Blog: Physical Therapy & Chiropractic

Health Update: Neck Pain

The Neck and Headache Connection

Patients with headaches also commonly complain of neck pain. This relationship is the rule, not the exception and therefore, treatment for headaches must include treatment of the neck to achieve optimum results. The term, “cervicogenic headaches” has been an accepted term because of the intimate connection between the neck and head for many years. There are many anatomical reasons why neck problems result in headaches. Some of these include:

The first 3 nerves exiting the spine in the upper neck go directly into the head. They penetrate the muscles at the top of the neck near the attachments to the skull and therefore, any excess pressure on these nerves by the muscles or spinal joints will result in irritation and subsequent pain.
The origin or nucleus of the 5th cranial nerve called the Trigeminal, innervates the sensation to the face and is located in the upper cervical region near the origin of the 2nd cervical spinal nerve, which innervates sensation to the back of the head up to the top. Therefore, problems located in the upper neck will often result in pain radiating up from the base of the skull/upper neck over the top of the skull to the eyes and /or face.
The 11th cranial nerve that innervates the upper shoulders and muscles in the front of the neck arises from the top 5 to 7 spinal cord levels in the neck. Injury anywhere in the neck can result in spasm and pain in these large muscle groups.
Other interconnections between the 2nd cervical nerve and trigeminal/5th cranial nerve include communication with the 7th cranial / facial nerve, the 9th cranial / glossopharyngeal nerve, and the 10th cranial / vagus nerve. These connections can affect facial muscle strength/movements, taste, tongue and throat movements, and stomach complaints such as nausea from these three cranial nerve interconnections, respectively.

When patients seek treatment for their headaches, a thorough examination of the neck, upper back, and cranial nerves is routinely performed for the above reasons. It is common to find upper cervical movement and vertebral alignment problems present in patients complaining of headaches. Tender points located between the shoulder blades, along the upper shoulders, on the sides of the neck and particularly, at the base of the skull are commonly found. Pain often radiates from the tender point over the top of the skull when pressure is applied in the upper neck/base of the skull area. Tenderness on the sides of the head, in the temples, over the eyes, and near the jaw joint are also common. Traction or pulling the head to stretch the neck is often quite pain relieving and this is often performed as part of the chiropractic visit and can also be applied at home with the use of a home cervical traction unit. Chiropractic adjustments applied to the fixated or misaligned vertebra in the upper neck often brings very satisfying relief to the headache sufferer. Exercises that promote movement in the neck, as well as strengthening exercises are also helpful in both reducing headache pain and in preventing occurrences, especially with stress or tension headaches.

courtesy: Forest Hills Rehabilitation
http://www.ForestHillsRehab.com

Chiropractic Treatments for Back Pain
As part of your overall back pain treatment plan, your chiropractor may use a combination of spinal manipulation, manual techniques, therapy instruments, and therapeutic exercises.

Example of spinal manipulation treatments are:

flexion-distraction technique, which is a gentle, non-thrusting type of spinal manipulation.
instrument-assisted manipulation is another non-thrusting technique. The chiropractor will use a hand-held instrument to apply force without thrusting into the spine.
specific spinal manipulation is an active, hands-on treatment that restores movement in the spine.
To treat your back pain, the chiropractor may also use numerous manual therapies. Examples of manual therapies are:

instrument-assisted soft tissue therapy, which is a technique that involves repeated strokes of the instrument over areas of restricted movement.

manual joint stretching and resistance techniques to ease back pain.
therapeutic massage to relieve tense back muscles.
trigger point therapy, which is a technique that helps the chiropractor identify specific tight, painful points on a muscle.
Various instruments may also be used to treat muscle inflammation. Examples are:

inferential electrical stimulation, which uses a low frequency electrical current to stimulate muscles.
ultrasound to reduce muscle spasms, swelling, stiffness, and back pain by sending sound waves into your muscle tissues. The specific treatment plan developed for you depends on your diagnosis; these are simply examples of what your chiropractor may do for your pain.
How Does Chiropractic Care Treat Back Pain?

Chiropractors treat the “whole person"—not just your back pain—so that you’ll be able to gradually increase your daily activities. Your chiropractor will also emphasize the importance of back pain prevention. With chiropractic care, you’ll learn how to prevent your back pain from getting worse as well as how to prevent future back pain.

Source - spineuniverse

http://www.ForestHillsRehab.com

Neat video I found on Spine Universe about degenerative disc disease. Our physical therapist and chiropractors treat disc herniation, disc injury, slipped disc, disc bulge and the video really shows what’s happening.

Copy and paste the url: http://webpagevidslarge.s3.amazonaws.com/DiscDisease.m4v

You can also go to our site and click on the “Disc Disease Video” link: http://www.foresthillsrehab.com/Conditions%20Treated/back%20pain/back_pain.html

Neat video I found on Spine Universe about degenerative disc disease. Our physical therapist and chiropractors treat disc herniation, disc injury, slipped disc, disc bulge and the video really shows what’s happening.

Copy and paste the url: http://webpagevidslarge.s3.amazonaws.com/DiscDisease.m4v

You can also go to our site and click on the “Disc Disease Video” link: http://www.foresthillsrehab.com/Conditions%20Treated/back%20pain/back_pain.html

Health Update: Neck Pain

Neck Pain – Can Chiropractic Really Help?

Neck pain is a very common problem affecting up to 70% of the adult population at some point in life. Though there are specific causes of neck pain such as arising from a sports injury, a car accident or “sleeping crooked,” the vast majority of the time, no direct cause can be identified and thus the term nonspecific is applied. There are many symptoms associated with patients complaining of neck pain and many of these symptoms can be confused with other conditions. Wouldn’t it be nice to know what neck related symptoms are most likely to respond to chiropractic manipulation before the treatment has started? This issue has been investigated with very favorable results!

The ability to predict a favorable response to treatment has been termed, “clinical prediction rules” which in general, are usually made up of combinations of things the patient says and findings from exams. In a large study, data from about 20,000 patients receiving about 29,000 treatments, was collected and analyzed to find out what complaints responded well to chiropractic treatment. The results showed that the presence of any 4 of these 7 presenting complaints predicted an immediate improvement in 70-95% of the patients: 1. Neck pain; 2. Shoulder, arm pain; 3. Reduced neck, shoulder, arm movement; 4. Stiffness; 5. Headache; 6. Upper, mid back pain, and 7. None or one presenting symptom. Items not associated with a favorable immediate response included “numbness, tingling upper limbs,” and “fainting, dizziness and light-headedness in 4-12% of the patients. The “take-home” message here is that was far more common to see a favorable response (70-95%) of the patients compared to an unfavorable response (4-12%), supporting the observation that most patients with neck complaints will respond favorably to chiropractic treatment.

So, what do we do the chiropractors at Forest Hills Rehabilitation do when a patient presents with neck pain? First, after gathering preliminary information such as name, address and insurance information, a history of the presenting complaint is taken. This consists of information including what started the neck complaint (if you know), when it started, what makes it worse, what makes it better, the quality of pain (aches, stiff, numb, etc.), the location and if there is radiating complaints, the severity (0-10 pain scale), timing (such as worse in the morning, evening, etc.), and if there have been prior episodes. Various questionnaires are included that are scored so improvement down the road can be tracked and a past history that includes a medication list, past injuries or illnesses, family history and a systems review are standard. The exam includes vital signs (BP, pulse, height, weight, temperature and respiration), palpation, range of motion, orthopedic and neurological examination. X-ray and/or other “special tests” may also be included, when needed. A review of all the findings are discussed and after permission to treat is granted, a chiropractic adjustment may then be rendered. A list treatment options may include:

Adjustments;
Soft tissue therapy (trigger point stimulation, myofascial release);
Physical therapy modalities;
Posture correction exercises and other exercises/home self-administered therapies;
Education about job modifications;
Co-management with other health care providers if/when needed.

Please visit our chiropractic forest hills page for more information:

http://www.foresthillsrehab.com/physical%20therapy%20clinic/chiropractor/chiropractor_chiropractic.html

or call anytime toll-free: (888) 595-7282