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Neck Pain

ANATOMY

THERE ARE SEVEN CERVICAL VERTEBRAEhttp://www.drnicholasshannon.com/userimages/mechanical%20neck%20pain_shoulder%20pain_cervical_headache_pinched%20nerve.gif

INBETWEEN THE VERTEBRAES ARE INTERVERTEBRAL DISKhttp://static.spineuniverse.com/displaygraphic.php/149/invert_disc-BB.jpg

The disk is made up of a Nucleus Pulposus (Gel like substance) made up mostly of water with some proteoglycans. They help the disk retain water. The disk is held to the vertebrae endplates by ligaments. The amount of fluid in the disk varies depending on day and night. The disks act like shock absorbers for the spine. The Annulus Fibrosus is mainly made up of collagen and proteoglycans and less water.
Each vertebra has spinal nerves that exit the sides of the vertebrae.  These nerves are known as spinal nerves.

 

CERVICAL SPRAIN/STRAIN (WHIPLASH)
http://www.atlantabrainandspine.com/photos/spine_anat/cervical-muscles.gif

THE MUSCLES AND LIGAMENTS OF THE NECK ARE EXTENDED PAST THE NORMAL RANGE OF MOTION AND TEARS FORM IN THE MUSCLES AND LIGAMENTS.  THESE TEARS CAN APPEAR AFTER A MOTOR VECHILE ACCIDENT, PLAYING SPORTS OR SOME TYPE OF TRAUMA. SWELLING AND PAIN IN THE NECK ARE VERY COMMON. MOST PATIENTS HAVE DIFFICULTY WITH RANGE OF MOTION AND ACTIVITIES OF DAILY LIVING.
DIAGNOSIS: A PROPER HISTORY SHOWING TRAUMA AND RULLING OUT MORE SERIOUS INJURY IS ADVISED.
TREATMENT: PHYSICAL THERAPY SHOULD BE STARTED AS SOON AS POSSIBLE TO PREVENT SCAR TISSUE AND ADHESIONS FROM FORMING. MANIPULATION SHOULD BE PERFORMED WHEN THE ACUTE PHASE SUBSIDES.


CEVICAL SUBLUXATION
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WHEN ONE VERTEBRA MOVES OUT OF PLACE IT IS CALLED A VERTEBRAL SUBLUXAITON.  PAIN IS FELT IN THE NECK. DEPENDING WHICH VERTEBRA MOVES OUT OF PLACE WILL DETERMINE WHERE THE PAIN IS FELT. THE C2 VERTBRA CAN REFER PAIN TO THE BACK OF THE HEAD AND CAUSE HEADACHES.  C5, C6, C7 CAN CAUSE RADIATING PAIN INTO THE NECK AND DOWN THE ARM.
DIAGNOSIS: A PROPER HISTORY WITH EXAMINATION MAY LEAD TOWARDS THE DIAGNOSIS OF VERTEBRA SUBLUXATION.  PALPATION OF THE VERTEBRA AND FEELING FOR ALIGNMENT CHANGES ALSO LEADS TO THE DIAGNOSIS OF VERTEBRA SUBULXATION. X RAYS WILL HELP SHOW ALIGNMENT ISSUES AS WELL TO  RULE OUT OTHER CONDITIONS.

 

CERVICAL HERNIATED DISK PINCHED NERVE

This condition occurs when the gel-like center of a vertebral disc (the nucleus pulposus) breaks through the outer ligament (the annulus fibrosis) of the inter-vertebra disc. This bulge of extruded material puts pressure on the adjacent nerve root, causing it to function improperly and send pain signals.
http://static.spineuniverse.com/displaygraphic.php/364/herndisc-BB.jpg

The symptoms of a pinched nerve may vary, depending on the location of the nerve or nerves involved.

Some symptoms may appear as:

  • burning
  • numbness
  • tingling ("pins and needles")
  • radiating pain down arm or leg
  • weakness in muscle

In some cases, symptoms may include a combination of these sensations, depending on the extent of the damage and the compression of the nerve.


PINCHED NERVE TREATMENT

Treatment of a pinched nerve can take a significant amount of time to stabilize.  In most case manipulation will not be done on a pinched nerve and preferred method of treatment is traction. A special traction table is used to open the disk space and take the pressure off the pinched nerve. Posture issue will be addressed as well as a stretching program. For long term success sometimes all of these measures will be necessary. If you condition does not improve over a significant amount of time you may be referred to a neurosurgeon for more serious intervention. Chiropractic and Physical Therapy should always be your first round of defense.
I am not a big advocate of prescription pain medication as many times addictions are formed. We prefer to use natural means to reduce your pain.
CLICK ON THIS LINK FOR CERVICAL STRETCHES

CERVICAL FACET SYNDROME
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THE FACET JOINTS WHICH HELP TO CONTROL MOVEMENT OF THE SPINE CAN WEAR OUT OVER TIME. DEGENERATIVE ARTHRITIS CAN AFFECT THE FACET JOINTS. BONE SPURS AND DEGENERATIVE CHANGES CAN CAUSE PAIN. PATIENTS TYPICALLY PRESENT HUNCHED OVER TO REDUCE THE FACET PAIN. THEY ARE ALSO RESTRICTED IN MOTION.
DIGANOSIS CAN BE MADE WITH AN XRAY OR CAT SCAN.
TREATMENT: PHYSICAL THERAPY CONSISTING OF ELECTRICAL STIMULATION, ULTRASOUND AND ICE MASSAGE CAN HELP REDUCE THE INFLAMMATION. TRACTION AND STRETCHING SHOULD BEGIN WHEN THE INFLAMMATION IS DOWN.

OSTEOARTHRITIS (DEGENERATIVE JOINT DISEASE)
http://www.haaswellness.com/clients/961/images/OA_spine.jpg

OSTEOARTHRITIS USUALLY IS THE DEGENERATION OF THE INTERVETBRAL DISK. THE DISK BEGINS TO FLATEN AND LOSES IT SHAPE. THE VERTEBRAL END PLATES FORM CALCIFICATION KNOWN AS ONE SPURS. THE SPINAL NERVES BECOME PINCHED AND PAIN FOLLOWS.
OSTEOARTHRITIS CAN BE ACCLERATED FROM CONSTANT WEAR AND TEAR OF THE JOINTS. IT IS ALSO ACCLERATED FROM BEING OVERWEIGHT OR SMOKING.
OSTEOARTHRIS PRESENTS ITSELF WITH PAIN WHEN STARTING EXERCISE AFTER RESTING. THE JOINTS SWELL AND BECOME INFLAMMED. DURING MOTION THERE MAY BE CRACKING SOUNDS IN THE JOINT.  THIS CRACKING SOUND IS CALCIFICATION OF THE LIGAMENTS AND END PLATES. SERVERE OSTEOARTHRIS CAN CAUSE CONSTANT PAIN AND BE VERY RESTRICTIVE.
DIAGNOSIS CAN BE CONFIRMED WITH XRAY AND MRI.
TREATMENT


PHYSICAL THERAPY TO REDUCE THE INFLAMMATION SHOULD BE STARTED AS SOON AS POSSIBLE.  A REGULAR STRETCHING PROGRAM SHOULD BE IMPLEMENTED AS SOON AS POSSBILE.


Sherman Sports Injury Center
22222 Sherman Way Suite #110
Canoga Park, CA 91303
(818) 888-8058