Neck pain is a condition that develops quite often in adults, especially women. More specifically, reports show that 15% and 25% of males and females, respectively, whose ages range from approximately 21 to 55 years of age experience both neck pain and shoulder pain during their lifetime. In addition, this condition often becomes the cause of chronic pain and discomfort. Furthermore, there is some evidence to support the notion that a large number of individuals who experience pain in the neck may continue to suffer from it up to six months after the pain has begun. In other words, neck pain tends to be recurrent, and a specific event that causes neck pain increases the susceptibility of experiencing frequent neck pain. Clinicians also report that patients who are aware of the incident that initiated their neck pain tend to suffer from this condition more frequently than those who never had a problem with neck pain. As a result, a previous condition or injury to the neck dramatically increases the probability of suffering from recurrent neck pain.
Although neck pain is typically localized to a small region, it can lead to dramatic functional and mobility impairments. Subsequently, the serious complications that neck pain may cause has been linked to a high number of disability cases, most of which hinder individuals from working properly and even functioning normally at home. In actuality, more than 10% of people who have persistent pain in the neck have to discontinue working. It is, therefore, not surprising that neck pain is now reported as one of the main health issues that have a negative impact on the economy. Decreased work productivity and significant increases in medical treatment have also been attributed to recurring neck pain. In particular, studies have reported that up to 50% of patients who have neck pain need to receive medical treatment to help manage their discomfort and painful symptoms. Accordingly, theoretical as well as empirical research regarding neck pain is gaining an increased amount of attention. For the past decade, research has specifically focused on identifying factors that indicate the onset of neck pain. Furthermore, clinical trials are being continuously conducted to determine if various types of treatments can effectively reduce neck pain or completely alleviate the symptoms.
The region of the spine positioned near the bottom of the head is known as the cervical spine and this area is typically held responsible for the onset of neck pain. However, muscle, ligament, and tissue damage in any part of the neck may contribute to this condition as well. Furthermore, the spine is surrounded by cerebrospinal fluid (CSF), which is a protective substance that cushions the nerves within the spine. The CSF and spinal cord are both held in position by a rigorous membrane known as the spinal canal. Spinal nerves that are embedded within the spinal cord provide signal transmission throughout the entire body as well as the brain. There are also cervical facet joints or small connective bones that are positioned within the neck. These joints are shaped differently from facet joints in lower parts of the spine so that the neck can move in a variety of directions. Damage or injury to the cervical facet joints, however, can result in inflammation, pain, stiffness, or soreness in the neck, upper back, or the shoulders.
The examination that is performed for neck pain usually involves a medical history questionnaire and a physical evaluation. A comprehensive examination helps a doctor diagnose the source of the neck pain correctly, although the cause of neck pain cannot be determined in some cases. When this happens, the doctor will instead try to rule out other potential causes. For instance, the doctor can perform an evaluation that could exclude problems with the spinal cord or nerve roots. The doctor could also evaluate the degree to which the neck pain is causing mobility issues and limiting activities. This type of evaluation allows the doctor to determine if yellow flags are present, which subsequently provide an indication of what the treatment and follow-up strategies should be. If signs of spinal problems or nerve damage are present, it does not necessarily mean that this health issue is causing the neck pain, although it does indicate that the patient has an increased risk of suffering from neck pain. Additional testing is usually recommended in such cases before a particular treatment is recommended. The main factors that doctors consider, however, involve assessing the degree of limited movements due to the neck pain and whether the symptoms may indicate that a problem other than neck pain is occurring simultaneously.
Causes of Neck Pain
Due to the complex structure of the neck and cervical spine, neck pain can develop from a variety of issues. The degeneration of muscle or tissue in the neck, which may gradually occur over time, often causes neck pain. Ligament, muscle, or joint damage in the neck are also among the primary causes of acute or persistent neck pain. Even though these types of problems commonly result in neck pain, sometimes the source cannot be accurately identified.
The cervical spine is the highest portion of the spine and it is connected to the base of the head. This spinal region appears to cause neck pain in the majority of cases. The cervical spine contains seven spinal bones called vertebrae, which are connected to each other by facet joints. The facet joints in the neck can easily become irritated, inflamed, or damaged. Fractured or dislocated spinal bones tend to cause neck pain as well, especially if these conditions are not treated.
An additional condition that can lead to neck pain is stenosis. This is a condition in which the spine becomes compressed and causes the spaces between the spinal bones as well as the tissue that surrounds them to become very narrow. There are several common causes of stenosis. However, the primary cause is scar tissue formation on the spinal cord. In addition, neck pain may be the result of bulging disc syndrome, which causes discs that are located between the spinal vertebrae to push outward. This leads to the painful compression and irritation of spinal nerves.
A similarly, common problem that causes neck pain is whiplash, which refers to a quick jolt that causes the neck and head to jerk back and forth. Rollercoaster rides and car accidents are highly associated with the occurrence of whiplash. Whiplash has never proven to be fatal, although it can lead to persistent pain. An injury such as this damages neck muscles, spinal bones, and the ligaments as the neck abruptly whips forward and backward.
Various factors can increase a person’s risks of developing chronic neck pain. A few include gender, due to women being more susceptible to neck pain than men, having a frequent history of neck pain, a loss of function in the wrists or hands, cycling on a regular basis, a quality of life that is poor, frequent anxiety attacks or stress, and age, especially for adults over 40.
Chiropractic Care for Neck Pain
Chiropractic care is a nonsurgical treatment option that may help reduce your neck pain and related symptoms. Listed below are some of the different types of neck (cervical) conditions that Doctors of Chiropractic (DC) treat:
- Cervical intervertebral disc injuries that don’t require surgery
- Cervical sprain injuries
- Degenerative joint syndrome of the neck (eg, facet joints)
- Facet joint sprain
How Does a Chiropractor Diagnose Neck Pain?
Your chiropractor will evaluate your spine as a whole because other regions of the neck (cervical), mid back (thoracic) and low back (lumbar) may be affected as well. Along with treating the spine as a whole, chiropractors treat the “whole person,” not just your specific symptoms. He or she may educate you on nutrition, stress management, and lifestyle goals in addition to treating your neck pain.
Before deciding which approach to try for your pain, the chiropractor will do a thorough examination to diagnose the specific cause of your neck pain.
He or she will determine any areas of restricted movement and will look at how you walk as well as your overall posture and spinal alignment. Doing these things can help your chiropractor understand your body mechanics.
In addition to the physical exam, you’ll also go through your past medical history with the chiropractor, and he or she may order imaging tests (eg, an x-ray or MRI) to help him or her diagnose the exact cause of your neck pain.
All these steps in the diagnostic process will give your chiropractor more information about your neck pain, which will help your chiropractor create a treatment plan customized for you.
Your chiropractor will also rule out a neck pain condition that will require surgery—if he or she believes your neck pain would be better treated by surgery, then you’ll be referred to a spine surgeon.
Chiropractic Treatments for Neck Pain
Your chiropractor may use a combination of spinal manipulation, manual therapy, and other techniques as part of your treatment plan for neck pain.
Below are some spinal manipulation techniques your chiropractor may use.
- Flexion-distraction technique is a gentle, hands-on spinal manipulation that involves a pumping action on the intervertebral disc instead of direct force.
- Instrument-assisted manipulation uses a hand-held instrument to allow your chiropractor to apply force without thrusting into the spine.
- Specific spinal manipulation helps restore joint movement using a gentle thrusting technique.
Your chiropractor may also use manual therapies to treat your neck pain.
- Instrument-assisted soft tissue therapy uses special instruments to diagnose and treat muscle tension.
- Manual joint stretching and resistance techniques can help reduce neck pain and other symptoms.
- Therapeutic massage can help relax tense muscles.
- Trigger point therapy is used to relieve tight, painful points on a muscle.
Other therapies may also be used to ease neck pain symptoms.
- Inferential electrical stimulation uses a low frequency electrical current to stimulate neck muscles.
- Ultrasound sends sound waves into your muscle tissues to help stiffness and pain in your neck.
Therapeutic exercises may also be recommended—these can help improve overall range of motion in your neck and prevent neck pain from progressing.
The treatments listed above are simply examples of possible chiropractic treatments for neck pain; your actual treatment plan will depend on your diagnosis. Your chiropractor should thoroughly explain your treatment options so that you know what will happen.