US Chiropractic Directory Presents:
Neck Problems
Neck problems are one of the most prevalent issues that people worldwide suffer. Neck pain has been called torticollis, stiff neck and a host of other names, however to the public, it is literally a "pain in the neck." Chiropractic has been safely and effectively helping patents with pain in the neck for over 100 years and The US Chiropractic Directory has create a forum of information combining the entire healthcare and scientific community to bring the public evidenced and researched based answers on how and why chiropractic works to help those with neck pain/problems.
Chiropractic has a Positive Effect on Depression and Anxiety
A report on the scientific literature
By: Mark Studin DC, FASBE(C), DAAPM, DAAMLP
Many patients who experience pain, also have concurrent anxiety and/or depression. Sometimes the pain doesn’t have to be severe or traumatically caused, it just exists for reasons unknown. Through the years, too many patients go to doctors and state they have been depressed or have an unusual amount of anxiety for reasons unknown and the doctor when asking probing questions uncovers that the patient has been in pain. Intuitively, the doctor and patient have concluded the reason for the depression or anxiety has been one of frustration out of being in pain for so long.
This author has experienced that for over 3 decades of treating patients in both acute and chronic pain with no answer better than “This too shall pass, be patient.” Research has now given us answers.
“Within the brain, the pain experience is subserved by an extended network of brain regions including the thalamus (THA), primary and secondary somatosensory, cingulate, and insular cortices. Collectively, these regions are referred to as thepain processing network (PPN) and encode the sensory discriminate and cognitive and emotional components of the pain experience. Perception of pain is dependent not merely on the neural activity within the PPN [pain processing network] but also on the flexible interactions of this network with other functional systems, including the descending pain modulatory system” (Gay et al., 2014, p. 617). This is part of the reason why some patients experience pain differently than others. Some have anxiety, depression and are at a loss to function while others can “ignore” the pain and maintain an adequate functional level as a productive member of society. Pain is deeply tied to the most primitive regions of the central nervous system and it appears as chiropractors have observed clinically for 116 years that therapeutically speaking, we can have an influence on these higher centers with little or no side-effects. Simply put, patients under chiropractic care have reported an improvement of both anxiety and depression after chiropractic care, which has also been this author’s repeated experience.
Gay et al. (2014) went on to report, “This study assessed the relationship of brain activity between regions of the PPN [pain processing network] before and after MT [manual therapy or chiropractic spinal adjustments]. Using this approach, we found common and treatment-dependent changes in FC [functional changes]…Our study is unique in our neurophysiologic measure because we used resting-state fMRI [functional MRI] in conjunction with FC [functional change] analyses. Our results are in agreement with studies that have found immediate changes using other neurophysiologic outcomes, such as Hoffman-reflex and motor-neuron excitability, electroencephalography with somatosensory-evoked potentials, transcranial magnetic stimulation with motor evoked potentials, and task-based fMRI with peak BOLD response” (p. 619 and 624). This study concludes that chiropractic spinal adjustments create functional changes in multiple regions of the brain based upon multiple outcome measures. In the study by Gay et al. (2014), this was measureable and reproducible.
We also know that chiropractic is one of the safest treatments currently available in healthcare and when there is a treatment where the potential for benefits far outweighs any risk, it deserves serious consideration. Whedon, Mackenzie, Phillips, and Lurie(2015) based their study on 6,669,603 subjects after the unqualified subjects had been removed from the study and accounted for 24,068,808 office visits. They concluded, “No mechanism by which SM [spinal manipulation] induces injury into normal healthy tissues has been identified(Whedon et al., 2015, p. 5).
References:
Neck Pain (Torticollis), Headaches, Dizziness, Radiating Pain, Nausea, Depression, Confusion, Ringing in the Ears Show Good Outcomes With Chiropractic Care
A report on the scientific literature
By: Marc D. Weiss, D.C., DAAMLP
Mark Studin DC, FASBE(C), DAAPM, DAAMPL
Although neck pain is the number one bodily injury or pain complaint from the general population in the west, many studies verify that chiropractic care for common neck pain has been effective. It has also been generally recognized that chiropractic care has helped a myriad of maladies and we are just starting to see those outcomes or positive results in the scientific literature to verify what both chiropractors and their patients have been reporting for over 100 years. The following study looks at outcomes of chiropractic treatment for neck pain and concurrent complaints throughout the Netherlands.
Rubenstein ET. Al (2007) used 79 chiropractors who each recruited approximately 10 patients. The patients were between the ages of 18-65 and had not received treatment 3 months prior to beginning this study. Participants who were treated for neck pain in this study all had different levels and frequency of visits with the chiropractor. Chiropractic spinal adjustments were the primary form of treatment. Each patient was asked a series of questions to assess their treatment success during each visit as well as during follow up appointments at 3 months and 12 months. Every symptom, including fatigue, headaches, nausea, and depression, significantly decreased from visit to visit, and significantly increased after the visits ceased.
This study covered a large area of patients with varying degrees and specifics of neck pain, as well as chiropractors with varying methods of treatment. Unlike many studies that gather data on effectiveness of treatments, especially pharmaceutical companies, this study showed statistics of both success in curing neck pain as well as adverse effects that arose during and after treatment. Only 5 of 4891 patients in the study group reported worsening of pain at the end of the study, which was 12 months after treatment. Also, only 2 of 4891 patients reported worsening of pain at the 3 month mark, which is when treatment for neck pain stopped.
The most prevalent improvement of neck pain in patients occurred during their first three visits. Additionally, most symptoms other than neck pain also improved during the first 3 months of treatment. Almost 50% of the patients were fully recovered when interviewed at their fourth visit. Almost 75% of the patients were fully recovered when interviewed at the three and twelve month follow up visits.
The following graph was presented by Rubenstein ET. Al (2007)
As you can see from the above graph, by the 2nd visit to a chiropractor, there has been significant improvement that continues to improve by the 4th visit. Although these patients initially sought care for neck pain, this study shows that many complaints respond favorably to chiropractic care and each complaint requires more independent research. The most impressive stastistic was 99.4% of people in the study would visit a chiropractor again at the 2nd visit and 98.7% at the 4th visit. That alone gives more insight than most other variables. If it wasn't successful, those numbers would not be there.
Chiropractic is one of the safest treatments currently available in healthcare and when there is a treatment where the potential for benefits far outweighs any risk, it deserves serious consideration.Whedon et al. (2014) based their study on 6,669,603 subjects after the unqualified subjects had been removed from the study and accounted for 24,068,808 office visits. They concluded,“No mechanism by which SM (spinal manipulation) induces injury into normal healthy tissues has been identified.(Whedon et al.,2014, p. 5)
Reference:
Cervical Disc Herniation with Radiculopathy (Arm Pain): Chiropractic Care vs. Injection Therapy
85.7% decrease in pain with spinal adjustments
25% decrease in pain with injection therapy
A report on the scientific literature
By: Mark Studin DC, FASBE(C), DAAPM, DAAMLP
Mark C. Zientek, DC DAAMLP, CHCQM
William J. Owens DC, DAAMLP
There is a large portion of the population who are dealing with various pain syndromes which includes neck pain from cervical disc herniations. According to Peterson, Schmid, Leemann, Anklin, and Humphreys (2013), this occurs in 83.2 out of every 100,000 people where symptoms range from mild to severe, but all negatively affect a person’s quality of life. To improve one’s quality of life, it becomes necessary to choose ways to manage and alleviate pain while reducing the side-effects of the actual treatment. Common methods range from simple masking of symptoms with over-the-counter medications to prescription opiates and invasive surgeries. Most people look for ways to manage pain and return to daily living activities without risky procedures and their inherent complications.
The use of over-the-counter medications and narcotics such as codeine and/or an oxycodone-acetaminophen combination like Percocet, is a common form of treatment by many primary care physicians and medical specialists alike. Kuehn (2013) reported:
“The FDA is concerned about inappropriate use of [opioid pain medications], which has reached epidemic proportions in the United States,” said FDA Commissioner Margaret A. Hamburg, MD, during a press briefing in September.
There was a 300% increase in prescribing of opioid pain medications between 1999 and 2010, a period in which the number of painkiller overdose deaths among women increased 5-fold and the number of such overdose deaths among men increased 3.6 times, according to the Centers for Disease Control and Prevention (MMWR Morb Mortal Wkly Rep. 2013:62[26];537-542). In 2010 alone, more than 15,000 US deaths were attributed to drug overdoses, and of the 10,000 overdose deaths in which a drug was identified, nearly two-thirds involved opioid pain medications…
The announcement comes after growing calls for the agency to tighten restrictions on the use of these drugs. In July 2012, Physicians for Responsible Opioid Prescribing (PROP), a group that includes prominent specialists in addiction, public health, emergency medicine, and pain medicine, petitioned the FDA to change the labeling for this class of drugs to discourage inappropriate use (Kuehn BM.JAMA. 2012;308[12]:1194-1196). The group argued that the drugs’ indications were overly broad and not consistent with the evidence base and may have been facilitating marketing for broader use than was appropriate. Specifically, the group argued that the agency should drop moderate chronic non-cancer pain as an indication, set a maximum daily dose, and add a maximum duration of use of 90 days. (p. 1547).
The problem, as acknowledged by the FDA, is that the AMA and many in medical academia appear to concur with the addictive qualities of the medications. The alternative option is the chiropractic spinal adjustment and it has been concluded in scientific outcomes to be a superior avenue for the relief of pain and reduction of disability with few side effects.
The earlier discussed study by Peterson et al. (2013) has confirmed that spinal adjustments (manipulations) provide significant improvement for patients with neck pain from cervical herniated discs, as well as arm pain (cervical radiculopathy) without the inclusion of opiates or surgery. In addition, this improvement was seen at all times, particularly at 3 months. In addition, in this Swiss study, it was found that the presence of radiating arm pain (radiculopathy) was not a contraindication to chiropractic treatment nor was it a negative forecaster of outcomes.
This study also found that with cervical herniated discs with radiculopathy, 85.7% of the patients experiencing acute pain reported significant improvement by three months with no patients being worse. For the sub-acute patients, 76.2% reported significant improvement by three months with no patients being worse with their disability indexes which were reduced from the onset of chiropractic care.
Another form of treatment for neck and arm pain commonly used is cervical spinal injections. In the same study compares cervical injection provided a 25% reduction in patients’ symptoms. The results of this current study of spinal adjustment (manipulation) treatments had substantially better results with more than 85% of acute patients and 76% of sub-acute patient improving, with a 65% reduction in arm pain as well as 59% reduction in neck pain at three months.
Chiropractic is one of the safest treatments currently available in healthcare and when there is a treatment where the potential for benefits far outweighs any risk, it deserves serious consideration, particularly as a first line treatment. Whedon, Mackenzie, Phillips, and Lurie (2015) based their study on 6,669,603 subjects after the unqualified subjects had been removed from the study and accounted for 24,068,808 office visits. They concluded, “No mechanism by which SM [spinal manipulation] induces injury in normal healthy tissues has been identified” (Whedon et al., 2015, p. 265). One risk factor for chiropractic care is a disc herniation. A properly credentialed chiropractor who has been trained to differentially diagnose and appropriately triage the patient is clinically indicated in this population of patients. The chiropractor can engage in co-management with medical specialists.
To best serve patients, a clear understanding of the outcomes and risks of procedures becomes necessary. Further research into the efficacy of chiropractic manipulation provides a clearly safe and effective treatment to the above-referenced condition. Examination of the research provides insight of avenues for relief of symptoms upon which physicians can undoubtedly rely.
Reference:
1. Peterson, C. K., Schmid, C., Leemann, S., Anklin, B., & Humphreys, B. K. (2013). Outcomes from magnetic resonance imaging–confirmed symptomatic cervical disk herniation patients treated with high-velocity, low-amplitude spinal manipulative therapy: A prospective cohort study with 3-month follow-up. Journal of Manipulative and Physiological Therapeutics, 36(8), 461-467
2. Kuehn, B. M. (2013). FDA tightens indications for using long-acting and extended-release opioids to treat chronic pain.The Journal of the American Medical Association, 310(15), 1547-1548.
3. Whedon, J. M., Mackenzie, T. A., Phillips, R. B., & Lurie, J. D. (2015). Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66-69 years. Spine, 40(4), 264-270.
Attention-Deficit Hyperactivity Disorder (ADHD) Outcomes Improve with Chiropractic Care
A report on the scientific literature
Mark Studin DC, FASBE(C), DAAPM, DAAMLP
Sangwoo Mah DC, DAAMLP
William J. Owens DC, DAAMLP
As a family practitioner of chiropractic, I, the first author, have treated many children who were diagnosed with a spectrum of hyperactivity disorders in the 1980’s. Each of these diagnoses revolved around children being uncontrollably hyperactive and their ages ranged from 3 years through 10 years old. In most of the cases, under chiropractic care, I witnessed that most of these children, according to their parents, demonstrated calmer behavior over a short amount of time with chiropractic care and this scenario became a regular pattern in my office. These clinical observations by a single practitioner is by no means a scientific answer, nor one that should garner conclusions to suggest an entire populous migrate towards this specific potential solution. However, over time, these results have been reported in many chiropractic offices by both parents and chiropractors alike and research is now catching up to these observations in a formal setting.
Attention-deficit hyperactivity disorder, or ADHD, has become a major concern to parents everywhere as of late. It seems that more and more children are being diagnosed with ADHD as time passes and has the hallmark characteristics of hyperactivity, inattention and impulsivity according to Alcantara and Davis (2010). They go on to report that parents are concerned regarding the causes of ADHD in children and what kinds of treatment are available should they become diagnosed with ADHD. Although the definitive cause of ADHD is unknown, genetics and the environment seem to have strong effects. Medical treatment of ADHD involves use of psychiatric medications and behavior therapy. However, there are growing concerns for long-term use of psychotropic drugs for children. Again, according to Alcantara, 10 years ago it was estimated that 20% of all white males were taking some type of psychotropic drug for behavioral disorders and based upon the potential for serious side effects, conservative alternative medical approaches were sought. With regards to the practitioner-based alternative therapies for children, chiropractic has become the most popular and highly utilized for ADHD.
In their literature search, Alcantara and Davis (2010) reported that 4 case studies recounted successful treatment of ADHD. There appears to be, in those cases, a strong connection between the neuro-muscular-structural connections. This suggests to the authors of this article that there is a resultant neuro-chemical imbalance as a result.
Such a case was four children treated with chiropractic adjustment in a single-doctor’s office. The parents of these children reported a 50% improvement in behavior of their children after 5 months. These results were collected via questionnaires.
Another significant case in the same study was a 5-year-old boy with seriously poor neck posture. This caused him to go for chiropractic treatment, but after 8 weeks, the boy’s behavior improved so significantly that his pediatrician declared he no longer exhibited symptoms of ADHD. During this time, his neck posture also improved dramatically, suggesting a link between the neck posture and ADHD.
Perhaps even more significant, a 9-year-old child who suffered for years from multiple chronic conditions including asthma, headaches, Tourette’s syndrome, ADHD, depression, insomnia, and neck pain also improved dramatically with chiropractic care. The child was taking multiple strong medications. This child was also found to have significantly stiff joints in the neck. After six weeks chiropractic care, the child no longer displayed any symptoms and all medications were discontinued except for a half dose of Wellbutrin. After 5 months, at the conclusion of the treatment, the child remained symptom free.
Muir (2012) reported:
Parents of a 5-year-old boy with diagnosed ADHD brought him for chiropractic care to address his subjective signs (acting out, ability to follow instructions, and poor home and school performance), which also included waking at night due to asthmatic symptoms and low self-esteem. Palpation revealed hypertonicity and trigger points in the paraspinal muscles at the thoracolumbar region with local pain. A preliminary diagnosis included cervical and thoracolumbar facet joint irritation with concurrent muscle hypertonicity.
Intervention and Outcomes: Treatment including spinal manipulative therapy, soft tissue therapy, and stretching was provided. Treatment began on a thrice-weekly basis and declined to twice weekly over the course of approximately 12 weeks. After 1 year of treatment, subjective improvements were noted in episodes of acting out, ability to follow instructions, and general home and school performance (p. 221).
Although much more research is indicated, these examples, along with our personal observations suggest that chiropractic should be considered to be included in comprehensive treatment of ADHD. Chiropractic is one of the safest treatments currently available in healthcare and when there is a treatment where the potential for benefits far outweighs any risk, it deserves serious consideration. Whedon et al. (2014) based their study on 6,669,603 subjects after the unqualified subjects had been removed from the study and accounted for 24,068,808 office visits. They concluded, “No mechanism by which SM (spinal manipulation) induces injury into normal healthy tissues has been identified. (Whedon et al., 2014, p. 5)
If your child suffers from symptoms of ADHD, consider having a chiropractor evaluate your child.
References:
1. Alcantara J., & Davis J. (2010). The chiropractic care of children with attention-deficit/hyperactivity disorder: A retrospective case series. EXPLORE, 6(3), 173-182.
2. Muir, J. M. (2012). Chiropractic management of a patient with symptoms of attention-deficit/hyperactivity disorder. Journal of Chiropractic Medicine, 11(3), 221-224.
3. Whedon, J. M., Mackenzie, T. A., Phillips, R. B., & Lurie, J. D. (2014). Risk of traumatic injury associated with chiropractic spinal manipulation in Medicare Part B beneficiaries aged 66-69. Spine, [Epub ahead of print] 1-33.
Effectiveness of Chiropractic Care
Certified for:
1. Low Back Pain: Chronic, severe, moderate & non-specific
2. Neck Pain: Severe and moderate
3. Migraine Headaches
4. Headaches: Cervicogenic
5. Dizziness: Cervicogenic
6. Hip Pain: From Arthritis
A report on the scientific literature
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
In order to understand the vast importance of this study, it is critical to understand the context of the work. These conclusions were based on randomized clinical trials and evidenced based results. The studies which the conclusions were based upon come from the input of hundreds of sources.
Randomized Clinical Trials
According to the National Cancer Institute (2004), "Randomization is a process that assigns research participants by chance, rather than by choice, to either the investigational group or the control group of all phase III (and some phase II) clinical trials...Each study participant has a fair and equal chance of receiving either the new intervention being studied (by being placed in the investigational group), or of receiving the existing or 'control' intervention (by being placed in the control group)" (http://www.cancer.gov/clinicaltrials/learning/what-is-randomization).
"The goal of randomization is to produce comparable groups in terms of general participant characteristics, such as age or gender, and other key factors that affect the probable course the disease would take. In this way, the two groups are as similar as possible at the start of the study. At the end of the study, if one group has a better outcome than the other, the investigators will be able to conclude with some confidence that one intervention is better than the other. A randomized, controlled trial is considered the most reliable and impartial method of determining what medical interventions work the best" (National Cancer Institute, 2004, http://www.cancer.gov/clinicaltrials/learning/what-is-randomization).
Evidenced Based Healthcare/Practice
According to Schardt and Mayer (2010), "[Evidenced based practice] is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician's cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal and unique concerns, expectations, and values. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology" (http://www.hsl.unc.edu/Services/Tutorials/EBM/whatis.htm).
"The evidence, by itself, does not make a decision for you, but it can help support the patient care process. The full integration of these three components into clinical decisions enhances the opportunity for optimal clinical outcomes and quality of life. The practice of EBP is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, or the etiology of disorders. Evidence-Based Practice requires new skills of the clinician, including efficient literature searching, and the application of formal rules of evidence in evaluating the clinical literature" (Schardt & Mayer, 2010, http://www.hsl.unc.edu/Services/Tutorials/EBM/whatis.htm).
Conclusion
In a 2010 study by Bronfort, Haas, Evans, Leininger and Triano, the researchers both randomized clinical trials and studied evidenced based practice results utilizing guidelines found in scientific literature. In each case, they compared the results of manipulation (chiropractic spinal adjustments or extremity adjusting) to "sham" treatment and concluded that manipulation was effective for:
1. Low back pain, soreness or tension
2. Neck pain
3. Hip pain from arthritis
4. Migraine
5. Headache localized in the neck or back of the head
6. Dizziness emanating from the neck
The following entities were included in the above study to help conclude the results of this research: The American College of Physicians/American Pain Society, The Journal of the AMA, the World Health Organization, Journal of Manipulative Physiological Therapeutics, New Zealand Journal of Medicine and many others. Some clarified what was not yet conclusive while others certified chiropractic as a viable choice for care. The arguments as to whether chiropractic works or not has been long silenced. The only question that now arises is when will the more scientific literature be published?
Asthma is one area is that is lacking in research. As the author of this article and a chiropractic practitioner for 30 years, there has not been one asthma patient that didn’t respond to chiropractic care ranging from the acute to the chronic patient where most discarded their drugs and inhalers (as a result of the advice of their medical practitioners) because they didn’t need them anymore. During most of my career, there was no literature, it just worked. Today, we do not have to go simply on faith as there is much literature in the scientific community confirming the benefits of chiropractic.
This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions for many problems and returning to a normal life. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.
References
1. National Cancer Institute. (2004, August 3).What is randomization? Retrieved from http://www.cancer.gov/clinicaltrials/learning/what-is-randomization
2. Schardt, C., & Mayer , J. (2010, July). What is evidence-based practice. Retrieved from http://www.hsl.unc.edu/Services/Tutorials/EBM/whatis.htm
3. Bronfort, G., Haas M., Evans R., Leininger, B., &Triano, J. (2010). Effectiveness of manual therapies: The UK evidence report. Chiropractic and Osteopathy, 18(3). Retrieved from http://www.chiroandosteo.com/content/18/1/3
Prediction of Outcomes with Chiropractic Care and Cervical Pain
A report on the scientific literature
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP
updated 12-4-2013
Pain located in the neck is a very common condition. Neck pain can come from a number of activities, disorders and diseases in the neck, such as degenerative disc disease, neck strain, whiplash, a herniated disc, or a pinched nerve. It can also come from overuse, sports injuries, and everyday home and work related activities. Usually, there is an underlying instability or problem in the neck that is a precursor to the pain. Neck pain is also referred to as cervical pain.
"Neck pain is commonly associated with dull aching. Sometimes pain in the neck is worsened with movement of the neck. Other symptoms associated with some forms of neck pain include numbness, tingling, tenderness, sharp shooting pain, fullness, difficulty swallowing, pulsations, swishing sounds in the head, dizziness or lightheadedness, and gland swelling" (MedicineNet.com, 2008, http://www.medicinenet. com/neck_pain/article.htm).
"There are seven vertebrae that are the bony building blocks of the spine in the neck (the cervical vertebrae) that surround the spinal cord and canal. Between these vertebrae are discs, and nearby pass the nerves of the neck" (MedicineNet.com, 2008, http://www.medicinenet.com/neck_pain/article.htm).
"Incredibly, the cervical spine supports the full weight of your head, which is on average about 12 pounds. While the cervical spine can move your head in nearly every direction, this flexibility makes the neck very susceptible to pain and injury" (American Chiropractic Association, n.d., http://www.acatoday.or/ content_css.cfm?CID=2430).
"The neck’s susceptibility to injury is due in part to biomechanics. Activities and events that affect cervical biomechanics include extended sitting, repetitive movement, accidents, falls and blows to the body or head, normal aging, and everyday wear and tear" (American Chiropractic Association, n.d., http://www.acatoday. or/content_css.cfm?CID=2430).
Further detailed explanations of some of the causes of neck pain are:
"Injury and Accidents: A sudden forced movement of the head or neck in any direction and the resulting "rebound" in the opposite direction is known as whiplash. The sudden "whipping" motion injures the surrounding and supporting tissues of the neck and head. Muscles react by tightening and contracting, creating muscle fatigue, which can result in pain and stiffness. Severe whiplash can also be associated with injury to the intervertebral joints, discs, ligaments, muscles, and nerve roots. Car accidents are the most common cause of whiplash" (American Chiropractic Association, n.d., http://www.acatoday.or/ content_css.cfm?CID=2430).
"Growing Older: Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease directly affect the spine.
- Osteoarthritis, a common joint disorder, causes progressive deterioration of cartilage. The body reacts by forming bone spurs that affect joint motion.
- Spinal stenosis causes the small nerve passageways in the vertebrae to narrow, compressing and trapping nerve roots. Stenosis may cause neck, shoulder, and arm pain, as well as numbness, when these nerves are unable to function normally.
- Degenerative disc disease can cause reduction in the elasticity and height of intervertebral discs. Herniated discs are NOT an effect of growing older and are a direct effect of trauma, but can also cause similar reduction in elasticity and height of the intervertebral disc, but have the potential to cause more serious problems.
"Daily Life: Poor posture, obesity, and weak abdominal muscles often disrupt spinal balance, causing the neck to bend forward to compensate. Stress and emotional tension can cause muscles to tighten and contract, resulting in pain and stiffness. Postural stress can contribute to chronic neck pain with symptoms extending into the upper back and the arms" (American Chiropractic Association, n.d., http://www.acatoday. or/content_css.cfm?CID=2430).
When considering solutions for neck pain, you must look at what will help you and how long it will take to get better. Like with any malady, the progression of treatment should be drugless first, involve drugs second and have surgery as a final option. A significant factor must be the scientific evidence that predicts the outcome of any treatment. A cancer patient or a heart disease patient, prior to undergoing chemotherapy or open heart surgery, will ask the doctor what the percentage of success is for the treatment. The same question should be asked of every doctor for every treatment and chiropractic is no different.
In 2008, Thiel and Bolton studied 19,722 patients that were treated for a variety of symptoms, most of which were pain or stiffness in the neck, shoulder or arm region. The purpose of the study was to determine the outcome of chiropractic care in patients with nonspecific musculoskeletal disorders, including mechanical neck disorders. The results revealed that 71.6% of females and 67.9 % of males had immediate improvement. This shouldn’t be confused with the overall satisfaction rate of 94% of patients treated with acute neck pain as reported by Haneline (2006), asThiel and Bolton (2008) examined immediate improvement, not improvement over time as Haneline did.
Since statistics can be manipulated in many different ways, let’s examine those patients who experienced immediate worsening. The Thiel and Bolton (2008) study revealed that 95.2% of females and 96.2% of males reported no immediate worsening, rendering an overwhelming predictor of a successful outcome. Predictable outcomes are critical in guiding both the public and the doctor in realizing a successful treatment plan.
These studies, along with many others, conclude that a drug-free approach of chiropractic care is one of the best solutions to treat neck pain. To find a qualified doctor of chiropractic near you, go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.
References:
1. MedicineNet.com. (2008, January). Neck pain. Retrieved from http://www.medicinenet.com/neck_pain/article.htm
2. American Chiropractic Association. (n.d.). Chiropractic and neck pain: Conservative care of cervical pain, injury. Retrieved from http://www.acatoday.org/content_css.cfm?CID=2430
3. Thiel, H. W., & Bolton, J. E. (2008). Predictors for immediate and global responses to chiropractic manipulation of the cervical spine. Journal of Manipulative and Physicological Therapeutics, 31(3), 172-183.
Acute Neck Pain (Torticollis), Disability
and Chiropractic:
Patient Satisfaction Results
The overall patient satisfaction rate was 94%
A report on the scientific literature
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP
"Acute neck pain means immediate neck pain. Neck pain that just started. This type of pain comes on suddenly and affects the ability to properly move your head in its proper range of motion. One serious type of acute neck pain is whiplash - the sudden jarring motion of your head going backwards and forward. This often occurs with a rear end collision. Acute neck pain can also be the result of a fall, sleeping awkwardly, a trauma or even a fall.. Often times when someone has just strained or irritated their neck in some way the pain is most severe. There is usually inflammation, immobility, and muscle tenderness. Often with acute neck pain, the muscles or ligaments are involved" (The Neck Pain Relief Shop, n.d., http://www.neckpainreliefkit.com/acuteneckpain).
The “real life” issue for the patient who either wakes up with this debilitating pain or is in an accident that causes it, is that taking drugs without narcotics is insufficient for relieving the pain. With the narcotics, one can be severely hampered and may not be able to go about his/her life. It is often a double-edged sword; take strong drugs and compromise your life or don't take drugs, receive no chiropractic care and suffer.
A 2006 study examined "...the extent to which a group of patients with acute neck pain managed with chiropractic [adjustments]...and the degree to which they were subsequently satisfied...A total of 115 patients were contacted, of whom 94 became study participants, resulting in 60 women (64%) and 34 men. The mean age was 39.6 years...The mean number of visits was 24.5...Pain levels improved significantly from a mean of 7.6...before treatment to 1.9...after treatment...The overall patient satisfaction rate was 94%" (Haneline, 2006, p. 288).
"There were reductions in disability recorded during the study that were statistically significant. Approximately 84% of the patients related that their activities were restricted before chiropractic treatment because of their neck pain, whereas only 25% still had activity restrictions at the time of the interview. Furthermore, 57% of those with physical restrictions described their disabilities as moderately severe or greater before treatment, whereas at the time of the interview, just 12% did (Haneline, 2006, p. 294).
"When comparing trauma with no-trauma cases, Trauma cases received more than 3 times as many visits. This difference may be related to tissue damage that often accompanies trauma, which, many times, heals imperfectly. In addition, patients with this type of problem may have ensuing long-term pain and physical impairment, which further shows that trauma complicates the recovery of acute neck pain (Haneline, 2006, p. 294).
This study along with many others concludes that a drug-free approach of chiropractic care is one of the best solutions to acute neck pain and returning to a normal life. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.com and search your state.
References
1. The Neck Pain Relief Shop. (n.d.). Acute neck pain.Retrieved from http://www.neckpainreliefkit.com/acuteneckpain
2. Haneline, M. T. (2006). Symptomatic outcomes and perceived satisfaction levels of chiropractic patients with a primary diagnosis involving acute neck pain. Journal of Manipulative and Physiological Therapeutics, 29(4), 288-296.
Chronic Neck Pain and Chiropractic:
A Comparative Study with Massage Therapy
A report on the scientific literature
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
William J. Owens DC, DAAMLP
Neck pain is a very common problem, second only to low back pain in its frequency in the general population and in doctors' offices treating musculoskeletal injuries. "The musculoskeletal system is an organ system that gives [humans] the ability to move using their muscular and skeletal systems" (Wikipedia, ,2010, http://en.wikipedia.org/wiki/Musculoskeletal). "Estimates of the prevalence of chronic neck pain vary. In a Swedish population 18.5% of females and 13.2% of males had neck pain for longer than 6 months; however, when continuous chronicity was rated, these figures were reduced to 10% and 7%, respectively. A Finnish study reported chronic neck pain in 13.5% of females and 9.5% of males. A Norwegian studyreported an overall rate of 13.8% for neck pain greater than 6 months duration; however, for subgroups with age greater than 43, the rate rose above 20%. It would appear that approximately 15% of females and 10% of men have chronic neck pain at any one time. Chronic neck pain produces a high level of morbidity by affecting occupational and avocational activities of daily living and by affecting quality of life" (Vernon, Humphreys & Hagino, 2007, p. 215).
"Manual therapy [chiropractic adjusting] is a generic therapeutic category that is composed of a variety of procedures directed at the musculoskeletal structures in the treatment of mechanical pain. Two major subcategories exist that divide these therapies into those which produce joint motion and those which do not. The first subcategory includes manipulation, mobilization, and manual traction. The second subcategory involves both generalized soft tissue therapies, such as the many types of massage, and focal soft tissue therapy, such as trigger point therapy, shiatsu, and acupressure. For this review, we used the separate therapy categories of manipulation, mobilization, manual traction, massage, and pressure techniques" (Vernon, Humphreys & Hagino, 2007, pp. 215-216).
There are numerous systematic reviews of the treatment of neck pain by manual therapy. With few exceptions, they have included studies of manual therapies for acute, subacute, and chronic neck pain. They have also included studies of subjects with neck pain due to whiplash-type injury as well as those in which whiplash-associated disorder (WAD) was not involved. These reviews have also included studies of subjects with or without concomitant headaches and/or arm pain...Finally, these reviews have included studies where manual therapies have been combined with other therapies such as exercises, relaxation therapy, etc (so-called 'multimodal therapy'). The most recent reviews by Gross et al, Bronfort et al and the Canadian Chiropractic Association Clinical Practice Guideline have brought the evidence base up to date but are similarly broad in scope" (Vernon, Humphreys & Hagino, 2007, p. 216).
The results of these research studies included studies that provided information of long-term outcomes, meaning they continued their study up to at least 52 weeks, with one going as high as 104 weeks (2 years) in order to determine the validity over a long period of time confirming the non-recurrence of the pain. The results of one long-term study that examined the effects of chiropractic treatment on the recovery of clinical trial patients found that approximately 70% of the patients showed full recovery. However,100% of the patients in five studies that varied in length had positive changes. It was also reported that 0%, or none of the massage therapy patients had positive outcomes at the 6 week period.
This study along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions to neck pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.USChiroDirectory.comand search your state.
References
1. Wikipedia, The Free Encyclopedia. (2010, July). Human musculoskeletal system. Retrieved from http://en.wikipedia.org/wiki/Musculoskeletal
Whiplash Disorders and Neck Pain
A report on the scientific literature
By
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
In car accidents and other trauma related causes, whiplash, formally known as WAD (Whiplash Associated Disorders), has the potential to create significant problems to the neck area or cervical spine. The treatment of these disorders ranges from rest or no care to non-invasive care such as chiropractic, acupuncture or physical therapy to invasive care starting with drugs and leading to surgery. Every one of these treatment modalities is indicated based upon the individual diagnosis of the condition and requires the care from a doctor who is experienced and credentialed in trauma related care.
The problem with whiplash is that it affects the ligamentous attachments that connect the bones to one another and creates hypermobility (too much movement or laxity). It often results in compression of the nerves causing pain and resultant premature degeneration. The biggest problem is that ligaments, as reported in a 2006 study, never heal or wound repair.1 They stay impaired for a lifetime, which affects different people in different ways.
Symptoms from whiplash include:2
When analyzing and comparing non-invasive modalities for care, interventions involving mobilization (chiropractic) were more effective than usual care. Multimodal treatment including manual therapy, which included relaxation therapy, led to a quicker return to work and increased satisfaction with recovery.3
With whiplash and resultant damage to ligaments, one the solutions is quick intervention where the joints are mobilized or put back in their normal position with a chiropractic adjustment before adhesions (internal scar tissue) can create a chronic (long term) problem. By getting the area “adjusted” after a conclusive diagnosis is one of the best approaches to treat whiplash disorders.
These studies along with many others conclude that a drug-free approach of chiropractic care is one of the best solutions for pregnant patients with back pain. To find a qualified doctor of chiropractic near you go to the US Chiropractic Directory at www.uschirodirectory.comand search your state.
References:
1. Tozer, S., & Duprez, D. (2005). Tendon and ligament; Repair and disease. Birth Defects Research (Part C) 75, 226-236.
Shoulder Pain, Neck Pain and Chiropractic
A report on the scientific literature
By
William J. Owens DC, DAAMLP
Mark Studin DC, FASBE (C), DAAPM, DAAMLP
Many people experience pain in the upper back area between the bottom of the neck and the shoulders. There is a very large muscle there called the trapezius muscle. Doctors of chiropractic have long understood the relationship between the nervous system and the rest of the body. In this area, the part of the nervous system that controls the trapezius is actually found in the neck. A research paper was presented that sought to determine whether a chiropractic adjustment to the neck at specific levels of the spine would result in reduced sensitivity to pain in the shoulders. What they found was VERY interesting.
The authors stated, “Our results suggest that a cervical spine manipulation [chiropractic adjustment] directed at the C3 through C4 segment induced changes in pain sensitivity...in the upper trapezius muscle” (Ruiz-Sáez, Fenández-de-las-Peñas, Blanco, Martínez-Segura, & García-Léon, 2007, p. 578). What this means is that stimulation and/or correction of the nervous system in the neck can effect the shoulders! This is important because many of the things that we do on a daily basis increase the demand on the vertebral column found in the neck. This in turn can create problems in the shoulders. While helping to reduce symptoms is important, only doctors of chiropractic are specifically trained to look to the CAUSE of the problem, essentially to find the SOURCE of your pain.
More and more research is coming out on a daily basis that shows what chiropractic patients have known for years; CHIROPRACTIC WORKS. If you are suffering from pain in the shoulders, especially the type that increases throughout the day, speak with a doctor of chiropractic today. According to this research article, you will be happy you did!
References:
1. Ruiz-Sáez, M., Fenández-de-las-Peñas, C., Blanco, C. R., Martínez-Segura, R., & García-Léon, R. (2007). Changes in pressure pain sensitivity in latent myofascial trigger points in the upper trapezius muscle after a cervical spine manipulation in pain-free subjects. Journal of Manipulative and Physiological Therapeutics, 30(8), 578-583.
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| Title | Hits |
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| Neck Pain and Chiropractic | 97040 |
| Neck Pain and Headaches | 60372 |
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