What is a chronic neck pain?
Neck pain is a common problem, with two-thirds of the population having neck pain at some point in their lives. It may arise due to muscular tightness in both the neck and upper back, or from pinching of the nerves emanating from the cervical vertebrae or, very commonly from degenerative joint disease of the cervical spine.
The head is supported by the lower neck and upper back, and it is these areas that commonly cause neck pain. The upper joints in the neck, allow for most movement of rotation your neck and head. The mid-lower joints in the neck, allow for most movement of flexion and extension. Together they create a supportive structure for your head to sit on. If this support system is affected adversely, then the muscles in the area will tighten, leading to neck pain.
Chronic neck pain , can come from any number of disorders and diseases that may affect almost any tissue or joints, located in the neck or near it, like degenerative disc disease, neck strain, whiplash, a herniated disc, radiculitis, or spinal stenosis.
What are the testing procedures to diagnosis Chronic Neck Pain?
- History and Examination – this is often the most neglected, yet, by far the most important part of the diagnosis process. Quoting Sir William Osler MD, “Listen to your patients, they are telling you the diagnosis”. It is absolutely crucial to spend the time taking a detailed history.” You cannot find what you do not look for”. It is absolutely crucial to spend the time performing a detailed exam. Based upon the results, a determination will be made as to whether to begin treatment or to order further tests.
- X-Rays – can provide a lot of information about the possible causes of neck pain. Disc degeneration, facet enlargement, sliding of the vertebrae, and the development of bone spurs can all be seen. X-rays are also used to evaluate spinal alignment.
- Cat Scan(CT) – used to see the boney structure and spinal stenosis, While less expensive than an MRI, it will expose the patient to high levels of radiation. Generally not the test of choice.
- MRI – will show both bone and soft tissue details and allows nerve root impingement to be well visualized. While this is an excellent test to help differentially diagnosis neck pain, there are inherent problems as well. First is the cost, which can be as high $2000 you Second, is that the time to perform the test is about 30-45 minutes and must lie still. This may be very difficult for many patients. Third and most importantly, is that very often, the findings that the MRI shows may have nothing to do with the presenting condition. You have to “marry the patient to the MRI, not the MRI to the patient”. Again, the history and examination will determine treatment going forward, in spite of the MRI findings.
What treatment can be done to help Chronic Neck Pain?
While there are certainly many different types of treatment, that are effective for chronic neck pain, many of which we readily use in our office, namely spinal manipulation, electric muscle stimulation, ultrasound and spinal exercises, it is not the intent of this article to list all of them but simply to introduce you to a type of treatment that you may not be aware of. SDT is not meant to necessarily replace any of the above therapies. In fact, utilizing them can be very helpful and will often enhance recovery. As a stand alone therapy or as an adjunct to pre-existing therapies, STD can be extremely effective to help you get well.
Spinal Decompression Therapy
Spinal Decompression Therapy is FDA approved and has a very high success rate for pain associated with herniated disc, degenerative disc disease and spinal stenosis.… even after failed surgery. It is a non-surgical, traction based therapy for the relief of back/ leg pain or neck/arm pain. During this procedure, we have the ability to cycle through distraction and relaxation phases and by proper positioning, a spinal disc can be isolated and placed under negative pressure, causing a vacuum effect within it, drawing it back from its herniated position and away from the nerve. If your condition is not discal and is secondary to arthritis, which can lead to spinal stenosis, we can change the parameters to focus on a more continuous shorter hold/relax phases, creating a “milking of the joints”. This will help to reduce inflammation and allow diffusion (absorption) of nutrients into the arthritic areas to lubricate and heal the irritated structures.