a) Cervical Myofascial Pain Syndrome with Articular Dysfunction: This condition has become an epidemic in our modern society. A majority of the adult working population complain of this chronic sense of tightness in their necks and upper backs. This is the most common cause of neck pain. It is caused by a combination of tight muscles, restricted fascia and immobile joints. Treatment involves releasing both a) the tight muscles and restricted fascia with soft tissue techniques such as Nimmo Technique and Fascia Release and b) freeing up restricted joints with chiropractic manipulation and mobilization. Physiotherapy modalities are also often used in the treatment including ultrasound, heat and laser. Acupuncture is also useful for this condition. Some of the most common Contributing factors to this most common of conditions include, previous inadequately treated injuries leading to scar tissue formation, excessive computer and desk work, excessive stress levels, lack of exercise, excessive sugar intake and excessive alcohol intake. Most of our patients find great relief of their symptoms with 5 to 10 visits over a time frame of 1 to 2 months. While reducing the effects of contributing factors and exercising regularly are important aspects of managing this type of case, there are limits to how successful self help alone can be. The only way to regain the maximum function of your joints, muscles and fascia is to to have physical care by professionals.
Some of these cases will also benefit from pursuing simple detoxification methods which can be done at home as part of a self help program. When a patient is unable to completely manage their unique set of contributing factors, such as having no choice but to work many hours a day at a computer, ongoing maintenance care is a useful tool to help minimize the pain and tightness. Maintenance care may include coming for treatment once a month or every 2 months to maintain the gains made with care.
b) Acute Mild to Moderate Cervical Spine Sprain: An acute cervical spine sprain often occurs without any particular trauma. A patient often describes waking up in the morning with neck pain, with the assumption that somehow they fell off their pillow in the night. Usually there is pain when turning the head one or both ways. This condition can sometimes be caused by performing a strenuous activity with the head such as a vigorous forms of dancing, or by performing an activity with the neck in an awkward position for a prolonged period such as watching TV while lying on a couch in an awkward position. Lifting heavy things overhead with the arms can also cause a sprain of the neck. Even prolonged exposure to a cold draft on the neck sometimes causes spasms of the neck musculature which can lead to a sprain. Treatment is usually similar to Cervical Myofascial Pain Syndrome with Articular Dysfunction with the avoidance of heating inflamed areas early in the case. Like an acute low back sprain, the key thing to remember in this kind of case is that the severity of the pain does not correspond with the severity of this condition. Despite the fact that the pain can be severe, most neck sprains are not serious and they usually respond very well to our treatment methods in 3-6 visits over a time period of 10 to 21 days. Without chiropractic treatment, it is common for the symptoms to last 6 weeks (42 days) or more. Furthermore, without chiropractic treatment, when the inflammation finally subsides on its own, and with it your acute pain, you are often left with chronically shortened muscles in your neck, shoulders or upper back, and poor mobility of your spinal joints, setting the stage for chronic muscle tension and the condition Cervical Myofascial Pain Syndrome with Articular Dysfunction described above.
c) Acute Severe Neck Sprain: This is often the result of a trauma. The trauma of a whiplash injury in an automobile accident is the perfect example of this type of sprain. The pain may radiate into the arm with this condition. Most acute severe sprains can still be treated successfully with our methods however, they take longer to recover than a mild sprain. Treatment methods are similar to treating a mild sprain however, the treatments have to be performed more gently, especially early in the case. Heating is also avoided to prevent increasing inflammation. A severe sprain of the neck is usually treated 3 times a week for the first 1 to 3 weeks, then twice a week for 2 to 4 weeks, then once a week for an additional 2 to 5 weeks. The exact number of treatments depends on the particulars of each case. We are continually re-assessing your condition with the aim to decrease the frequency of treatment as soon as possible in an effort to limit the cost to you. All cervical sprains cause a decrease in cervical joint mobility. Treating a severe sprain by means of medication and physical therapy modalities only, such as ultrasound is inadequate. While this approach may eventually successfully eliminate the inflammation and acute pain, it will fail to re-establish joint and fascia mobility. This sets the stage for chronic muscle tension and scar tissue formation, leading to the chronic condition of Cervical Myofascial Pain Syndrome with Articular Dysfunction described above.
d) Herniated Cervical Disc: A herniated cervical disc can either occur suddenly with a trauma, or gradually. If a herniated disc occurs gradually, it usually starts with neck pain and then later begins to radiate pain, tingling and/or numbness to the shoulder blade and or arm. A herniated disc can also occur with a neck sprain. There are some important things that all patients who have been diagnosed with a herniated disc need to know and they are:
1) Not all herniated discs cause symptoms. Studies have been done where adults with no history of spinal pain are given MRI examinations. The researchers find that about one third of the subjects have evidence of some degree of disc herniation visible on the MRI. What this means is that just because a herniated disc has been identified on an MRI, it doesn’t necessarily mean that it is the cause, or the entire cause of your problem. It also doesn’t mean the opposite that it is not the cause. In the real world, the relevance of the MRI findings has to be sifted through on a case by case basis. Here are a few general rules to keep in mind about discs:
2) The more the symptoms radiate into the arm and hand, the more likely the herniated disc is a “symptomatic disc” and an important part of the patient’s pain syndrome. When a patient complains of neck pain that stays in the neck, it is less likely that a herniated disc is the exclusive cause of the pain, even if an MRI indicates the presence of a herniated disc. While tingling and numbness to the arm are symptoms of herniated disc, they are less serious than muscle weakness. Muscle weakness is usually a sign of a more serious herniation. Atrophy (shrinking) of the muscle of the arm and hand are the result of prolonged weakness and are typically indicative of prolonged nerve root compression.
3) Having a cervical herniated disc does not automatically exclude the possibility that you have another problem that is also contributing to the overall pain syndrome. Neck pain that radiates into the arm can also come from other causes such as Scalene Syndrome. In this syndrome, a tight scalene muscle in the front of the neck can also cause neck pain numbness and tingling radiating to the arm and hand. Articular dysfunction in the joints of the neck can also cause similar symptoms in the arm and hand. We have had many cases where a herniated disc was present on an MRI and we treated other abnormalities present such as articular dysfunction, and the patient’s symptoms disappeared.
As you can see, the diagnosis of a cervical herniated disc and how it should be treated are not as straightforward as some would have you believe. In most cases where a herniated disc is identified on an MRI, it would be a misleading to be told the only option is to have an immediate operation before trying conservative treatment methods such as the methods used in our clinic. Most herniated cervical discs can be successfully treated using a combination of chiropractic a physical therapy methods. In addition to some of the methods described for the treatment of other types of neck pain described above, we also use disc decompression and traction techniques for cervical disc cases.
A herniated cervical disc is usually treated 2 to 3 times a week for the first 1 to 3 weeks, then twice a week for 2 to 4 weeks, then once a week for an additional 2 to 5 weeks. The exact number of treatments depends on the particulars of each case. We are continually re-assessing your condition with the aim to decrease the frequency of treatment as soon as possible in an effort to limit the cost to you. All herniated cervical discs cause a decrease in mobility of the cervical joints. Treating a herniated cervical disc by means of medication and physical therapy modalities only, such as ultrasound is inadequate. While this approach may eventually successfully eliminate the inflammation and acute pain, it will fail to re-establish joint and fascia mobility. This sets the stage for chronic muscle tension and scar tissue formation leading to the chronic condition of Cervical Myofascial Pain Syndrome with Articular Dysfunction described above.
e) Cervical Spondylosis: Cervical spondylosis is degeneration of the cervical spine, It is also called osteoarthritis of the cervical spine. Cervical spondylosis is treatable with the conservative treatment we offer at our clinic. This condition may cause local pain in the neck or pain radiating down the arm if spurs on the cervical vertebrae (calcium deposits) pinch the nerves. The goals of treatment are to restore as much motion as possible to the cervical spine, and reduce trigger point activity and muscle tightness. This problem is a problem of aging. As such, it can not be permanently cured but rather managed. Most patient are treated twice a week for 2 to 3 weeks, then once a week 4 to 6 weeks. Many of our patients with cervical spondylosis choose to continue to come for maintenance once a month to maintain the improved mobility and decreased pain they experience with our care.