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PAIN IN THE NECK

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by Dr. Michael Kaye

PAIN IN THE NECK

Pain in the cervical spine (or neck) is one of the most common complaints I treat.
Often patients report to the office frustrated after spending money on neck pillows, personal massages, and a variety of medications (both prescribed and over the counter) all in an effort to relieve their pain, all to no avail.

Persistent neck pain can have several different causes, from the relatively benign to the more serious, and it’s necessary to identify the source of the pain in order to properly manage and treat it. If you have been experiencing neck pain for two weeks or longer and have not seen any change for the better, it is time to report to your doctor. The first order of business is to get an x-ray.  Your doctor may feel your pain is the result of arthritis; however, you should be persistent in your request for an x-ray since an x-ray examination will provide your doctor with additional information.

From a Boomer perspective it is important to rule-out any cervical stenosis.  Spinal stenosis is when the spinal canal (the anatomical structures surrounding the spinal cord) decreases in diameter, producing pressure on the spinal cord.  The result is neck pain, weakness in the upper extremities and other possible neurological symptoms.  Similarly, foraminal stenosis occurs when the anatomical structures surrounding the spinal nerve decrease in diameter, causing neck pain and possible symptoms in the arms such as weakness, tingling, numbness, etc.  Stenosis can be tough to treat; however, the symptoms can be managed with proper medication, manual therapy, and exercise. At times surgical consideration may be warranted.

When the neck pain is not the result of stenosis but rather arthritis or an “aging cervical spine” the pain can be managed with chiropractic, physical therapy, acupuncture and small movement exercises throughout the day to maintain flexibility. Additionally, cervical facet injections by a pain specialist can also help to manage the pain.

Quite often neck pain is a result of muscular strain caused by postural dysfunction and stress. This type of neck pain is best treated by correcting your posture. This means assessing your posture not only at work but at home as well. Often patients tell me they have an “ergonomic” chair and a computer tray at work yet when they go home they sit for hours on a recliner or sofa with poor posture. It’s important to have proper posture at work and at home. Avoid sitting for more than 20 minutes at any one time.  After 20 minutes of sitting: stand up, walk and perform some stretches for the neck. The easiest stretch or movement pattern to perform is the shoulder shrug.  Just shrug your shoulders to your ears and let them down slowly for 3-5 repetitions.

It’s necessary to address sleeping posture as well. I know there are many cervical/neck pillows on the market. Regardless of the pillow, I recommend my patients adhere to the following rule: there should be enough of the pillow from your bed to your head. In other words, your neck/head should remain in a relative neutral position whether you are lying on your back or your side. Additionally, if you find that lying on your back creates symptoms of tingling and numbness in your arms, you will have to train yourself to sleep in a different position. I know some people enjoy sleeping on their stomach which is okay if this is the only way you can get sleep, does not cause symptoms or dysfunction, and offers you the ability to sleep longer or deeper.

Usually the most effective treatment for neck pain caused by muscular strain is a combination of manual therapy, manipulation/mobilization, daily stretches, and learning how to manage and/or reduce your stress. Manual treatment should produce an effective outcome within 10-12 visits barring no underlying complications (prior surgery, neurological dysfunction, arthritis, diabetes, cancer, etc.) in the spine.  Additional treatments with effective outcomes (meaning the reduction in symptoms with respect to frequency, intensity and duration) also include trigger point injections. Trigger point injections are performed to the muscle knots (tight tissue) in your neck and surrounding muscular structures.
 

One last note about neck pain and Boomers:  as we age, the arteries in the neck can be compromised by plaque. If you experience neck pain, balance problems, dizziness, and/or vertigo it is important to not overlook these symptoms or simply classify them as “I am getting old.”  Please report these symptoms to your primary care provider. Hopefully he/she will recommend an ultrasound of the arteries in your neck to assess blood flow and to rule out the build-up of plaque which can put you at risk for a stroke.

To a Healthier & Pain-Free Neck,




Tags: health pain management cervical spine michael kaye chiropractor wellness life changes boomers

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