, arms, hands, and up into the head. Although chiropractic care is thought of as being effective for low back pain by many people, neck pain responds even better to chiropractic care and upper cervical specific chiropractic techniques. Most chiropractors use a variety of methods and techniques in their practice so I will explain some of these approaches and the reasons behind why they work for specific conditions. Many people are looking for a different approach than the traditional drugs and surgery route, the good news is that a large majority of neck problems can be managed without drugs or surgery if you find the right healthcare provider to help you. The chiropractic profession is growing and expected to grow at a higher rate than most other professions because people are seeking health care that is effective and affordable and also because chiropractic care now has the research to back it up. Chiropractic care works to restore function and health to the spine whereas traditional medicine has the goal many times of only covering up or suppressing the symptoms. You may even find that you get more than just pain relief but overall general health improvement from chiropractic care.
Obviously, tumors, fractures, and other life-threatening conditions that cause neck pain are referred out; so we will focus on the types of neck pain that are seen in a chiropractic office. The most common chronic conditions causing neck pain seen in a chiropractic office include muscle strain, joint sprain or dysfunction, myofascial pain syndromes, degenerative conditions, or arthritis of the spine (spondylosis), cervical disc problems, stenosis, and vertebral subluxations or vertebral fixations.
Traditionally chiropractors address what is referred to as Vertebral Subluxations which are spinal joint dysfunctions. Simply put, the joints in the spine are meant to have movement and when trauma occurs whether it be by accidents, injuries, or repetitive microtraumas and the joints in the spine have become damaged, chemicals are released into the blood, and blood is increased to the injured site. Scar tissue is formed and after a while the spinal joint becomes fixated and in other words, loses their normal movement. With lack of movement several things happen:
- Circulation is impaired and the swelling hangs around and chemicals irritate nerves and cause pain
- The small intrinsic muscles of the spine atrophy due to lack of use
- A decrease in the normal imbibition of fluid into and out of the disc
- Arthritic changes occur due to the inflammatory response
- Feedback to the brain is decreased and normal proprioception is lost
So you see, this joint dysfunction affects the body on many levels and now I am going to relate how this vertebral subluxation affects the chronic conditions causing spinal problems.
Neck pain is common when there is added stress in a person’s life and muscles tighten up in the neck. Too much caffeine can add to the situation and over time trigger points can develop in the muscles of the neck. Trigger Points are hyperirritable areas in the muscles that cause painful knots in the muscles and can refer pain to other areas. Adhesions in the connective tissue can also develop over time and cause pain. Trigger point and myofascial release is done by hand by a chiropractor or a massage therapist trained and experienced in these methods. Also, a method of stretching called Post Isometric Relaxation (PIR) works by having the patient contract and relax certain muscle groups while the practitioner stretches the patient. Once the muscles are stretched out and relaxed the pain usually resolves. Dealing with the underlying stress is also critical as the pain may not resolve until that is done. Many times a change in perspective can make all the difference, I often tell my patient’s “you can resign from your job as general manager of the universe any time you want.”
As people age spinal degeneration occurs and you may be told that you have spondylosis, osteoarthritis, degenerative joint disease, bone spurs, arthritis, which are all terms that describe the same degenerative process. Three things happen 1. Sclerosis, meaning a buildup of mineral around the joints of the spine. 2. A decrease in the joint space, in other words, the disc pad between the vertebra decreases in size. 3. lipping and spurring - bone spurs form around the joint. This process is one that takes many years to form and if you have pain there is nothing better than good chiropractic care. A Specific upper cervical approach has been incredibly successful with this spinal degeneration. When the top bone in the spine (atlas) becomes subluxated and the head is not sitting on top of the spine correctly the rest of the spine goes out of balance to compensate for it and until this is addressed the spine will remain imbalanced and the spinal joints will not function properly.
Many times a specific adjustment to fixated, swollen, or otherwise dysfunctional vertebra found in the lower cervical spine or upper thoracic spine can give miraculous results to neck pain sufferers. Also, chiropractic is aimed at restoring brain-body communication so that when there is inflammation- as there is with arthritis- the body is unable to manage its inflammation, as the inflammatory process is an immune response, when the brain/body communication is restored the body is once again able to appropriately manage its immune response and the inflammation resolves.
Upper cervical adjustments restore brain/body communication so the tissues are better innervated by nerves from the brain and the body is better able to deal with it’s inflammatory process. The body’s natural healing process can deal with the swelling.
Head and neck misalignment causes the lower neck to misalign and will irritate the already degenerated structures in the lower neck.
Specific adjusting and mobilization techniques to a vertebra in the lower cervical spine can result in:
Improved range of motion of the fixated degenerated segments. More movement results in better proprioception (neurological feedback) to the brain which again is better brain/ body or body to brain communication. And also the improvement in movement allows the body to have better circulation and a better ability to remove inflammation.
Cervical disc problems
The discs of the spine can cause pain. The discs can decrease in size (degenerative disc disease), they can develop fissures and leak their contents onto the spinal nerve and irritate it, they can swell up, they can bulge, the discs can herniate and irritate nerves. Chiropractic care has effectively helped with many cases of cervical disc problems. The body will take care of the swelling on its own over time and with chiropractic care, the body will be able to take care of the swelling most efficiently. With proper joint movement, the discs can imbibe fluids and remain healthy, when there is joint dysfunction the circulation is impaired in the joint and the disc is unable to imbibe fluid and chiropractors believe this to be one of the reasons that the discs lose their height. This is also the basis or one of the reasons for chiropractic maintenance care. Of course, the chiropractor will evaluate each case individually and refer out those cases that are not chiropractic cases because some discs are just too damaged and at times surgery may be needed.
Radiculopathy comes from the word radical or root, it means it’s a disease of the nerve root. When the nerves are irritated, pinched, compressed, the pain radiates into the upper back, shoulders arms, or hands. The solution is of course to get to the cause of the problem in the neck. It does no good to try to deal with the pain in the back, shoulders, arms or hands if the problem is coming form the neck. For there to be a radiation of pain there must be a significant amount of impingement on the nerve root. Many people will try to get a massage for relief but if you have radiculopathy a massage will do no good and not offer relief. Chiropractic adjustments shine in this situation, I love this type of case because I know I can get great results with a majority of these cases.
Stenosis is a narrowing of either the spinal canal that houses the spinal cord or a narrowing of the intervertebral foramen which are the holes whereby the nerves exit between the vertebra. If the narrowing causes a compression on the spinal cord it is called myelopathy, if bone spurs are causing impingement to the spinal nerves it is called foraminal stenosis. Stenosis can be seen on an MRI and an MRI is the definitive diagnosis, however plane film x-rays are almost as good when it comes to detecting stenosis. Many people are in a rush to have surgery when they find out they have stenosis, for they see the bone pressing on the spinal tissues and see no other reasonable way to deal with this problem other than cutting away bone that is pressing on the spinal cord and nerves. I have seen many cases of stenosis and I have seen many cases safely and easily handled with chiropractic care. Attitude plays an important part. Many surgeons warn against chiropractic adjustments with people who have stenosis and that is too bad. The reason I believe they think that it is not good is because they usually are only aware of one type of chiropractic technique. They have seen a chiropractor or an osteopath do a rotary break manipulation and they think that is what chiropractic is. Specific Upper Cervical methods of chiropractic like toggle recoil and NUCCA and the Blair method do not use rotary break manipulations, no twisting or jerking the spine. These methods are gentle, safe, effective at restoring balance to the neck and the rest of the spine. I get great results with upper cervical chiropractic on patients with stenosis. Don’t be afraid to find an upper cervical chiropractor and get checked by one. Also, very gentle mobilization techniques to the spine work to increase range of motion, decrease swelling, improve proprioception(brain/body communication) which allows the body’s natural healing abilities to manage the inflammation and decrease pain.
Problems in the upper cervical spine can irritate nerves that go up into the head and refer pain into the head and cause headaches and migraines. Of all the cases of headaches that have come through my doors over the last 23 years about 85% have resolved with the care that I provide. Upper cervical chiropractic specialists will get the best results with headaches over general chiropractors. The nerves from the upper cervical spine run up into the head and can cause headaches, also innervation of the arteries that spasm and cause migraines to come from the upper cervical spine. Upper cervical chiropractors specialize in adjusting the upper cervical spine. The reason that upper cervical chiropractic is a specialty within the chiropractic profession is because the upper cervical spine has different biomechanics than the rest of the spine. Upper cervical chiropractors go on and get extra training in upper cervical care and also upper cervical philosophies are different than regular chiropractic philosophy. Upper cervical methods are gentle, most don’t rotate or twist the neck and they are not associated with cavitation(popping sound) The assessment is scientific, the analysis is specific and the correction is precise there is no forcefulness to the corrections to the neck and the effect is on the full spine body. Body balance, body imbalance
When chiropractors are talking about misalignment they refer to them as Vertebral subluxations. There are really two things going on here, Fixation and subluxation of the spine. Misalignments in the spine occur in almost all cases in the upper cervical region of the spine. The upper cervical spine surrounds and encases the brain stem and the brain stem is the area of the brain that controls posture. With an upper cervical misalignment, the body can become out of balance. The thing to know about having a misalignment is that you will many times have trouble moving or turning your head.
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