Chiropractic & Neck Pain

Neck Pain Treatments

Neck Pain Treatments

Neck pain is a common pain symptom experienced by most of us. Most neck pain begins with some kind of trauma, but sometimes the origin is difficult to identify.

With all neck pain—no matter what the cause—the pain itself tells us that there is some kind of problem in the functioning of the different parts of the spine.

The human spine is an amazingly versatile and complex structure that provides support, protects the internal organs and nervous system, but at the same time allows incredible flexibility and movement.

Many different pieces have to work together to maintain a healthy spine. The spinal cord and nerves of the back are the communication lines between the brain and the rest of the body. The bones of the spine—or the vertebrae—protect those nerves. The vertebrae are separated by fibrous discs. The ligaments of the spine hold the vertebrae together. And the muscles attach to the vertebrae and provide stability and allow us to move.

When all of these pieces are working together in harmony, we’re not even aware of them. When one piece fails to work properly, all of the other parts are affected, as well. The role of chiropractic is to make sure that all of the pieces work together the way they’re supposed to.Here are some articles that discuss the benefits of chiropractic for neck pain.

 

Articles:

Title
Neck Pain, Proprioception and Chiropractic
Chiropractic Treatment of Disc Herniations
Chiropractic Reduces Unnecessary Interventions in Low Back and Neck Pain Cases
Chiropractic More Effective for Neck Pain Than Drugs
Chiropractic Increases Range of Motion for Neck Patients
Chiropractic + Exercise Effective for Neck Pain
Pain Relief through Strength Training

Neck Pain, Proprioception and Chiropractic

Proprioception is the part of the nervous system that tells your brain the position of your body in space.

There have been a number of studies examining the relationship between whiplash and proprioceptive dysfunction. A new study adds to our knowledge, by examining the effectiveness of chiropractic in patients with chronic neck pain.

In this study, 20 patients with chronic neck pain were evaluated at the beginning of the study for pain levels and proprioceptive functioning. The patients were then divided into two groups: Group A, who received six sessions of spinal manipulation; Group B, who were instructed to perform stretching exercises twice daily for 3-4 weeks.

After the study period, the spinal manipulation patients showed a 44% improvement in pain symptoms on average, while the stretching patients showed just a 9% improvement. In regard to proprioceptive functioning, similar results were found: a 41% improvement in the manipulation group, but only an 11% improvement in the stretching group.

How spinal manipulation effects proprioception is not yet known, but the authors speculate that chiropractic treatment somehow stimulates the deep articular mechanoreceptors in the spine, in turn leading to improved functioning.

Rogers RG. The effects of spinal manipulation on cervical kinesthesia in patients with chronic neck pain: a pilot study. Journal of Manipulative and Physiological Therapeutics 1997;20(2):80-85.

Chiropractic Treatment of Disc Herniations

This study examined 27 patients in a private chiropractic practice who presented with neck or back pain and who had MRI-documented cervical or lumbar disc herniations that corresponded with clinical findings.

“Patients were treated with a course of chiropractic care consisting of traction for the cervical spine or flexion distraction in the lumbar spine in the acute phase of care, in addition to interferential/ultrasound combination and cryotherapy. In the subacute phase, rotational manipulation was judiciously added, as were isometric and flexibility exercises. In the chronic stage of care, distraction manipulation and rehabilitative exercises were continually employed. Rehabilitative exercise included extension exercises in addition to pelvic tilts, lifts and knee flexion stretching.”

“Treatment frequency was typically four to five times/wk for weeks 1 and 2, then three times/wk with decreasing frequency as the patient progressed. Duration of active care varied from 6 wk to 6 months.”

“When patients reached the point at which their VAS [visual analog scale] score was ?2, their exam findings reversed and their extremity pain resolved, a repeat MRI was obtained. This scenario occurred as early as 6 wk after initiation of care.”

If the patients did not reach these milestones, follow-up MRI was performed 1 year after the initiation of care.

The study found that 22 of 27 (80%) had good clinical outcomes; 17 of the 22 (77%) “had not only good clinical outcome but also evidence of reduced or resolved disc herniation upon repeat MRI scanning.”

Five patients (18.5%) had a marginal or poor outcome, but none had worse clinical signs or pain ratings at the end of the study.
At the beginning of the study, all 27 patients had left work because of the severity of the pain; at follow-up, 21 (78%) were back to work in their former occupations.

VAS scores decreased from an average of 6.9 before treatment to 1.9 following treatment.

One important issue that the author addresses is the controversy of whether manipulation is contraindicated for disc herniation. After reviewing the literature, and from his clinical findings, he concludes that manipulation is indeed safe for disc herniation: “…in the cervical and lumbar spine, rotational manipulation most likely cannot be implicated in disc failure or exacerbation of a disc herniation, and for rotational forces from a manipulation to be involved in disc failure, facet fracture must occur first.” No complications occurred in this study.

BenEliyahu DJ. Magnetic resonance imaging and clinical follow-up: study of 27 patients receiving chiropractic care for cervical and lumbar disc herniations. Journal of Manipulative and Physiological Therapeutics 1996;19(9):597-606.

Chiropractic Reduces Unnecessary Interventions in Low Back and Neck Pain Cases

Over the last few years, there have been increasing pressures to reduce the costs associated with treating low back pain, while, at the same time, increasing the effectiveness of that treatment. A recent study1 sums up the problem:

“A growing body of clinical evidence and expert opinion indicates that a more conservative approach to the treatment of low back pain and cervical spine pain is appropriate. The evidence indicates that procedures and practices such as inpatient care, advanced imaging, surgery, and even plain-film radiographs are only infrequently necessary for the successful treatment of most cases of low back pain and neck pain.

“In spite of the evidence, these procedures and practices continue to be used at rates in excess of that which the published literature defines as clinically indicated.”

Previous studies have found that chiropractic adjustments can be an effective treatment modality for certain types of low back and neck pain. In this current study, the authors set out to examine the “effects of managed chiropractic benefit on the rates of specific diagnostic and therapeutic procedures” for the treatment of these patients.

The authors analyzed the claims data from a managed-care health plan over a period of four years. The study looked at four different medical procedures and tests and compared employer groups that provided a chiropractic benefit with those that did not.

The authors found reductions in nearly every area per episode of back pain or neck pain in the groups that had a chiropractic benefit:

Procedure or Practice

Percentage Reduction

Back Pain

 

Surgery

-32.1%

Plain film radiography

-23.1%

CT/MRI

-37.2%

Inpatient care

-40.1%

 

 

Neck Pain

 

Surgery

-49.4%

Plain film radiography

-36.0%

CT/MRI

-45.6%

Inpatient care

-49.5%

This is not the first study to find that chiropractic care reduced overall costs when included in managed care programs. A 2004 study2 also found that these patients had a lower utilization of plain film radiographs, MRI, hospitalizations, and surgery.

The 2004 study put forth four possible explanations for these findings:

  1. Positive risk selection.
  2. Substitution of chiropractic for traditional medical care.
  3. More conservative, less invasive treatment protocols.
  4. Lower health service costs associated with managed chiropractic care.

These two studies show that not only can chiropractic care be an effective treatment for certain patients with low back or neck pain, it can also reduce the use of unnecessary and expensive interventions:

“Among employer groups with chiropractic coverage compared with those without such coverage, there is a significant reduction in the use of high-cost and invasive procedures for the treatment of low back pain and neck pain…The resultant chiropractic care is far less likely to lead to the use of these invasive procedures.”

  1. Nelson CF, Metz RD, LaBrot T. Effects of a managed chiropractic benefit on the use of specific diagnostic and therapeutic procedures in the treatment of low back and neck pain. Journal of Manipulative and Physiological Therapeutics 2005;28:564-569.
  2. Legorreta AP, Metz RD, Nelson CF, Ray S, Chernicoff HO, Dinubile NA. Comparative analysis of individuals with and without chiropractic coverage: patient characteristics, utilization, and costs. Archives of Internal Medicine 2004;164(18):1985-1992.

Chiropractic More Effective for Neck Pain Than Drugs

A new study from the prestigious medical journal, “The Annals of Internal Medicine,” reports that chiropractic is more effective for neck pain than medication.

 

 

In the study, 272 patients with acute or subacute neck pain were given one of three treatments: medication, exercise with the advice of a health practitioner, or chiropractic care. After 12 weeks of treatment, patients in the chiropractic and exercise groups experienced the most pain reduction. When compared to the medication group, both exercise and chiropractic had more than doubled the likelihood that participants experienced complete relief of their pain. For chiropractic patients, these benefits lasted for at least a year, demonstrating that chiropractic can provide long-term relief.

The strong success of chiropractic and exercise is likely due to the fact that both treatments address the cause of neck pain, rather than just masking the symptoms. Whether your neck pain is a result of an injury or sitting at a desk for long hours, chiropractic care can restore your normal health free of pain, without the adverse effects of drugs.

Bronfort, Gert, Roni Evans, Alfred Anderson, Kenneth Svendsen, Yiscah Bracha, and Richard Grimm. Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain: A Randomized Trial. Annals of Internal Medicine. 2012, January; 156 (1): 1-10.

Chiropractic Increases Range of Motion for Neck Patients

neck pain and chiropracticAs we get older, we may begin to lose some range of motion in our necks. Sometimes we experience pain or chronic neck problems; other times, we just begin to notice we can't move our necks as far as we once did. A recent study showed how chiropractic care can help increase range of neck motion.

The neck should be able to move in the following manner:

  • Flexion: Forward to touch the chin to the chest (40-60 degrees)
  • Extension: Tilting the head back to look at the ceiling (60-80 degrees)
  • Rotation: Turning your head to the left and right. Chin should be in line with the shoulders (60-80 degrees)
  • Lateral Bending: Bending your head to bring your left ear or right ear to your left or right shoulder, respectively (45 degree angle or halfway)

Did you test yourself? If not, try all the motions above. If your neck seems stiff or inflexible, don't try to force the movement--moving your neck beyond its normal range of motion is how injury occurs. If you do feel as though you have limited range of motion, gentle spinal manipulation may help increase your neck's range of motion as well as prevent further degeneration.

In a recent study, researchers found that spinal manipulation increased neck range of motion in patients with intervertebral, asymptomatic cervical motion restriction. This suggests that spinal manipulation may be a very good therapy for age-related cervical degeneration.

Passmore S, Burke J, Good C, Lyons J, Dunn A. Spinal Manipulation Impacts Cervical Spine Movement and Fitts' Task Performance: A Single-Blind Randomized Before-After Trial. Journal of Manipulative and Physiological Therapeutics. March 2010: Vol. 33, Issue 3, Pages 189-192.

Chiropractic + Exercise Effective for Neck Pain

Neck pain, whether caused by whiplash or other injury, is a serious condition that can lead to chronic headaches, lost time at work, and an overall reduction in quality of life. It is one of the leading reasons people seek out the help of a chiropractor.

But while many people react to neck pain by reducing their level of physical activity, research shows that exercise, when combined with chiropractic manipulation, may be the true key to recovery. A recently published review of studies on different treatments for neck pain reveals that in many instances, patients experienced the greatest pain relief when they combined chiropractic manipulation and mobilization with exercise.

A team of researchers from McMaster University in Canada, Northwestern Health Sciences University in Minnesota, and the Canadian Memorial Chiropractic College reviewed the results of 17 controlled trials conducted between 1996 and 2009, each of which looked at different treatments for neck pain. Patients in the trials included those suffering from acute neck pain, chronic conditions, symptoms related to whiplash, cervicogenic headache, and those with degenerative conditions. The trials investigated the effectiveness of combining chiropractic manipulation with exercise, compared to the effectiveness of no treatment at all, manipulation alone, exercise alone, traditional cures (including medication and wearing neck collars), or other responses like surgery or electrotherapy.

The research showed that patients who underwent a combined treatment of manipulation, mobilization, and exercise experienced greater short- and long-term pain relief than those who received either no treatment or only one type or therapy. The combined approach was also more effective at reducing pain than traditional treatments. In addition, these patients reported greater improvement in quality of life, and greater satisfaction with their results.

In their analysis, the researchers suggest that while manipulation and mobilization has been shown effective for relief of neck pain, combining this treatment with certain exercises can result in a greater benefit for patients, especially over the long term. Though they note that more research will be needed to determine what specific types of exercise are most effective, they conclude that pairing exercise with chiropractic manipulation can provide significant benefits to patients who suffer from many different types of neck pain.

Miller J, Gross A, D'Sylva J, Burnie SJ, Goldsmith CH, Graham N, Haines T, Bronfort G, Hoving JL. Manual therapy and exercise for neck pain: A systematic review. Manual Therapy 15(2010) 334-354.