Migraines
Back Clinic Migraine Team. This is a genetic neurological disease characterized by episodes called Migraine attacks. They are quite different from regular headaches, which are non-migrainous. About 100 million people suffer from headaches in the U.S., And 37 million of these people suffer migraines. The World Health Organization estimates that 18 percent of women and 7 percent of men in the U.S. suffer.
They are called primary headaches because the pain is not caused by a disorder or disease, i.e., a brain tumor or head injury. Some cause pain only on the right side or left side of the head. In contrast, others result in pain everywhere. Individuals that suffer can have moderate or severe pain but usually can’t participate in regular activities because of the pain.
When a migraine strikes, a quiet, dark room may help with the symptoms. Migraines can last for four hours or can last for days. The range of time someone is affected by an attack is actually longer than the migraine itself. This is because a pre-monitory or build-up and a post-drome can last for one to two days.
by Dr Alex Jimenez | Chiropractic, Chronic Back Pain, Migraines, Neck Pain
El Paso TX. Chiropractor, Dr. Alex Jimenez discusses ways�to assist you to get the care you’ll need at your next appointment.
Dr. Michael J. Cooney, D.C�I�ve been treating patients with severe and chronic pain from around the corner in Rutherford, New Jersey to as far away as Australia and South Africa.
From our patient�s first reference to the past treatment office visit, the success of any pain treatment we prescribe is contingent upon us (the health care provider) correctly treating the root cause of your pain.
As the patient, just describing your intense pain or neuropathic pain is a high stakes� conversation that is �. I am able to read your medical history, attributing lab results and physician reports, however this really is secondary to understanding each patient�s pain mechanics. It is absolutely vital this is communicated to your pain management provider as correctly as possible.
For those fighting �invisible pain” such as fibromyalgia, CRPS (complex areas pain syndrome), RSD (reflex sympathetic dystrophy), diabetic neuropathy or long-term pain after cancer treatment, correctly communicating the place, frequency and depth of the discomfort can be especially demanding and emotionally taxing.
You might wish to bring this short article for your next doctor visit and go over each of the key pain description points I�ve outlined below.
I really hope your doctor will ask you these questions, but if not, you are able to behave as your own pain promoter and offer this information.
�Tell Me About Your Pain�
Based upon your medical records, we already know the reason behind your pain (injury or ailment). In order to restart your highest quality of life possible, our goal would be to remove or minimize this symptom.
Pain symptoms are private, subjective –and unique. (What Joe describes as �unbearable pain� could be considered �fairly disagreeable pain� to Mike). Through the years, I developed my own �pain diagnostic� conversation with patients to assist my team and I understand what, where, when and just how much pain patients are feeling.
I�ve outlined key points below:
Time Matters
This is key to a proper analysis. Don�t presume we know you�ve combated with this pain to get a month a year or a decade.
1.I�ve had this pain for _________________.
2.How frequently and how long does it last?
3.What ignites (flare) or lessens your pain and for how long?
Location, Location, Location
Graphic of a human body with a rear & front view (see above)
Doctors may instruct you to indicate the area/s where your pain is concentrated. They may also request that you notice a difference between pain which is on pain and the surface that’s below the surface.
The front and back of the unisex individual figure are the most identifiable, although this tool comes from the McGill Pain Questionnaire including other measurements.
Most referring physicians, regardless of their medical specialty, utilize 1 to 10 point pain scale that is simple, so�I keep everyone on the same page.
This tool comes from the McGill Pain Questionnaire including other measurements, but the front and back of the unisex person body are the most identifiable.
How Bad Is Your Pain – Measurement Tool
Simply said, take into consideration where your pain level falls the majority of the time�unless you experience extreme pain changes.
No Pain
0 � Painfree
Manageable Pain
1 � Pain is quite mild, barely noticeable. You don’t think about it.
2 � Small pain. Annoying and may have occasional twinges that are stronger.
3 � Pain distracting and is noticeable, you may get used to it and adapt.
Moderate�Pain�Disrupts Regular Day-To-Day Living Tasks
4 � Moderate pain. If you should be deeply in an action, it may be blown off to get a time frame, but is diverting.
5 � Moderately strong pain. It can’t be dismissed for more than a few minutes, but you still can manage to work or participate in some social activities.
6 � Rather strong pain that interferes with normal daily activities. Difficulty focusing.
Severe�Pain�Disabling; Debilitating, Reduces Daily Quality Of Life, Cannot Live Independently
7� Severe pain that dominates your senses and significantly restricts your capability to perform ordinary daily tasks or maintain social relationships. Interferes with sleep.
8� Intense pain. Physical action is seriously limited. Conversing requires great exertion.
9. Not able to converse. Weeping outside or moaning uncontrollably.
10� Unspeakable pain. Perhaps and bedridden delirious. Mobility may be undermined.
�My Pain Feels Like��
Most of the time, patients experience one or two consistent pain �feelings� but some can experience a variety of sensations.
The most common pain kinds are:
- Sharp stabbing pain
- Extreme heat or burning sensation
- Extreme cold
- Throbbing, inflamed tissue
- Susceptibility to contact / touching
- Itching
- Numbness, tingling, pins & needles
Create A Pain Journal
I motivate patients or their family members to document a weeklong pain cycle till they meet with chiropractic, their pain management or alternative medicine team.
Additionally, jot down any treatments or activities�that lessen or increase your discomfort.
As an example, maybe you have discovered that hot showers or cold weather allows you to feel worse, but exercise or Epsom salt baths makes the pain more manageable.
If you come prepared with all this information, your time with all the physician can be spent focusing on next steps and also a treatment plan, rather than a lengthy Q & A review of the information supplied here.
More importantly, addressing these issues beforehand will ensure your physician receives up-to-date, higher quality information.
Consequently, your case could be assessed more quickly and a pain management plan can be placed into action to begin removing or reducing your suffering as rapidly and efficiently as possible.
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by Dr Alex Jimenez | Chiropractic, Chronic Back Pain, Migraines, Neck Pain
About Pain Management (Medicine) Specialists
A pain medicine specialist is a medical or osteopathic doctor who treats pain due to disease, ailment, or injury. Many of these doctors are physiatrists or anesthesiologists although called interventional pain management specialists or pain medicine. Pain medicine is a mutlidisciplinary team effort generally affecting specialists in other disciplines, complimentary alternative medicine, along with radiology, psychiatry, psychology, oncology, nursing, physical therapy, and the patient’s primary care physician or other treating doctor.
Education & Training
After graduating medical school and completing a one-year internship, the physician enters a residency program normally in physical or anesthesiology medicine but sometimes from other fields like psychiatry and neurology. Upon conclusion of a residency program (typically 3 years long), the physician completes a one-year fellowship for advanced training in pain medicine.
Many pain medicine specialists are board certified. The organizations that board certify physiatrists, anesthesiologists, neurologists, and psychiatrists all collaborate to provide the board examination for the subspecialty of Pain Medicine. You can find numerous opportunities for pain management specialists to remain current with medical and technical improvements in pain medicine, such as scientific journals and society meetings.
Targets of Pain Management
The goal of pain medicine is to handle severe or long-term pain by reducing intensity and pain frequency. Besides addressing pain problems, a multidisciplinary pain management program may address your functional goals for activities of day-to-day living. Overall, a pain medicine plan aims to give you a feeling of well-being, increase your level of action (including return to work), and reduce or eliminate your reliance on drugs.
Many Kinds of Pain Treated
Pain medicine specialists treat all sorts of pain. Severe pain is described sharp or as acute and may indicate something is wrong. The pain experienced during dental work is an instance of intense pain. Pain lasting 6 months or longer is defined as chronic. This type of pain varies from mild to serious and is consistent. Spinal arthritis (spondylosis) pain is frequently chronic. A good consequence is produced by uniting different treatments regularly although chronic pain is difficult to handle.
- Degenerative disc disease
- Facet joint pain
- Sciatica
- Cervical and lumbar spinal stenosis
- Spondylolisthesis
- Whiplash
What to Anticipate During an Appointment
Your appointment with a pain or interventional pain management practitioner is much like other doctor visits. Although there are many similarities, the focus is fast managing it, and on your pain, the cause or contributing factors.
Pain medicine physicians execute a physical and neurological examination, and review your medical history paying particular focus on pain history. You may be asked many questions about your pain
- On a scale from zero to 10, with 10 being the worse pain imaginable, speed your pain.
- When did pain start? When pain started, what were you doing?
- Does pain disperse into other regions of the body?
- Is its intensity persistent, or is it worse at different times of night or the day?
- What really helps to alleviate the pain? Why is pain worse?
- What treatments have you ever attempted? What worked? What failed?
- Would you take over the counter drugs, vitamins, or herbal nutritional supplements?
- Does one take prescription medication? If so, what, how much, and how frequently?
Most pain medicine specialists utilize a standardized drawing of the front/back of the body to let you mark where pain is sensed, as well as indicate pain spread and type (eg, light, sharp). You may be asked to complete the form each time you see with the pain physician. The finished drawing helps you to evaluate your treatment progress.
Accurate Analysis Key to Treatment
Pain medicine includes diagnosing origin or the cause of pain. Making the proper identification may include getting an X ray, CT scan, or MRI study to verify the reason for your neck pr back pain. When treating spine-associated pain (which may include arm or leg symptoms), other tests, like discography, bone scans, nerve studies (electromyography, nerve conduction study), and myelography could possibly be performed. The proper analysis is crucial to some favorable treatment plan.
Some spinal ailments and pain treatment requires involvement of other specialists, such as your primary care physician, neurosurgeon, orthopaedic surgeon, and practitioners in radiology, psychiatry, psychology, oncology, nursing, physical therapy, and complimentary alternative medicine. The pain medicine specialist may consult with and/or refer you to a neurosurgeon or orthopaedic spine surgeon to determine if your pain difficulty necessitates back operation.
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by Dr Alex Jimenez | Chiropractic, Chronic Back Pain, Migraines, Neck Pain
You get up with it. You go to sleep with it. An incredible number of men and women live with chronic back or neck pain every day. What’s chronic pain? It is technically defined as pain that lasts for 12 weeks or more�even after pain isn’t any longer acute (short-term, serious pain) or the injury has healed.
Accurate Analysis
Getting an exact identification of the reason for neck pain or your back is vital to the outcome of your treatment plan. Depending on the severity and cause of your pain that is chronic, you might need to find out different specialists in addition to your own primary care physician�pain medicine specialist, orthopaedic spine surgeon, neurosurgeon, physiatrist, rheumatologist, physical therapist among others. Over time your chronic pain need to be reevaluated, and may transform, which might affect the way it is handled.
Your chronic back or neck pain treatment generally features a variety of treatments to maximize results that are great. A number of the treatments your doctor prescribes and recommends may include:
Physical Therapy:
Extending and strengthening muscles is vital in the treatment of neck pain or chronic back.
Chiropractic Care:
Depending on your own diagnosis, chiropractic care may be recommended by your doctor. Studies have demonstrated that two weeks of day-to-day exploitation by a chiropractor can result in considerable progress in a few patients with persistent low back pain and referred leg pain.
Medicines:
There are lots of different prescription medications to take care of neuropathic pain, inflammation, muscle spasms, and pain. Additionally, you will find drugs to treat conditions that often accompany chronic pain, including drugs that will help you sleep, alleviate depression, and reduce nervousness.
Processes:
Your doctor may recommend a spinal cord stimulator, spinal injections, drug heart, or spine surgery. You can get a second opinion, in the event you might be uncertain about the treatment plan recommended.
Coping skills:
Never underestimate the power of your head. Your mood and mental perspective can greatly make an impact on your level of pain. Talk with a trained specialist to understand relaxation and coping skills.
Complementary Treatments:
Many physicians recommend acupuncture and other types of traditional Chinese medicine. Speak to your doctor about these choices.
A couple of words about …. age, fitness, body weight
You probably involve some control over body weight and your level of fitness, although you can�t stop aging or its effects. While you can�t stop the clock on the cellular changes that are recognized to accompany aging�such as loss of muscle mass and bone density �you can take little steps today to build a more stronger�you tomorrow.
It�s understood that patients with chronic back or neck pain may not feel like being active, going to the gym and even adhering to a home exercise program. Yet, being active can help chronic pain because during exercise your body releases endorphins�your body�s natural painkiller.
Moreover, by teaming up together with and/or your physician physical therapist you can start to build abdominal muscles that are strong �essential to your own body�s center strength which helps support your back.
Did you know that by simply losing even 5 to 10 pounds you can reduce back pain? It�s true. Carrying around extra weight translates to added stress to the low back that may exacerbate pain.
Conclusion
In many instances, aggressive and early treatment of chronic back or neck pain can make a life-changing difference. But remember that knowledge is power: Be certain you comprehend your alternatives before deciding which route to take.
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by Dr Alex Jimenez | Chiropractic, Lower Back Pain, Migraines, Neck Pain
Although their main method of treatment is the spinal manipulation, many chiropractors also use other therapies to treat their patients. The following is a brief description of some of the most common therapies chiropractors offer.
Therapeutic Exercise
Chiropractors commonly prescribe specific strengthening exercises for their patients with back, neck, and extremity problems. These exercises can decrease pain, prevent muscle deterioration, promote joint health, increase strength, stability and range of motion, and protect against new or recurring injuries.
Your chiropractor will show you how to do the exercises and supervise you until you are comfortable doing them on your own. It’s important to keep up with your exercises as prescribed (similarly to drug prescriptions). Studies show that individuals who follow their exercise instructions heal faster than those who do not.
Therapeutic Stretches
Following an injury, therapeutic stretching is an important way to prevent scar tissue from forming. Even after the injury has healed, maintaining a regular stretching program helps keep tissues flexible, increases mobility, and protects you from new injuries. As with exercise, your chiropractor will instruct you on proper stretching techniques and will supervise you until you are comfortable enough to do them on your own.
Traction
Many chiropractors use traction, in which traction devices are applied to distract areas of the spine. This treatment helps separate the vertebrae resulting in disc decompression, reduced nerve root pressure, and decreased.
Soft Tissue Manual Therapy
Chiropractors use a variety of hands-on soft tissue therapies to improve the function of the soft tissues (muscles, ligaments, tendons, and joint capsules).�These include pin and stretch, also known under a proprietary name Active Release Technique (ART) and instrument-assisted soft tissue mobilization (Graston Technique).
Physical Therapy Modalities
Muscle Stimulation
This type of therapy uses light electrical pulses that are transmitted to specific areas of the body through electrodes placed on the skin. There are many different types of electrical stimulation. Some are more beneficial for pain relief or to reduce inflammation, some best treat muscle spasm, and some actually cause muscles to contract in order to reduce muscle atrophy. Some forms of electrical stimulation have combination effects.
TENS
A TENS (transcutaneous electric nerve stimulation) unit is a small, battery-powered, portable muscle stimulation machine that can be used at home to help control pain. Variable intensities of electric current are used to control pain. This treatment is recommended to help patients get through periods of severe (acute) pain. TENS units are typically not recommended for chronic pain. In fact, a 2009 �report from the American Academy of Neurology found that TENS units are not effective at treating chronic low back pain.1
Ultrasound
Therapeutic ultrasound is a form of deep heat therapy created by sound waves. When applied to soft tissues and joints, the sound waves are a form of micro-massage that help reduce swelling, increase blood flow, and decrease pain, stiffness, and spasms.
Ice and Heat Therapy
Ice and heat have long been used to treat many painful conditions. Ice therapy is often used to reduce swelling and help control pain immediately after an injury. Heat therapy is used to relax the muscles, increase circulation, and can provide relief to patients with chronic pain. Depending on the patient’s condition, a combination of ice and heat can be used.
Diet and Nutritional Counseling
Studies have shown that poor diet and nutritional imbalances contribute to a number of serious illnesses, such as heart disease, stroke, diabetes, and cancer. Chiropractors are specifically trained in diet and nutritional counseling. Your chiropractor can design a nutritional program specific to your needs that can help you maintain good health and minimize the risk of developing these serious health conditions.
Lifestyle Modification Counseling
Good health is much more than the absence of pain or disease. The lifestyle choices you make on a daily basis can greatly affect your long-term health. We now know that years of seemingly small unhealthy lifestyle choices can, over time, turn into very large health problems. Examples of lifestyle choices and behaviors that can have negative effects on your health include:
- lack of regular exercise
- smoking
- poor diet
- excessive mental stress
- over-reliance on medication
- excessive consumption of alcohol
- poor posture
- improper lifting
Your chiropractor will talk to you about your lifestyle choices, help you sort through and identify unhealthy health habits, and give you practical strategies to deal with and manage them.
As you can see, chiropractic medicine is more than just spinal manipulations. Chiropractors use a variety of treatment modalities to help the body to heal itself and return the patient to a pain-free and healthy life.
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by Dr Alex Jimenez | Chiropractic, Chronic Back Pain, Migraines, Neck Pain
Many of us experience back and neck pain. But when is it the right time to see a chiropractor for a diagnosis or treatment? And can they really help? The answer is yes.
Chiropractors have been around for a hundred years, and are licensed doctors who are required to pass a series of four national board exams and are regulated by state licensing boards. They are medical professionals who diagnose and treat musculoskeletal and nervous system disorders.
A chiropractor can use many different techniques to relieve pain, including applied pressure, massage, and hands-on manipulation (adjustment) of the vertebrae and joints. They may also order X-rays, MRI studies, and lab work. Chiropractors don�t prescribe medications, but they do recommend such things as therapeutic and rehabilitative exercises and nutritional and lifestyle counseling to help the body heal itself.
Chiropractors believe one of the main causes of back or neck pain is subluxation. Subluxation occurs when your vertebrae become misaligned. Treating subluxations can help to alleviate pain associated with a myriad of conditions, including:
- headaches
- sciatica
- trauma, such as whiplash
- scoliosis
- leg pain
- sports injuries
- bursitis and tendonitis
- fibromyalgia
- spinal arthritis (spondylosis)
Sometimes chiropractic care (eg, an adjustment) can cause mild soreness or aching but that usually resolves itself within 12 to 48 hours.
Chiropractic Tests
When you visit your chiropractor for the first time, he/she will probably ask you to perform a series of simple tests to evaluate your posture and range of motion. You may be asked to bend forward,� backward or side-to-side. The chiropractor will also check the way you walk and how your posture looks sitting down and standing up.� Other tests may include:
- Piriformis Test: The patient flexes and bends the knee while lying down.
- Straight Leg Raise: One leg at a time is raised in a locked-knee position to check the sciatic nerve and flexibility of the hamstring muscle.
- Measuring the length of each leg helps determine if there is a discrepancy in leg length or if the pelvis is out of balance.
- Hand strength (grip)
- Evaluation of reflexes and muscle testing
Sometimes you might hear a pop while the chiropractor is testing or adjusting you, which is perfectly normal. This is caused by small pockets of air or bubbles in the fluid that surrounds your joints. When joint tissues are stretched, those pockets of air �pop,� which creates the cracking sound you hear.
Diagnosis
Once the chiropractor identifies the problem, he/she can recommend treatment options, and explain how many chiropractic visits are necessary to reach an expected outcome (eg, resolution of pain). He/she may also suggest improvements to your diet and lifestyle, such as quitting smoking or increasing/modifying certain activities. A chiropractor may also recommend certain types of exercises in conjunction with chiropractic treatment to stretch and/or strengthen the back and neck.
Adjustment Techniques
A chiropractor is educated in dozens of ways to treat pain. Here is a sampling of the different techniques that may be used.
Toggle Drop � The chiropractor presses down firmly on a particular area of the spine followed by a quick and precise thrust.
Lumbar Roll � With the patient on his/her side, a quick thrust is applied to the misaligned vertebrae.
Release Work � The chiropractor uses gentle pressure with the fingertips to separate the vertebrae.
TENS (Transcutaneous electrical stimulation) � This device sends stimulating pulses across the surface of the skin and nerve strands to block pain signals along the nerves and release endorphins which are natural painkillers.
Cold/Heat Treatment � Chiropractors may alternate between ice and heat therapy to treat back or neck pain. Ice packs are used to reduce inflammation (swelling) for 15 minutes at a time. A heating pad (or other heat source) helps increase circulation and may promote faster healing.
Table Adjustments � The patient lies on a special table with a �drop piece� then a quick thrust is applied when the table drops.
Instrument Adjustments � Instead of hands-on manipulation, the patient lies on the table face down while the chiropractor uses a spring-loaded activator instrument to perform the adjustment.
Manipulation Under Anesthesia � This is performed by chiropractors certified in this technique. The treatment is performed in a hospital outpatient setting.
Keep in mind that chiropractic care is not a cure-all for your back and neck pain! However, it is considered by many to be a safe and effective way to help relieve pain and improve spinal function. Many physicians and surgeons recommend chiropractic care to their patients.
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Written by Stewart G. Eidelson, MD
by Dr Alex Jimenez | Chiropractic, Migraines, Neck Pain, Spine Care
What Is Neck Pain (Cervical Pain)?� The cervical spine is a marvelous and complex structure. It is capable of supporting a head weighing 15 or more pounds while moving in several directions. No other region of the spine has such freedom of movement. This combination however, complexity and mobility, make the neck susceptible to pain and injury.
Quick Cervical Spine Anatomy Lesson
This complex structure includes 7 small vertebrae, intervertebral discs to absorb shock, joints, the spinal cord, 8 nerve roots, vascular elements, 32 muscles, and ligaments.
The nerve roots stem from the spinal cord like tree branches through foramen in the vertebrae. Each nerve root transmits signals (nerve impulses) to and from the brain, shoulders, arms, and chest. A vascular system of 4 arteries and veins run through the neck to circulate blood between the brain and the heart. Joints, muscles, and ligaments facilitate movement and serve to stabilize the structure.
Neck mobility is matchless. It is capable of moving the head in many directions: 90� of flexion (forward motion), 90� of extension (backward motion), 180� of rotation (side to side), and almost 120� of tilt to either shoulder.
Neck Pain Causes
The causes of neck pain are as varied as the list is long. Consider a few examples:
- Injury and Accidents: Whiplash is a common injury sustained during an auto accident. This is typically termed a hyperextension and/or hyperflexion injury because the head is forced to move backward and/or forward rapidly beyond the neck’s normal range of motion. The unnatural and forceful movement affects the muscles and ligaments in the neck. Muscles react by tightening and contracting creating muscle fatigue resulting in pain and stiffness.
- Growing Older: Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease are known to affect the spine.
Osteoarthritis is a common joint disorder causing progressive deterioration of cartilage. The body reacts by forming new bone termed osteophytes (bone spurs) that impact joint motion.
Spinal stenosis causes the foramen, small neural passageways, to narrow possibly compressing and entrapping nerve roots. Stenosis may cause neck, shoulder, and arm pain and numbness when these nerves are unable to function normally.
Degenerative disc disease (DDD) can cause the intervertebral discs to become less hydrated, resulting in decreased disc elasticity and height. Over time, a disc may bulge or herniate causing upper extremity pain, tingling, and numbness.
- Everyday Life: Poor posture, obesity, and weak abdominal muscles disrupt the spine’s balance often causing the neck to bend forward to compensate. Stress and emotional tension can cause muscles to tighten and contract resulting in pain and stiffness.
- Other Disease Processes: Although neck pain is commonly caused by strain, prolonged pain and/or neurologic deficit may be an indication of something more serious. These symptoms should not be ignored. Spinal infection, spinal cord compression, tumor, fracture, and other disorders can occur. If head injury has been sustained, more than likely the neck has been affected too. It is wise to seek medical attention promptly.
Neck Pain Diagnosis: Figuring Out What is Causing Your Pain
Obtaining a proper diagnosis is paramount to determine the best course of treatment for neck pain. You have to know what spinal condition is causing your neck pain before you can know how to treat it.
The physician will take the your medical history. The oral segment of the examination often includes many questions such as:
- When did the pain start?
- What activities preceded the pain?
- What have you tried to relieve the neck pain?
- Does the pain radiate or travel into other body parts?
- What makes the pain less or greater?
A physical examination includes observing the your posture, range of motion, and physical condition. Any movement generating pain is carefully noted. The physician will palpate or feel the curvature of the spine, vertebral alignment, and detect muscle spasm.
The neurological examination tests the patient’s reflexes, muscle strength, sensory and/or motor changes, and pain distribution.
Radiographic studies may be ordered. An x-ray can reveal narrowing of disc space, fracture, osteophyte formation, and osteoarthritis. Bulging discs and herniations, often responsible for neurologic symptoms, are detected using MRI.
If nerve damage is suspected, the physician may order a special test to measure how quickly nerves conduct impulses. These tests are termed nerve conduction studies and/or electromyography. Typically these studies are not performed immediately because it may take several weeks for nerve impairment to become apparent.
Common Questions About Neck Pain
I woke up with neck pain. What can I do?
Daily life (and night life) can take its toll on your neck. You may have slept wrong last night, causing your neck muscles to tighten. The best thing to do is give your body time to heal on its own. To get through the day without letting the pain interfere with your normal activities, you have a few options.
- Gently stretch your neck.
- Take over-the-counter pain medications, such as Tylenol or Advil.
- Alternate between heat and ice treatments on your neck: 20 minutes of heat followed by 20 minutes of ice should help the pain and the healing process.
Will I need surgery?
Most patients with neck pain respond well to non-surgical treatments (such as medication), so cervical spine surgery is seldom needed to treat it. In fact, less than 5% of neck pain patients need surgery. However, there are situations when you may want to go ahead with spine surgery.
- Non-surgical treatment is not helping�that is, you’ve tried a combination of chiropractic care, physical therapy, medication, massage, exercises, and more, and you’re still in pain.
- You experience progressive neurological symptoms (numbness, tingling, weakness) involving your arms and legs.
- You’re having trouble with balance or walking.
- You are otherwise in good health.
Generally, surgery is done for degenerative disc disease, trauma, or spinal instability. These conditions may put pressure on your spinal cord or on the nerves coming from the spine.
Read an article focused on cervical spine surgery.
What kinds of surgery are used for neck pain?
Typically, surgeons use 2 surgical techniques for cervical spine surgery.
- Decompression, where they remove tissue pressing against a nerve structure
- Stabilization, where they work to limit motion between vertebrae
There are different types of decompression procedures such as discectomy, corpectomy, and TransCorporeal MicroDecompression (TCMD).
- Discectomy: The surgeon removes all or part of a damaged disc.
- Corpectomy: The vertebral body is removed to access whatever is compressing the spinal cord or nerve.
- TransCorporeal MicroDecompression (TCMD): The surgeon accesses the cervical spine from the front of the neck. TCMD is performed through a small channel made in the vertebral body to access and decompress the spinal cord and nerve.
Your surgeon will determine what’s best for your condition.
Stabilization surgery is sometimes�but not always�done at the same time as a decompression surgery. In some forms of decompression surgery, the surgeon may need to remove a large portion of the vertebra or vertebrae. That results in an unstable spine, meaning that it moves in abnormal ways, and that puts you more at risk for serious neurological injury. In that case, the surgeon will restabilize the spine. Commonly, this is done with a fusion and spinal instrumentation, or implantation of an artificial disc.
Some patients are at high-risk for poor bone healing or unsuccessful fusion. Smoking and diabetes are two of several risk factors that impede bone healing and fusion. A bone growth stimulator may be recommended and prescribed for patients with certain risk factors.
What are some non-surgical options for treating my neck pain?
Less than 5% of neck pain patients will need surgery, and there are a lot of options for you to try before surgery.
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by Dr Alex Jimenez | Migraines, Neck Pain
The Modern Sore Neck
You may have noticed a new buzzword in health news recently: Text neck.
See How to Avoid Neck Pain from Texting
Text neck is the term used to describe the neck pain and damage sustained from looking down at your cell phone, tablet, or other wireless devices too frequently and for too long.
Children & Teens Especially At Risk For Suffering Symptoms Of Text Neck.
Learn more: How to Avoid Text Neck Overuse Syndrome
Recently, a patient came in to my practice complaining of severe upper back pain. He woke up and was experiencing severe, acute, upper back muscle strain. I told him I believe the pain is due to the hours he was spending hunched over his cell phone. Diagnosis: Text neck.
See All About Upper Back Pain
This posture of bending your neck to look down does not occur only when texting. For years, we’ve all looked down to read. The problem with texting is that it adds one more activity that causes us to look down�and people tend to do it for much longer periods. It is especially concerning because young, growing children could possibly cause permanent damage to their cervical spines that could lead to lifelong neck pain.
See Cervical Spine Anatomy and Neck Pain
Symptoms Associated With Text Neck?
Text neck most commonly causes neck pain and soreness.
In addition, looking down at your cell phone too much each day can lead to:
- Upper back pain ranging from a chronic, nagging pain to sharp, severe upper back muscle spasms.
- Shoulder pain and tightness, possibly resulting in painful shoulder muscle spasm.
- If a cervical nerve becomes pinched, pain and possibly neurological symptoms can radiate down your arm and into your hand.
See What Is Cervical Radiculopathy?
As some studies suggest, text neck may possibly lead to chronic problems due to early onset of arthritis in the neck.
See Facet Joint Osteoarthritis
Watch:�Neck Strains and Sprains Video
Poor neck posture of all kinds, not just from texting, can lead to strain or sprain.
How Common Is Text Neck?
A recent study shows that 79% of the population between the ages 18 and 44 have their cell phones with them almost all the time�with only 2 hours of their waking day spent without their cell phone on hand.1
See Causes of Upper Back Pain
How Is Text Neck Treated?
First, prevention is key. Here are several pieces of advice for preventing the development or advancement of text neck:
Hold your cell phone at eye level as much as possible. The same holds true for all screens�laptops and tablets should also be positioned so the screen is at eye level and you don’t have to bend your head forward or look down to view it.
See Ten Tips for Improving Posture and Ergonomics
Take frequent breaks from your phone and laptop throughout the day. For example, set a timer or alarm that reminds you to get up and walk around every 20 to 30 minutes.
If you work in an office, make sure your screen is set up so that when you look at it you are looking forward, with your head positioned squarely in line with your shoulders and spine.
See Ergonomics of the Office and Workplace: An Overview
The bottom line is to avoid looking down with your head bent forward for extended periods throughout the day. Spend a whole day being mindful of your posture�is your head bent forward when you drive? When you watch TV? Any prolonged period when your head is looking down is a time when you are putting excessive strain on your neck.
See Office Chair, Posture, and Driving Ergonomics
Watch:�Neck Strains and Sprains Video
Keeping the neck straight and your phone at eye level can help prevent text neck.
Rehabilitation Is Important
Many people don’t know this, but you need to have strong core muscles�the abdominal and lower back muscles�to support your upper body, including your neck. Your core muscles usually do not get enough exercise during normal daily activities, so you need to do specific exercises to target these muscles.
See Core Body Strength Exercises
You also need strong and flexible muscles the neck to minimize strain on your cervical spine and help support the weight of your head. Again, your neck will not get sufficient stretching and strengthening during normal daily activities, so it is best to learn specific neck exercises with the help of a health professional.
See Neck Stretches
Some people will also benefit from a more comprehensive treatment plan, such as a combination of manual adjustments, massage therapy, and cold laser therapy.
Chiropractic Leads the Charge Against �Text Neck Syndrome�
( Los Angeles Times) Dr. Dean Fishman, a chiropractor in Florida, was examining an X-ray of a 17-year-old patient�s neck in 2009 when he noticed something unusual. The ghostly image of her vertebral column showed a reversal of the curvature that normally appears in the cervical spine � a degenerative state he�d most often seen in middle-aged people who had spent several decades of their life in poor posture.
�That�s when I looked over at the patient,� Fishman says. She was slumped in her chair, head tilted downward, madly typing away on her cellphone. When he mentioned to the patient�s mother that the girl�s posture could be causing her headaches, he got what he describes as an �emotional response.� It seemed the teen spent much of her life in that position. Right then, Fishman says, �I knew I was on to something.�
The flexed neck can put strain on cervical disks. (Zephyr / Getty Images/Brand X)
He theorized that prolonged periods of tilting her head downward to peer into her mobile device had created excessive strain on the cervical spine, causing a repetitive stress injury that ultimately led to spinal degeneration. He began looking through all the recent X-rays he had of young people � many of whom had come in for neck pain or headaches � and he saw the same thing: signs of premature degeneration.
Fishman coined the term �text neck� to describe the condition and founded the Text Neck Institute (text-neck.com), a place where people can go for information, prevention and treatment.
�The head in neutral has a normal weight� of 10 to 12 pounds, says Fishman, explaining that neutral position is ears over shoulders with shoulder blades pulled back. �If you start to tilt your head forward, with gravity and the distance from neutral, the weight starts to increase.�
A recent study in the journal Surgical Technology International quantified the problem: As the head tilts forward 15 degrees from neutral, the forces on the cervical spine and supporting musculature increase to 27 pounds. As the tilt increases, the forces increase to 40 pounds at 30 degrees, 49 pounds at 45 degrees and 60 pounds at 60 degrees.
�When your head tilts forward, you�re loading the front of the disks,� says Dr. Kenneth Hansraj, study author and chief of spine surgery at New York Spine Surgery & Rehabilitation Medicine. Though the study didn�t look at long-term effects of this position, Hansraj says that, after seeing approximately 30,000 spinal surgery patients, he�s witnessed �the way the neck falls apart.�
He explains, �When you�re eccentrically loading the spine, you�re going to get cracks in the disks, slipped disks or herniated disks. This leads to stenosis or blockage of the spine.�
In addition, Fishman says, text-neck posture can lead to pinched nerves, arthritis, bone spurs and muscular deformations. �The head and shoulder blades act like a seesaw. When the head goes forward, the shoulder blades will flare out � and the muscles start to change over time.�
Much like tennis elbow doesn�t occur only in people who play tennis, text neck isn�t exclusive to people who compulsively send text messages. Hansraj says people in high-risk careers include dentists, architects and welders, whose heavy helmets make them especially vulnerable. He adds that many daily activities involve tilting the head down, but they differ from mobile-device use in intensity and propensity.
I�ve noticed a LOT of adolescents slumped over their phone sitting in the passenger seat of their parent�s cars�.there will be a whole range of physical and emotional problems that result from this behavior, believe these printed words! See you in the future!
�Washing dishes is something nobody enjoys, so you do it quickly. And while your head is forward, it�s probably tilted at 30 or 40 degrees,� he says. People tend to change position periodically while reading a book, and they glance up frequently while holding an infant. But mobile devices are typically held with the neck flexed forward at 60 degrees or greater, and many users, particularly teens, use them compulsively. The study reports that people spend an average of two to four hours a day with their heads tilted at a sharp angle over their smartphones, amounting to 700 to 1,400 hours a year.
To remedy the problem, Hansraj has a simple message: �Keep your head up.� While texting or scrolling, people should raise their mobile devices closer to their line of sight. The Text Neck Institute has developed the Text Neck Indicator, an interactive app that alerts users when their smartphones are held at an angle that puts them at risk for text neck ($2.99, available for Android; in development for iPhone).
Fishman also recommends that people take frequent breaks while using their mobile devices, as well as do exercises that strengthen muscles behind the neck and between the shoulder blades in order to increase endurance for holding the device properly.
He adds, �I�m an avid technology user � and I use it in the proper posture.�
Exercises To Ease The Strain Of �Text Neck�
If you�re not mindful of your body alignment, engaging with mobile devices for long periods of time can wreak havoc on your spine. This behavior can result in muscle strain, a straightening of the normal curvature of the cervical spine, disk compression, slipped disks, pinched nerves and arthritis. Here are some exercises that can help prevent and relieve �text neck�:
Neck Stretches
Increasing the range of motion in the neck keeps the cervical spine flexible and helps maintain its normal curvature. Gentle stretches relieve neck tension as well as lengthen muscles that may have shortened due to chronic poor posture.
First, relax your shoulders and nod your head �yes� and �no� slowly a few times. Then, holding one arm behind your back, grasp the side of your head with your opposite hand and press gently, tilting your head to the side until you feel a gentle stretch. Hold for 20 seconds. Next, tilt your chin up and hold for 20 seconds; tilt your chin down and hold for 20 seconds. Repeat on the other side.
Chest Opener
Expanding the chest muscles helps to counteract slumped posture.
Stand in a doorway with your arms held out from the body like a T, forearms resting on each doorjamb at a 90-degree angle to upper arms. Next, lean your body forward through the doorway, leading with your sternum until you feel a gentle stretch across your chest. Hold for 20 seconds. Now move your arms up the door jamb so they are positioned like a V and repeat the forward stretch, again holding for 20 seconds.
Shoulder, Upper Back & Neck Muscle Strengtheners
Strong muscles in the back of the neck and between the shoulder blades will support proper posture, preventing muscle strain and spinal degeneration. With more strength, you will be able to comfortably hold your mobile device in your line of sight without having to bend your neck forward and hunch over. Here are two exercises that help strengthen these postural support muscles:
Wall Angels
If you�ve ever made snow angels, you can use a similar movement to strengthen your shoulder muscles while standing against a wall. First, stand with your heels, back and head resting against a wall. Hold arms perpendicular to the body with the forearms pointing upward at a 90-degree angle to your upper arms. Press your shoulder blades back and down. Keeping your arms bent at a 90-degree angle, move them slowly overhead without letting them lift from the wall. Next, move arms slowly down until your upper arms touch the sides of your body. (Forearms are still perpendicular to upper arms, and shoulder blades are still locked down.) Do 12 repetitions.
Sky Diver
Lying face-down on a mat or other firm, comfortable surface, hold your arms straight over your head at an angle so your body forms the shape of a Y. Lift your upper torso from the mid-back, leading with your sternum and keeping your chin down so your neck is aligned with your spine. Hold for 30 seconds, then release. Next, still lying face-down, hold your arms straight out to the sides so your body forms the shape of a T. Rotate your arms so your thumbs are pointing skyward. Once again, lift your upper torso from the mid-back, leading with your sternum and keeping your chin down. While maintaining the upper body lift, pinch your shoulder blades together as you slowly lift and lower your arms for 12 repetitions.
Sourced through Scoop.it from: www.elpasochiropractorblog.com
Check out our sister site on upper back disorders.
Text neck is the term used to describe the neck pain and damage sustained from looking down at your cell phone, tablet, or other wireless devices too frequently and for too long.��For Answers to any questions you may have please call Dr. Jimenez at�915-850-0900
