Poorly managed and untreated neck pain can lead to complications such as headaches, numbness of arms, tingling sensation and other issues. Most pharmacological and surgical interventions are associated with side effects. As such, chiropractic options can be employed as a form of alternative treatment for neck pain relief.
According to statistics reported in the peer reviewed journal Arthritis and Rheumatology (1), approximately 30.1 million people experience moderate to severe neck pain that may last for more than 3 months. These statistical figures indicate the prevalence of neck pain in United States alone. The prevalence of chronic neck pain in other parts of the world is even higher (a recent report suggested that the prevalence of moderate to severe neck pain in Hong Kong population is as high as 17 to 25%) (2).
In today’s fast-paced life style a lot of people tend to overlook musculoskeletal problems (such as chronic neck pain or back pain). The resultant effect is, most people are never able to learn what are the causative factors, triggers and complications of poorly managed neck pain.
Contributing Risk factors To Chronic Neck Pain
- One of the leading risk factors that directly contributes to neck pain is improper posture (keeping the head flexed for longer periods of time or keeping the back stooped). Research also suggests that people who do not keep their back straight are also at risk of suffering from chronic neck pain. This is mainly because, inadequate posture affects the integrity of spine or vertebrae and speeds up the normal age-related wear and tear processes.
- Trauma or accidents can cause stretching or damage to micro-muscle fibers of neck that may result in inflammation and leads to degeneration of neck musculature and bony architecture.
- Certain occupational or recreational activities like professional drivers, weight lifters, wrestlers, construction workers are at fairly high risk of developing chronic neck pain.
What are some of the common causes of neck pain?
Sometimes neck pain is a mild symptom of an underlying serious disorder or disease process. Quite often, neck pain is trivial and responds very well to lifestyle modification and holistic care. If recurrent neck pain occurs, one should consult a doctor for professional opinion.
Upon doctor consultation, mention the frequency of pain, specify of its location, any activities that aggravate or lessen it, family history and any medications or previous treatment sought for neck pain or other chronic medical or metabolic ailments.
Some of the most probable causes of neck pain are as follows:-
- Muscular strains: Strains occur when neck muscles are exposed to excessive pressure or stress due to wrong posture (such as hunching over on computers, long-distance driving, reading the book while bending down), bad sleeping position or even gritting teeth habitually can cause strain on neck.
- Spinal cord compression: The spinal nerve (especially cervical nerves) are at high rise of undergoing temporary or permanent damage as a result of compression, especially if the adjoining discs of vertebral column are not optimally aligned. This is possible in the setting of spinal degenerative conditions (like spinal stenosis, spinal disc herniation, or disc prolapse).
- Cervical injuries: Over-use of neck muscles or excessive stretching beyond the anatomical or natural confines can lead to damage to muscles, nerves, tendons or associated connective tissue structures of neck. The potential situations are rare-end auto collisions (also referred to as whiplash injuries) and assault.
- Diseases or disorders that involve neck architecture: Some common diseases that may lead to chronic neck pain are hernia, cancer, rheumatoid arthritis and osteoarthritis. Acute or chronic infections (such as meningitis or encephalitis) can also present with neck pain.
Chiropractic Adjustments For Neck pain
Over the counter medicines such as ibuprofen, aspirin, naproxen and acetaminophen are available commonly for short term relief but is it a sensible approach to consume OTC pain killers for chronic neck pain?
Healthcare providers believe that early identification of cause can help in controlling pain symptoms and can also prevent complications caused by other irrelevant therapeutic options (such as over-the counter painkillers). Chiropractic help and holistic medicine is often effective for the management of moderate to severe neck pain regardless of the cause. Here are some practical chiropractic techniques that may prove effective for neck pain relief:
- Chiropractic Technique # 1: Cervical manipulation for neck pain
Cervical manipulation also known as neck adjustment is an ancient chiropractic technique for the optimal management of neck pain. The procedure is usually performed in the hands of an experienced chiropractor who has extensive experience and training in performing these procedures.
Cervical manipulation targets cervical vertebrae in order to enhance the spinal disc realignment to reduce the pressure and strain on nerves, muscles, tendons and soft tissues. This is in to facilitate healing by promoting blood circulation. This involves application of manual pressure on specific areas of vertebral column.
Most of the times, chiropractors use instruments in order to deliver uniform pus or pressure on the vertebrae. When a joint is adjusted during cervical manipulation, it releases a gas bubble which makes a cracking or popping sound, similar to the sound when cracking the knuckles. This is not painful at all and originates because of change in pressure within joint.
Primary outcome of cervical manipulation
After chiropractic cervical adjustments, most patients can more easily perform different neck motions. This procedure also enhances the movement of adjoining muscles which mitigates tension and pressure. Patients undergoing this procedure typically report pain reduction, improvement in stiffness and soreness. Besides, other beneficial effects like better progress in turning and tilting their head, overall better health as well as functioning of other organs and tissues.
This is because spine in human body connects different parts of the body. Adjusting spine helps in alleviating stress and discomfort in other body parts. This also explains why management of one health problem can help in providing soothing relief from other symptoms that may involve a distant organ (such as cervical vertebral issues often affect upper limb functioning due to involvement of nerves).
Limitations of cervical manipulation
Discomfort or pain may occur as a result of manipulation. Several recent researches concluded that cervical manipulation is a safe procedure if carried out well within the normal mobility range of head (which also suggests that drastic movements are usually prohibited). The risk of complications decreases significantly if the performing physician is experienced and well qualified.
What else should you know about cervical manipulation?
There is no treatment available which is completely free from side effects. There are some adverse effects related with chiropractic procedures but are short term and minor.
- It is observed that most of the patients experience immediate neck pain relief. However, some patients might experience little swelling, pain and stiffness during or after procedure.
- It is also seen in rare situations that patients might also experience symptoms like local numbness, radiating pain or dizziness.
- If you experience any of the mentioned symptoms during or after the procedure, highlight to the chiropractor immediately.
Comparison of cervical manipulation with other health remedies suggests a higher degree of safety, efficacy and quality of results. For example, using prescription or non-prescription pain relieving drugs are strongly linked to more serious complications than cervical manipulation.
- Chiropractic technique # 2: Proprioceptive neuromuscular facilitation
If cervical manipulation seems an aggressive option for you, there are always strength training and muscle stabilizing exercises and protocols such as proprioceptive neuromuscular training. This method is used for the acute as well as chronic management of neck pain along with other chiropractic techniques and procedures. It involves neuromuscular training of soft tissues of the neck in order to facilitate or inhibit certain neck movements. Other benefits of using PNF are:
- Improvement in overall muscle coordination
- Enhancement of muscular strength
- The procedure is pain-free and believes in the philosophy of unveiling hidden potential and power of neck muscles
- Utilizes multiple approaches (active training, self-training, motor training, interactive participation)
It is extremely helpful in situations where neck pain is due to organic debilitating diseases such as multiple sclerosis, polio or cerebral palsy. In addition, it is also helpful in managing sports-related neck pain and discomfort. Few common varieties of PNF include hold relax with contraction of agonist muscles, contract relaxation and agonist contraction.
According to a research published in peer reviewed World Journal of Sport Sciences (4), investigators compared the efficacy of PNF against traditional neck exercises for the management of chronic, non-specific neck pain. Thirty-one patients were enrolled in the study and were randomly assigned in either of the study groups.
After 10 therapeutic sessions, investigators identified that the strength and flexibility of extensor-flexor muscles approved significantly in the treatment group (those who received proprioceptive neuromuscular facilitation training) as compared to those who received traditional exercises. Author suggested that the exercises and maneuvers of PNF should be ideally performed with appropriate muscular stimulation and active resistance to increase the efficacy.
- Chiropractic technique # 3: Ischemic compression of myofascial trigger points
This chiropractic procedure is mainly utilized in patients who experience chronic neck pain due to myofascial pain syndrome (a condition marked by painful banding of neck muscles, twitching and myofascial trigger points). Myofascial pain syndrome (MPS) is a frequent complication of misuse, disuse of neck muscles or prolong emotional stress.
Research published in Soo A Kim (5) and associates suggested that trigger point injection with ischemic compression reduces pain, improve neck flexibility and mobility as well as enhancing range of motion. As part of the study, Kim and associates enrolled 60 patients in the study with recognized history of myofacial pain syndrome as the cause of chronic neck pain.
These study participants were randomly assigned into 3 groups (those who just received trigger point injection, those who received trigger point injection with 30 seconds of ischemic compression and those who received trigger point injection with 60 seconds of ischemic compression.
The responses were recorded before the therapy, soon after the procedure and 1 week after the procedure to identify that group of patients who get trigger point injection with ischemic compression reported significant improvement in neck pain and overall quality of life.
- Chiropractic technique # 4: Cervical mobilization
A lot of people may confuse spinal manipulation with cervical mobilization which is not entirely correct. Results of a new study (6) that was conducted on 100 patients with chronic history of unilateral neck pain suggested that cervical mobilization is effective at alleviating neck pain and range of motion. However, even higher quality of results can be achieved with cervical manipulation (reduction in pain intensity up to 85% as opposed to 69% in patients who received cervical mobilization).
- Chiropractic technique # 5: Applied kinesiology
In most situations when neck muscles are mal-aligned, the risk of damage to associated structures increases. In all such situations, where chiropractors want to assess the degree of instability and wants to review the possible options, applied kinesiology is used.
It is a diagnostic as well as interventional method that helps in balancing the opposing muscles to reduce pain and strain on soft tissues. This is usually accomplished by massaging pressure points, evaluating neuro-muscular feedback and other methods of muscular testing.
The procedure is highly safe and effective (can be used in children as young as 10 years). According to the case study published in the Journal of Chiropractic Medicine (8), investigators Scott Cuthberta and Anthony Rosnerb presented the case of a 10-year boy who presented with multiple health issues like headaches, asthma and developmental delays in addition to chronic neck pain.
However, after the child was managed with applied kinesiology, symptomatic improvement in all the variables was achieved.
The study concluded:
“The care provided to this patient seemed to help resolve his chronic musculoskeletal dysfunction and pain and improve his academic performance.”
- Chiropractic technique # 6: Release work
Release work is a specialized chiropractic procedure that allow chiropractor to apply gentle pressure via fingertips to the involved mal-aligned cervical vertebrae. The gentle push and traction helps in restoring the natural anatomical alignment of spinal segments to alleviate pressure and pain symptoms.
Self-Chiropractic Help Options
Invasive procedures like cervical manipulation or adjustments should be only performed in hands of expert chiropractors. Yet, certain chiropractic techniques can be used at home to optimize healing of cervical musculature and reduce the swelling, pain and discomfort in between the visits:
- Use of heating pads
- Application of ice or moist heat to allow rapid pain relief
- Yoga exercises as well as periodic stretching neck exercises increases the flexibility and strength of neck musculature in order to promote free range of movements.
- Traction with the help of certain devices (inversion table or gravity boots) can also be perform in the setting of home without increasing the risk of complications.
A latest report published in Journal of Manipulative and Physiological Therapeutics (7) suggested that based on the type or nature and severity of neck pain as well as assessment of patient factors, chiropractors can use multiple therapeutic options for neck pain relief without increasing the risk of complications or injuries.
Beside the above listed chiropractic techniques, other chiropractic methods of intervention for the management of neck pain includes:
- Therapeutic deep tissue massage
- Receptor-Tonus Technique
- Cranio-sacral therapy
1. Lawrence, R. C., Felson, D. T., Helmick, C. G., Arnold, L. M., Choi, H., Deyo, R. A., … & Wolfe, F. (2008). Estimates of the prevalence of arthritis and other rheumatic conditions in the United States: Part II. Arthritis & Rheumatism, 58(1), 26-35.
2. Lau, E. M. C., Sham, A., & Wong, K. C. (1996). The prevalence of and risk factors for neck pain in Hong Kong Chinese. Journal of Public Health, 18(4), 396-399.
3. Evans, R., Bronfort, G., Schulz, C., Maiers, M., Bracha, Y., Svendsen, K., … & Transfeldt, E. (2012). Supervised exercise with and without spinal manipulation performs similarly and better than home exercise for chronic neck pain: a randomized controlled trial. Spine, 37(11), 903-914.
4. Rezasoltani, A., Khaleghifar, M., Tavakoli, A., Ahmadi, A., & Minoonejad, H. (2010). The effect of a proprioceptive neuromuscular facilitation program to increase neck muscle strength in patients with chronic non-specific neck pain. World Journ of Sport Sci, 3(1), 59-63.
5. Kim, S. A., Oh, K. Y., Choi, W. H., & Kim, I. K. (2013). Ischemic Compression After Trigger Point Injection Affect the Treatment of Myofascial Trigger Points. Annals of rehabilitation medicine, 37(4), 541-546.
6. Cassidy, J. D., Lopes, A. A., & Yong-Hing, K. (1992). The immediate effect of manipulation versus mobilization on pain and range of motion in the cervical spine: a randomized controlled trial. Journal of Manipulative and Physiological Therapeutics, 15(9), 570.
7. Palmgren, P. J., Sandström, P. J., Lundqvist, F. J., & Heikkilä, H. (2006). Improvement after chiropractic care in cervicocephalic kinesthetic sensibility and subjective pain intensity in patients with nontraumatic chronic neck pain. Journal of manipulative and physiological therapeutics, 29(2), 100-106.
8. Cuthbert, S., & Rosner, A. (2010). Applied kinesiology methods for a 10-year-old child with headaches, neck pain, asthma, and reading disabilities. Journal of chiropractic medicine, 9(3), 138-145.