Neck pain in Fox Chapel & Pittsburgh is not fun to deal with and is not something you should have to suffer from. The good news is that neck pain, just like low back pain, is a very treatable condition. The key is to know how to differentiate where the pain is coming from and then use individualized treatments to relieve the pain. As was discussed on the causes of neck pain page, there are 4 main reasons why people have neck pain: disc derangement, radiculopathy, joint dysfunction, and myofascial pain. Each of these causes of neck pain has their own treatment strategies.
Disc derangement is the most common cause of neck pain, but it is also easily treatable. Disc derangement in the neck will present as localized neck pain and occasionally it will have accompanying pain that radiates into the shoulders or arms. When someone has disc derangement in the neck, they will usually respond to end range loading—a type of exercise that takes the joint to the end of its range of motion. This loads the joint in a certain direction which can help to reduce the disc derangement and ultimately, your pain. A trained doctor can determine which direction to end range load the neck in order to alleviate pain. This is done by taking you through an examination where you will perform end range loading. During the examination two phenomena will be looked for—centralization and peripheralization. Centralization is when your pain moves towards the center of the body, and peripheralization is when the pain moves out from the center of the body into the shoulder or arm. The goal of the examination is to find the direction that causes centralization of your symptoms. The direction that produces centralization is called your direction of preference. Once your direction of preference is found, exercises may be prescribed to reduce your pain. As your treatment at Tauberg Chiropractic & Rehabilitation progresses, the pain you feel will slowly be relieved and you will likely gain range of motion in your neck that you did not have prior to treatment.
Radiculopathy occurs when there is irritation of a nerve root. This is usually due to stenosis, although it can also be due to disc herniation. However, disc herniation in the cervical spine is not all that common. When you have radiculopathy, you will likely have localized neck pain as well as pain shooting down one or both arms. There may also be associated numbness, tingling, or weakness. Radiculopathy can be a very debilitating condition. To treat radiculopathy, the irritation on the nerve root needs to be reduced. The best way to do this is through neurodynamic therapy, a type of exercise therapy where the goal is to move and pull on the nerve. Pulling on the nerve allows it to start to move more freely. Once the nerve is able to move more freely, it reduces the amount of pain that you feel. In addition, movement of the nerve also causes the irritation at the nerve root to become desensitized. Once the area is desensitized, there will be less pain and inflammation. The exercises that will be prescribed to you will depend on which nerve root is irritated. This can be determined by performing different tests which put tension on the nerve roots.
Joint dysfunction of the neck is when there is pain due to facet joints in the cervical spine moving incorrectly. When the joint is not moving correctly, there is less information sent from the position sensors of the joint. These signals normally help counteract the pain sensors in the joint. At the same time, the pain sensors increase firing. This causes more pain sensation to be sent to the brain. Usually pain is localized to the neck with joint dysfunction. You may also have restrictions in range of motion of the neck. Joint dysfunction is best treated through manipulation or mobilization. Manipulation is the high-velocity low amplitude thrust that most people associate with chiropractors, and mobilization is taking the joint to its end range and helping it to move further through slow oscillatory movements. Manipulation and mobilization help restore range of motion to the facet joints. This restoration in motion causes the joint position nerves to fire normally again. When the joint position nerves fire normally, they block out the information from the pain nerves. This decreases the sensation of pain in the area.
Myofascial pain in the neck is just like myofascial pain of the low back. It is generally caused by tight musculature which develops trigger points. Myofascial pain can be treated through soft tissue work. Soft tissue work helps the muscles relax and relieves the trigger points. It is likely that soft tissue work activates nerve endings, which causes the muscle to relax. Once the muscle relaxes, blood is able to better flow to the area. This allows the trigger points to be relieved. Soft tissue work can include myofascial release, instrument work, vibration therapy as well as other types of treatment. Stretches can be done to help loosen overall muscle tightness and relieve pain.
Deciding which treatment is right.
Determining which treatment to apply depends on what is causing your pain. In many cases, you will have more than one of these causes of neck pain. For that reason, the treatment that you need may be a combination of the above treatments. In order to determine what the exact cause of your neck pain is, you should have a thorough history and examination performed by a qualified practitioner. The good news is that once the cause is identified, it is usually treatable and people often respond to care quickly. Once the cause of your pain has been alleviated, a qualified practitioner will equip you with exercises that you can do on your own to prevent the future occurrence of neck pain.
If you are suffering from neck pain in the Pittsburgh area and would like to talk to Dr. Alex Tauberg at Tauberg Chiropractic & Rehabilitation about your condition please call 412-517-8124.
- Murphy, D., Jacob, G., & Heffner, S. (2016). Clinical Reasoning in Spine Pain Volume II. Cranston: CRISP Education and Research, LLC.
- Murphy, D., Seaman, D., & Heffner, S. (2013). Clinical Reasoning in Spine Pain Volume 1. Pawtucket: CRISP Education and Research, LLC.