Neck Pain-Does Chiropractic help?
Neck pain is a very common problem affecting up to 70% of the adult population at some point in life. 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! In fact the Bronfort report which is based on evidence recommends chiropractic treatment for neck pain.
There is certain information that can predict an outcome. This is usually made up of combinations of things the patient says and findings from exams. In a study which included 20,000 patients receiving about 29,000 treatments the data was collected and analyzed to find out what complaints responded well to chiropractic treatment. 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 as chiropractors when a patient presents with neck pain? First, after gathering preliminary information such as name, address and possible 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), palpation of the spine, range of motion, orthopedic and neurological examination. X-ray, MRI Scans or Blood tests can be ordered as deemed necessary.
A review of all the findings are discussed and after informed consent is gained treatment can be started. Treatment may include: 1. Adjustments which can be spinal, extremity or cranial adjustments; 2. Soft tissue therapy (trigger point stimulation, myofascial release); 3. Acupuncture 4. Physiotherapy physical therapy modalities such as taping or Ultrasound 4. Posture correction exercises and other exercises/home self-administered therapies; 5. Advice on Seating, driving, sleeping or working. 6. Looking at factors that cause stress.