Neck pain… a literal pain in the neck. How your Oakville Chiropractor treats your neck depends on why it hurts in the first place. The pain can start for many reasons. Picking up the kids or sleeping in an awkward position are two common ways of developing neck pain. Sitting at a desk for 8 hours straight, or looking down at your IPhone all day are also common culprits for neck pain. Our Oakville chiropractors are experts at treating the spine, so they treat neck pain on a daily basis.
There are a number of different structures and conditions of the neck that can be responsible for neck pain. The joints, muscles, ligaments and nerves can all cause discomfort. Regardless of where the neck pain originated, our chiropractors are skilled at getting rid of it!
Causes of Neck Pain
Degenerative Disc Disease & Degenerative Joint Disease
Many Oakville patients come into the clinic and have had x-rays of their spine. Sometimes they’ve been told that they have degenerative disc disease (DDD) and/or degenerative joint disease (DJD) in their neck. The x-rays can look a little bit scary, but our Chiropractors have good news for you. Despite what you’ve been told about degenerative joints in the neck, they are not necessarily the cause of any neck pain. Even a person with no neck pain at all may have an x-ray that looks significantly degenerated. So the moral of the story is that an x-ray showing some degenerative changes is not the end of the world.
One of the main reasons Dr. Steve doesnt take x-rays is that it gives you too much information. Information that is not needed to treat your neck pain and is most likely there due to wear and tear on your cervical spine. If our Oakville Chiropractors were to x-ray every patient our clinic would be much different then it is now. Most paitents with acute and even chronic neck pain have improved range of motion, posture and symptoms wthin 10 to 12 visits. If Dr. Steve or Dr. Jenn took xrays and the xrays determined that your neck was a little worse for wear, they would have to extened your treatment plan to as much as 40 visits. Our chiropractors don’t want to treat X-ray findings, they want to treat your symptoms and get you back to your regular routine as quickly as possible.
Much like the other joints in our body, our necks can develop a little bit of arthritis as we age. In fact, many individuals over the age of 40 can starts showing signs of degeneration on an xray. The cervical spine has 7 vertebra, and degeneration is most common in the 4th to 7th vertebra. Our bones get a little bit worn down after years of movement and muscles pulling on them everyday. The discs between our vertebra dehydrate a little bit as we age, and therefore our bones lie a little bit closer together, and necks get a little bit more stiff.
DDD and DJD result in a more limited range of motion and a stiff neck. Pain associated with these conditions is more frequently described at uncomfortable, and rarely described as acutely painful. These pains typically have a more gradual onset, and don’t just appear overnight.
Similar to a way you can sprain an ankle, you can sprain a ligament in your neck. Ligaments are sprained when they are overstretched. It is usually a trauma that causes a ligament in the neck to sprain. A fall onto the head/shoulder, a car accident or being struck in the head can all cause the neck to move beyond its typical range of motion and cause a ligament to stretch.
Our ligaments are typically tight and they help hold our bones in proper alignment. When these ligaments stretch too far, they can allow too much movement at the injured area and result in pain and dysfunction. When ligaments are sprained, the surrounding muscles often tighten up to protect the vulnerable area.
There are a lot of ligaments in the neck. The neck is built to provide a great range of motion. It is built for rotation, and with that increased range of motion comes an increased vulnerability. Ligaments connect bone to bone, and help prevent the joints from moving too much. We have ligaments that run up the front of the vertebra, within the spinal column and even in between the bumps that stick out the side of the vertebra. Sprains are graded I-III. First-degree sprains are relatively mild, whereas third-degree sprains are quite severe and associated with significant swelling and joint laxity.
Muscle strains are one of the most common neck injuries. A muscle strain can range from mild to severe. Mild muscle strains can feel dull, whereas more severe strains can feel quite sharp.
Our muscles have a optimal length, where they are happiest and most effective. If a muscle is overstretched, it has a built in protection mechanism to contract/activate in order to keep it within its optimal range. The stretch reflex is built in to prevent a muscle from stretching too far. Sometimes the contraction can linger and create tight, painful muscles.
In cases where the muscle is really stretched, it is possible that it tears. A torn muscle often displays bruising, limited range of motion, pain and swelling.
Cervical Facet Syndrome
The facet joints in the neck are what allow us to look up and down, and side to side. These small joints allow us to move our heads, but when these joints get stiff or stuck they can cause all sorts of trouble. It doesn’t take much to make these joints angry. A mild twist or a slightly awkward movement can often be enough to lock up these small joints
There are a number of pain-causing mechanisms around the facet joints, including nerves, muscles and the joint capsule itself. Pain felt in the shoulder or head can actually be a result of problematic joints in the neck. These joints can be responsible for headaches and even ringing in the ears.
If you’ve ever woken up and feel sharp pain in the neck that makes it feel as if you can’t move your head at all, there’s a good chance the problem is a facet joint. The pain can be so severe that the person may feel like they have to support their neck with their hand. Turning and tilting the head can be extremely painful when a facet joint is locked. The nerves of the spinal cord exit the spinal column between facet joints, and therefore a locked up joint can start to both those nerves enough that symptoms can sometimes be felt in the arm and hand as well!
Stenosis is a condition that develops in people over the age of 50. Bony build-up starts to narrow the spinal canal, or the lateral canal where the nerve exits. This narrowing of the canals starts to affect the nerves. As we age, the cartilage between our bones wears down and the bones start to rub against each other. This bone-on-bone contact stimulates the body to lay down more bone, and it creates bony overgrowth around joints. This excess bone can interfere with the nerves and blood vessels that run through the canals near those joints, creating symptoms down the arms and into the hands.
Symptoms of cervical stenosis can include neck pain and stiffness, numbness/tingling in the hand or arm. Weakness in the arm and hand. Individuals may notice a decrease in grip strength and clumsiness with the hands. In more severe cases sensation to the upper extremity may be affected, and the skin may look paler or have a bluish tinge.
A radiculopathy is more commonly referred to as a pinched nerve. The term radiculopathy refers to a cluster of symptoms that can include a decreased sensation in the arm/hand (which can be described as tingling, numbness, pins and needles), weakness in the arm and hand, and a decrease in the reflexes of the upper limb. Degenerative changes that result in bony build-up can negatively impact the nerves as they are leaving the spinal cord. If these nerves get caught up between bones, the nerve becomes irritated and can send pain all the way into the arm and hand. The nerves that exit the spinal cord are responsible for innervating the arm and hand, so that is why an issue in the neck can cause pain much further away.
In the younger population, a radiculopathy can also be caused by a herniated disc. These are most often caused by some sort of significant trauma (an aggressive hit during a football game, a serious motor vehicle accident, falling onto your neck/shoulder from a ladder). Disc injuries aren’t overly common, but when they occur they can be very painful and really interfere with the simple tasks that were once taken for granted. Brushing and washing your hair, lifting a pot off the stove and getting dressed can all become extremely difficult.
Myofascial Neck Pain
Myo-facial; myo meaning muscle and fascia referring to the thin network of tissue laying between our muscles that helps transfer tension forces and allows muscles to glide over each other without friction. All of our muscles have very specific pain-patterns when they get too tight or strained.
These specific referral patterns can also be present when a muscle has a trigger point. A trigger point is a small muscle contraction in a few of the muscle fibers within a muscle. Scientists haven’t discovered exactly why they occur, but here’s what we DO know. These points are often tender to touch, and are sometimes called ‘muscle knots’. Our chiropractors will be able to feel trigger points within muscles and help release them to alleviate pain.
When most people think of whiplash, they think of it as a result as a car accident. Getting rear-ended and having the head snap back and forth from the impact. Whiplash doesn’t have to be the result of an MVA. Any blow to the head or body can result in a whiplash injury. Sports, a fist fight, a fall from a height, can all cause whiplash.
When the head is forced back and forth, like it is in whiplash, some muscles become overstretched. When they are overstretched, there is a built-in mechanism within the muscle that automatically contracts the muscle to try and prevent it from stretching too much. This automatic muscle contraction can linger, causing a muscle to stay tight and in spasm. In more severe cases of whiplash, even the ligaments of the neck can be stretched too far. Common signs of whiplash include pain in the neck, pain in the shoulder and/or arms, loss of range of motion, headaches, neck stiffness and dizziness. In more severe cases whiplash can cause blurred vision, a ringing in the ears and sleep disturbances. Whiplash is commonly graded on a scale from I-IV. Grade I is the least severe, with a minor impact on the activities of daily living. Grade IV includes the most serious cases that involve a fracture or dislocation.
Grade I – IV Neck Pain
These terms are relatively new in the manual therapy world. They are catchall terms that provide broader, less specific terms to neck pain. Isn’t a more specific term better? Not really. While our chiropractors will be able to feel the problems in your neck, it isn’t overly important what it’s called. Most of the condition we mentioned above occur in combination with each other. Locked facet joints are often accompanied by tight, painful musculature. Whiplash involves both the joints and muscles. Grade I, II, III and IV neck pains simply imply that both the muscles and joints are involved.
So what do the different grades mean? Grade 1 Neck Pain means the chiropractor has identified painful joints and/or muscles in the neck, but that these restricted and uncomfortable areas do not interfere with the daily life of the patient. Grade II Neck Pain is the same as Grade I, except the painful structures of the neck hinder the activities of daily living of the patient. Grade III Neck Pain is more serious, and suggests that there are neurological changes (for example, muscle weakness, a change in sensation, reduced reflex activity). Lastly, Grade IV Neck Pain is neck pain with signs of major pathology. These cases are often emergencies, and our chiropractors can help detect them and refer them for suitable and immediate care. These cases include serious issues like infection, fracture and tumours.
Neck Pain Treatment
When it comes to neck pain, chiropractors are your best bet to get rid of the pain quickly. They are neck pain experts and can fix painful joints safely and effectively. When the joints in the neck are stiff and/or stuck, it can be incredibly painful. Turning the head to check your blindspot while driving may feel impossible. Luckily, a chiropractic adjustment can fix this painful problem very quickly. An adjustment is a quick, shallow thrust through a stiff joint. When the joints ‘pop’ it can feel like a release of pressure and pain.
Our chiropractors are also very well trained to treat the muscles of the head and neck. There are a number of different techniques they use to help stretch and loosen tight muscles. ART is a technique that helps stretch and massage the muscles and Graston uses small plastic/metal tools to loosen tight muscles and fascia. Both techniques are very effective at relieving tension.
Acupuncture is great for neck pain and headaches. Really great. When muscles are too tight, it only takes a few acupuncture needles to relieve the tension. For the less severe tight muscles that result from stress and too much desk-work, acupuncture works like a charm. Sticking some needles into the muscle knots in the back of the neck and shoulders helps them relax and significantly reduces the feeling of tension and headaches. Stress that is carried in the shoulders and neck is no match for acupuncture needles.
The more serious injuries also respond well to acupuncture. Any condition involving the facet joints and referred pain can be effectively treated with acupuncture. Radiculopathy injuries where pain is felt into the arm and hand involve nerve irritation, and acupuncture is designed to treat the nerves. All acupuncture points are aligned along nerve pathways, and inserting a needle into the hand can have an effect all the way up the arm.
All of the patients with neck pain at our Oakville chiropractic clinic will receive stretches and exercises to complete at part of their rehab program. These stretches will help to lengthen tight muscles and the exercise will help strengthen the deep neck musculature. Improving the strength of the neck muscles helps support the spine and improve posture to keep the head and neck in optimal positions that helps to limit pain and discomfort.
Our chiropractors have put together a comprehensive list of neck stretches to address all the key muscles of the head and neck. They have also designed a complete exercise program for people suffering from neck pain, as well as those looking to improve their posture.