Neck Pain

Symptoms by body part:

Cervical Paraspinal (Side of Neck)
Acute Pain
Cervical Spine (Central-Neck)
Dull pain
Reduction in Range of Motion

Neck pain is a common condition treated in our office. There are varying causes, but typically due to mechanical errors within the joints of the neck. It can have contributions from the upper back (thoracic) and ribs (costal). Pain can be referred into the arm/hand, upper back, shoulder blades and shoulders. A Chiropractic Neurologist can help determine the source of your condition, whether simple or complex. 

Why choose Portland Chiropractic Neurology for your neck pain? 

What sets our neck pain treatments apart from so many others is the incorporation of our deep understanding of the nervous system and how that translates into healing- it's not just about changing the structure but also changing the pathways that connect the structure to the brain. And it's this reconnection and reintegration that serve as the backbone of what we do. We are New England's premier center for chiropractic neurology. 

We understand that everything in the body is conected. From the spine to the brain, the nervous system is the engine of feeling. And when a connection is broken, you feel it. The connection and reintegration is the inspiration behind our care, demonstrating the core of who we are: restoring connections in our patients. 

A person's pain is a result of a combination of factors involving muscle, joint, nerve and brain. Thereby, a diagnostic and treatment approach that involves all of those structures will create the best possible, long-term outcome. That's what the Portland Chiropractic Neurology model incorporates, reconnecting all of these structures through a multi-modal appraoch that combines chiropractic, physical therapy, occupational therapy, neurology and hyperbaric oxygen therapy. Our analysis allows us to determine which therapies are right for you and then applied over a certain treatment plan we achieve long-lasting, permanent results if possible. 

What does the research say?

Neck pain is a prevalent condition that nearly three quarters of persons experience at some point in their lives. One of the most commonly reported symptoms in primary care settings (12). 

In 2012, research published in the Spine journal analyzed the prevalence, patterns and predictors of chiropractic utilization in the U.S. general population. The researchers found that, "Back pain and neck pain were the most prevalent health problems for chiropractic consultations and the majority of users reported chiropractic helping a great deal with their health problem and improving overall health or well-being (4)." 

Patients who saw a chiropractor as their initial provider for low back pain (LBP) had 90% decreased odds of both early and long-term opioid use (3). 

High quality evidence-based research concludes that Chiropractic is a proper treatment for neck pain

A review of scientific literature found evidence that patients with chronic neck pain enrolled in clinical trials reported significant improvement following chiropractic spinal manipulation. As part of the literature review, published in the March/April 2007 issue of the Journal of Manipulative and Physiological Therapeutics, the researchers reviewed nine previously published trials and found “high-quality evidence” that patients with chronic neck pain showed significant pain-level improvements following spinal manipulation. No trial group was reported as having remained unchanged, and all groups showed positive changes up to 12 weeks post-treatment (2). 

Chiropractic allows for a reduction in medications

Another study, funded by the National Institutes of Health and published in the Annals of Internal Medicine in 2012, tested the effectiveness of different approaches for treating mechanical neck pain:  272 participants were divided into three groups that received either spinal manipulative therapy (SMT) from a doctor of chiropractic, pain medication (over-the-counter pain relievers, narcotics and muscle relaxants) or exercise recommendations. After 12 weeks, about 57 percent of those who met with chiropractors and 48 percent who exercised reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group. After one year, approximately 53 percent of the drug-free groups continued to report at least a 75 percent reduction in pain, compared to just 38 percent pain reduction among those who took medication (2). 

Neck pain can conribute to Headaches

Although cervicogenic headache (CGH) has been described as a “final common pathway” of cervical spine dysfunction (9), its true prevalence is difficult to determine due to inconsistent use of diagnostic criteria in the literature. Incidence of cervicogenic headache has been reported to range from 0.7% to as high as 13.8% in populations of patients suffering from headache disorders (10). Others have reported cervicogenic origins of higher values (14% to 18%) in all chronic headaches (11).

The anatomical basis for CGH is the convergence of the afferent input of the upper cervical spine nerve roots (C1-C3) with the afferent tracts of the trigeminal nerve in the trigeminocervical nucleus. This convergence results in cervical spine nociceptive input being expressed in the sensory distribution of the trigeminal nerve, most commonly the ophthalmic branch of the trigeminal nerve, which innervates the forehead, temple, and orbit and has its greatest topographic representation near the dorsal horns of spinal nerves C1-C3 (6-7). Therefore, any structure innervated by C1, C2, or C3 spinal nerves can be implicated in the etiology of CGH. This includes the atlanto-occipital, median atlanto-axial, lateral atlanto-axial, and C2-3 zygapophyseal joints as well as the C2-3 intervertebral disc, suboccipital, upper posterior cervical, and upper paravertebral musculature, the trapezius and sternocleidomastoid muscles, upper cervical spinal dura mater, and the vertebral arteries (6-8). Because of the ability of afferent nerves to travel up to three segments cephalically or caudally in the cervical spinal cord, bony and soft tissue structures of the middle and lower cervical spine cannot be excluded from contributing to CGH (6-7).

Cervical spine manipulation was associated with significant improvement in headache outcomes in trials involving patients with neck pain and/or neck dysfunction and headache (1). 

PCN core spinal treatments (may include one, two or many within the list below, depending on your particular condition)

  • Specific Corrective Spinal Chiropractic Neurological Manipulations (SCSCNM)
  • Disc Decompression Therapy (traction therapy) (DDT)
  • Electrical Muscle Stimulation (EMS)
  • Active Muscle Release Therapy (ART)
  • Percussor Muscle Therapy (PMT)
  • Graston Soft Tissue Technique (GSTT)
  • Postural Restoration (PR)
  • Specific Corrective Chiropractic Neurological Manipulations for Oxygenation L/S/T (SCCNM-O)
  • Gait protocol Non-Invasive Nerve Stimulation (NINS-gait)
  • Vestibular Rehabilitation (VR)
  • Occuptational Therapy (OT)
  • Physical Therapy (PT)
  • Co-treatment (CT)
  • Functional Neurological Rehabilitation/Neuroplasticity Retraining Exercises (FNR/NRE)

 

References: 

(1) McCrory, Penzlen, Hasselblad, Gray (2001), Duke Evidence Report

(2) https://www.acatoday.org/patients/health-wellness-information/neck-pain-and-chiropractic

(3) Kazis et al. (2019), BMJ Open

(4) Adams, Jon PhD et al. The PrevalencePatterns, and Predictors of Chiropractic Use Among US Adults. Spine: Dec. 1, 2017. Volume 42, Issue 23, p 1810-1816

(5) Gert Bronfort, DC, PhD, Roni Evans, DC, MS; Alfred V. Anderson, DC, MD; Kenneth H. Svendsen, MS; Yiscah Bracha, MS; Richard H. Grimm, MD, MPH, PhD. Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck PainA Randomized Trial. Annals of Internal Medicine. 3 January 2012. 

(6) Biondi DM. Cervicogenic headache: Mechanisms, evaluation, and treatment strategies. J Am Osteopathic Assoc. 2000;100(9Suppl):S7–S14. [PubMed[Google Scholar]

(7) Bogduk N. The neck and headaches. Neurologic Clinics. 2004;22(1):151–171. [PubMed[Google Scholar]

(8) Sizer PS, Phelps V, Brismee J. Diagnosis and management of cervicogenic headache and local cervical syndrome with multiple pain generators. J Man Manipulative Ther. 2002;10:136–152. [Google Scholar]

(9) Sjaastad O, Fredriksen TA, Pfaffenrath V. Cervicogenic headache: Diagnostic criteria. The Cervicogenic Headache International Study Group. Headache. 1998;38:442–445. [PubMed[Google Scholar]

(10) Martelletti P, van Suijlekom H. Cervicogenic headache: Practical approaches to therapy. CNS Drugs. 2004;18:793–805. [PubMed[Google Scholar]

(11) Zito G, Jull G, Story I. Clinical tests of musculoskeletal dysfunction in the diagnosis of cervicogenic headache. Man Ther. 2006;11:118–129. [PubMed[Google Scholar]

(12) Fejer, R et al. The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J. 2006. Chapt 15: 834-48