Back Clinic Neck Treatment Team. Dr. Alex Jimenezs collection of neck pain articles contain a selection of medical conditions and/or injuries regarding symptoms surrounding the cervical spine. The neck is made up of various complex structures; bones, muscles, tendons, ligaments, nerves, and other types of tissues. When these structures are damaged or injured as a result of improper posture, osteoarthritis, or even whiplash, among other complications, the pain and discomfort an individual experiences can be impairing. Through chiropractic care, Dr. Jimenez explains how the use of spinal adjustments and manual manipulations focuses on the cervical spine can greatly help relieve the painful symptoms associated with neck issues. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
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.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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
It�s obvious that Posture has become the new buzzword surrounding physical health and wellbeing over the past few years. We don�t have to look very far to understand why. Though there are many potential causes for poor posture, there�s no doubt the most widespread cause of our current posture dilemma is a direct result of our obsession with and our dependence on mobile devices. Tablets, smartphones and other technologies are not only a luxury but a necessity in our day-to-day lives.
It�s nearly impossible to avoid the onslaught of news articles and video segments cautioning the public of the harmful effects of long-term mobile device use on spinal health. As a result, our patients (and potential patients) are becoming increasingly aware of this issue as well.
This is great awareness, right?
The media is doing the hard work for us by effectively and efficiently reaching millions of people currently affected �by this epidemic. Arming them with information and questions they need to ask their healthcare providers in order to work towards finding a solution to their problem.
Perfect. That�s us, right?
Now, all we have to do is deliver the correct treatment regimen and the patient walks out of our office with perfect posture, a smile and the quality of life they�ve always dreamed of. Well� Not so fast�
Where do I go from here? Spinal function or spinal structure?
Unfortunately, like most of you are probably thinking at this very moment, it�s not that simple. But, why not? Shouldn�t it be? At one point in our careers, likely as na�ve chiropractic students in our first few trimesters, fixing spines was the ideal we were all hoping to achieve when we became doctors. Then, something changed.
Let�s reflect for a moment on the core principle our great profession is built upon;
bone(s) out of place ? nerve interference ? dis-ease and dys-function
From a global spinal perspective, it looks like this;
cervical curve loss & forward head posture ? nerve interference
? dis-ease and dys-function
As a young student this principle offered our analytical minds an objective means of measuring our success as a future spine care specialist;
correct the abnormal structure ? improve nerve function ? maximize health potential
Unfortunately, we were never taught how to correct abnormal structure and as we continued through the �clinical� trimesters in school we heard less and less about the importance of spinal structure and the overwhelming focus began to land on spinal function. Confused, conflicted, yet anxiously awaiting our release into the real world, we then began to put less and less importance on spinal structure as well and we carried that philosophy with us to our clinical practices. Likely thinking, structural spinal correction was merely for theoretical discussion and not practical application in a clinical setting.
Herein lies a major conflict. The very principle we were taught as the foundation of our careers is now something most of us have been encouraged to disregard because it�s too difficult to achieve, it�s too time consuming, it�s not possible, etc., etc.
Putting more focus towards structural spinal correction is the way forward.
Fortunately for our patients and ourselves, the structure dictates function principle is still very alive and well within us and I believe the latest advancements in traction technology will allow us to incorporate this principle with each of our patients like never before.
Throughout the next 10 months I, along with a few special guest contributors, will be engaging and challenging doctors around the world to take the lead in their communities to begin changing people�s lives by integrating cervical curve remodeling and posture correction into their existing treatment protocols.
We will be using a variety of information disseminating platforms such as blogs, infographics and ebooks to share case studies. Also, treatment protocols and latest advancements in cervical spine remodeling devices will be put in place to demonstrate how quickly and easily cervical curve remodeling and posture correction can be integrated into your existing clinic(s).
We care about posture. We care about quality of life.
Our goal is to create a collaborative, productive discussion. We are taking the lead and fighting this posture epidemic in the communities we serve. I encourage you to reach out and share your questions and ideas with us.
By Dr. Alex Jimenez
Doctors of Chiropractic Offer Tips for Good Posture
Proper Posture has become a passing thing that is�no longer paid attention to. However, through proper posture people would not be in�pain or in some form of disablement. The time has come to bring proper posture awareness.
While automobile accidents are the most common cause of whiplash, it must be noted, that these aren�t the only possible incidents behind the well-known injury. Any type of accelerated motion which thrusts the head forward and then backwards with extreme force from the entire body can lead to whiplash. Accidents from sports can also cause whiplash-associated injuries but auto accidents are the most prevalent.
The unexpected jolt of the head can damage the complex structures of the cervical spine, leaving the tendons and ligaments within the neck intensely irritated and inflamed. Furthermore, the tendons and ligaments as well as other tissues of the neck may become overly stretched and torn.
A whiplash type injury may be suspected if the individual involved in an automobile accident experiences the following symptoms: neck pain and stiffness; worsening pain with movement; loss of range of motion in the neck; headaches, most often starting at the base of the skull; tenderness or pain in the shoulder, upper back or arms; tingling or numbness in the arms, fatigue and dizziness. Other individual�s may experience: blurred vision; ringing in the ears; sleep disturbances; irritability; difficulty concentrating; memory problems; and even depression. While these are some of the most common symptoms of whiplash, they may also suggest the presence of another type of injury or condition resulting from the automobile accident.
Thus, it�s essential to visit a qualified healthcare professional who can properly identify a whiplash injury and offer the required treatment to eliminate the resulting pain and symptoms.
Apart from assessing the doctor�s experience and qualifications, the victim of an automobile accident must primarily consider their geographical location and the type of insurance they are covered by when deciding on the type of doctor to visit following a whiplash type injury. Other factors that should influence the affected individual�s decision include whether they are represented by an attorney and whether they are living in a state where PIP, or personal injury protection, is mandatory.
Whiplash Specialists
A large number of people who�ve suffered injuries from auto accidents fail to receive the kind of medical care they require, occurring more frequently in the case of whiplash victims. It has been previously determined that the outcome of the patient�s rehabilitation depends on the type of doctor they receive care from.
Many individuals who�ve been involved in an automobile accident, regardless of the severity of the collision, will generally visit the emergency room, or ER, to have their injuries evaluated. The majority of ERs are designed to take patients out of life threatening situations. First, they immediately assess any visible injuries, such as open wounds and broken bones, treating them effectively on the spot. They may even prescribe medications to temporarily relieve the painful symptoms following a traffic collision. However, many victims are not treated for their whiplash injuries. The trained specialists from the ER, provide first-aid, X-rays and medications to remove individuals from life-threatening situations but they don�t readily treat soft-tissue injuries like whiplash. From there, patients are sent to see their primary care physician, or PCP, to assess the rest of their injuries, yet, they may still face hardships to finally receive the proper care they deserve for their injuries.
Primary Care Physicians and Whiplash
Unfortunately, many primary care physicians are not specifically qualified to treat automobile accident injuries and many of these may even deny patients treatment. For many years, whiplash-associated disorders have been misunderstood in the medical field. Many doctors believe whiplash is not a legitimate injury, however, those whom are suffering from whiplash can account for how painful it could really be.
Other doctors refuse treatment to whiplash patients because they may not accept any kind of 3rd party billing, a paying method where the doctor seeing the car accident victim has to bill the party at fault�s insurance company or utilize PIP or med pay to receive compensation.�This is a commonly well-known reason for denial of treatment as a large number of primary care physicians, or PCPs, still don�t have the required authorizations to accept 3rd party billing.
Besides primary care physicians, medical doctors, orthopedics, chiropractors and physical therapists are several types of qualified healthcare professionals that specialize on treating automobile accident injuries such as whiplash. Among these, chiropractic treatment is the most popular, alternative treatment option for treating various soft tissue injuries or conditions.
Chiropractic Care for Whiplash
A wide number of people belonging to the legal and medical industry will disregard the idea of visiting a chiropractor to treat auto injuries. However, the fact is that a chiropractors are some of the only doctors who offer therapeutic treatments to accident victims. Treatment offered by medical doctors might include the use of drugs, although in many cases, they may also recommend physical therapy. This automatically highlights the importance of chiropractic care for whiplash victims because chiropractic care and physical therapy are very similar forms of treatment.
Whenever an individual who�s been involved in an automobile accident visits a chiropractor and complains of pain in the neck, the medical specialist will carry out a series of tests to determine whether the patient has suffered whiplash. Instead of focusing solely on the specific injury, chiropractors are trained to inspect the affected individual�s entire spine. Aside from soft tissue injuries like whiplash, chiropractic doctors may also check for: disc trauma or injury, tightness or tenderness, restricted mobility, muscle spasms, joint injuries, ligament injuries, posture and spinal alignment. They may also analyze the patient�s gait.
Besides checking for the above, chiropractors might also request X-rays and MRI of the patient�s spine in order to find out whether the spine features any degenerative changes which might have developed before the accident. To offer the best possible treatment, it is extremely important to determine which problems existed prior to the accident and which ones resulted from the accident. In most cases, insurance companies may argue that every single injury in the victim�s body is preexisting. This makes the role of the chiropractor considerably important as they will make sure to document all the previous and new injuries separately to ensure the insurance company pays for the patient�s treatment. In addition, the evaluation performed by the chiropractor also allows them to create the most effective treatment plan for each individual whiplash victim.
Stages of Treatment
The primary concern for chiropractors treating individuals who�ve experienced whiplash-associated disorders involves alleviating the inflammation in the neck, one of the main sources of pain for victims. Chiropractors often recommend ice therapy, or the application of ice pack against the affected area, multiple times a day. This remedy is capable of reducing both pain and inflammation. Once the inflammation subsides, they often carry out a variety of manual therapeutic techniques to restore and increase the individual�s strength, flexibility and mobility.
The kind of chiropractic treatment the individual will require depends largely on the severity of the whiplash encountered. However, it has been previously determined that the majority of individual�s with whiplash find spinal manipulations useful. The most common chiropractic treatment techniques involve, spinal adjustments and manual manipulations, to carefully re-align the structures of the spine and help reduce symptoms. The following spinal techniques are also used to treat whiplash injuries:
Instrument-assisted, this treatment involves the use of handheld instruments to provide a gentle massage by applying force onto the spine without utilizing any kind of thrust. Instrument-assisted chiropractic therapy is used mostly to treat older patients with degenerative joints; flexion-distraction, this technique involves the use of a non-thrusting motions, best described as a slow pumping action; specific spinal manipulation, this therapy involves the use of a mild thrusting technique and is mostly used for restoring motion to the affected joints. Specific spinal manipulation helps stretch the soft tissues, which makes the job of restoring motion to the affected areas of the spine easier; instrument-assisted chiropractic therapy, also known as the Graston Technique, is used during this form of chiropractic therapy to perform repetitive strokes on the injured body part; therapeutic massage, performed to ease muscle tension and stress in the injured region; interferential electrical stimulation, where a patient undergoing this type of therapy will see the chiropractor passing electrical current at a very low frequency through their body. This low frequency current helps stimulate the muscles and reduces inflammation; trigger point therapies, as the name suggests, involves the application of direct pressure onto specific points to alleviating muscle tension; and finally ultrasound therapy, capable of decreasing stiffness, pain, and muscle spasms in the affected areas. When ultrasound is passed through the patient�s muscle tissues, it warms up the treated region and increases blood circulation.
Neck Pain and Auto Injury
Chiropractic Recovery
Ultimately, chiropractors can help victims of whiplash in many ways. These health care providers can ensure that an individual� whiplash and its associated symptoms may subside completely. They always make sure to create a patient-specific treatment plan to make the process of recovery simpler for every individual.
Other than recommending immediate treatment for reducing the acute pain and inflammation, the chiropractor might additionally recommend a series of stretches and exercises, to help speed up the rehabilitation process as well as help increase the individual�s strength, flexibility and mobility.
Whiplash injuries, when left untreated, can cause severe complications. If you or a loved one have been involved in an automobile accident, visit a chiropractor immediately. By being prompt, you can even reduce your recovery time significantly. That�s not all; the chiropractor will also provide the required assistance to your lawyer, proving that the injury resulting from the accident wasn�t a preexisting injury or condition.
When you are injured in a car accident, you must get acquainted with your rights as soon as possible to receive the proper compensation and treatment for your specific situation. There is no such thing as a simple car crash.
Certain injuries or conditions which may have developed following an automobile accident may become chronic or permanent if left untreated. If an individual is experiencing neck stiffness or headaches after a traffic collision, it�s absolutely wrong to assume that this will subside in a few days. A minor discomfort could turn out to be a more serious complication. Often, people injured in auto accidents develop scar tissue that remains with them throughout the rest of their lives and without the necessary treatments or exercises, these can become stiff and greatly limit an individual�s ability to move properly. The above issues generating from a car accident show how important it is for people to seek immediate legal and medical help. Chiropractors are known for their expertise in managing soft tissue injuries and the resulting chronic and traumatic pain; as a result, they are often considered to be the best healthcare professionals to consult after a car accident.
Symptoms of neck pain that radiate to the shoulders and down the arms can be caused due to a variety of injuries and conditions, most occurring as the result of complications to the cervical spine and its surrounding structures. A subluxation, or spinal misalignment is one of the most common results of neck and back pain, however, the gradual degeneration of the spine can also create issues over time if not treated accordingly.
A cervical disc herniation is a frequent complication caused by the wear and tear of the tissues around the cervical spine, primarily a degeneration of the discs found cushioning each vertebra of the spine. This condition originates in the upper spine and can generally be referred to as a pinched nerve, ruptured disc or a herniated disc.
Anatomy of the Cervical Spine
The upper region of the spine is commonly described and identified by healthcare professionals as the cervical spine, which primarily functions to support the weight and movement of the head. The cervical spine is made up of seven vertebrae, from top to bottom, C1 through C7. Each vertebrae in the neck is separated by intervertebral discs which consist of a fibrous tissue, known as the annulus, with a soft nucleus at the center. The annulus and the nucleus that make up each disc function simultaneously to provide each vertebra of the spine to absorb the shock of every movement of the spine as well as help the pressure of these be distributed evenly, separating each vertebrae individually to allow smooth movements.
However, when the annulus of one of these intervertebral discs ruptures, the nucleus can occasionally separate from the center of the disc. If this occurs, the disc is no longer able to properly separate the vertebrae as this process alters the natural shape of the discs, which could often lead to the compression and irritation of the spinal nerves. The symptoms of pain, discomfort and numbness experienced in the neck, shoulders and arms can be closely associated with the compression and irritation of the nerves surrounding the cervical herniated disc.
Causes of Cervical Disc Herniation
The gradual degeneration of the different structures of the body which occurs naturally over time is one of the most common causes of cervical disc herniations, although, these can generally develop until a person is in his 40�s. Other causes for cervical disc herniation includes trauma from improperly lifting heavy objects, equipment or machinery or from other physical activities such as an abrupt, intense twist. Additionally, cervical spine complications may be caused due to damage or injury resulting from an automobile accident or other personal injury accident.
Whiplash is a common injury caused due to the sudden force of an impact, which results in the jolting, back-and-forth motion of the head and neck in any direction, most commonly due to an auto collision. During a whiplash-associated injury, the structures that surround the cervical spine, primarily the tendons, ligaments and nerves, are stretched beyond their natural limit, partially or completely tearing the tissues around the cervical spine. Furthermore, the normal alignment of the spine may be affected, causing a subluxation in the vertebrae of the neck.
As a result, the intervertebral discs found between each vertebrae can become ruptured, leading to the compression or irritation of the spinal nerves, causing symptoms of pain and discomfort, among others, associated with a cervical disc herniation.
Symptoms of Cervical Disc Herniation
Cervical disc herniation could be the cause of an individual�s painful symptoms in their neck, shoulders, and/or arms. The following symptoms could suggest the presence of a cervical disc herniation, however, it�s essential to visit a healthcare professional to receive a proper diagnosis and similar symptoms could suggest the presence of another injury or condition.
Pain, discomfort, or burning sensations originating from the neck and traveling down one or both arms;
Pain with movements of the head or neck;
Pain in the shoulder region;
Tingling or numbness in one or both arms;
Weakness in one or both arms;
Limited mobility or difficulty properly moving the neck, arms or hands;
Difficulty sleeping due to neck, shoulder and/or arm pain.
Diagnosing Cervical Disc Herniation
Your healthcare provider should be able to properly refer you to the best doctors and specialists in the region to properly diagnose your injuries and/or conditions before following through with treatment. Chiropractic care is a common, alternative treatment options that is preferred by many individuals with spine complications. Chiropractic specialized on the diagnosis and treatment of injuries and conditions associated to the musculoskeletal and nervous systems.
Foremost, when visiting a chiropractic office, the chiropractor will perform a thorough physical evaluation to determine the exact cause of the symptoms. In addition, the spine specialist may also take a closer look at the individual�s medical history, including previous test results and prior doctor visits. If necessary, the doctor of chiropractic may issue additional tests if necessary, including X-rays and MRI scans. Once the healthcare professional has concluded the diagnosis and has resolved the source of the symptoms, they will provide the patient with information regarding their injury or condition as well as cover the risks and benefits of each treatment option which may be available to the individual. The chiropractor will determine the individual�s best treatment options according to their specific type of injury or condition and depending on their severity.
Chiropractic Care for Cervical Disc Herniation
Chiropractic treatment utilizes spinal adjustments and manual manipulations to carefully restore the natural alignment of the spine, gradually re-aligning the vertebrae to reduce the pressure being applied against each structure. Chiropractic adjustments and manipulations can ultimately help decrease the compression and irritation of the spinal nerves, relieving the symptoms associated with cervical disc herniation. Subsequently, by reducing the individual�s pain and discomfort, their original strength, flexibility and mobility may also be gradually restores, helping them return to their normal lifestyles in no time.
Additionally, a chiropractor may recommend a series of stretches and exercises to speed up the rehabilitation process. Also, certain lifestyle changes may be implemented to ensure the recovery process proceeds smoothly without further issues. Physical therapy can also be an excellent treatment option to provide the patient with the necessary strength, flexibility and mobility to regain their original way of life.
In conclusion, in the instance that the individual is in need of further treatment through the use of other medical procedures, a chiropractor may refer the individual to other spine specialists that can provide other beneficial treatments and curative methods. In severe cases of cervical disc herniation, a patient may be referred to a spinal surgeon for treatment.
Chiropractic Care and Headaches
Complications affecting the cervical spine, such as a cervical disc herniation, can develop a variety of other symptoms, including headaches. Constant head pain can source from many types of issues along the upper region of the spine, commonly manifesting after an automobile accident or other form or personal injury accident. Fortunately, chiropractic treatment can help restore the original function of the structures surrounding the cervical spine, decreasing the symptoms, including headaches, improving the individual’s lifestyle.
For more information, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Neck Pain and Auto Injury
After being involved in an automobile accident, the tremendous force of the impact can cause damage or injury to the body, primarily to the structures surrounding the spine. Whiplash is a common result of an auto collision, affecting the bones, muscles, tendons, ligaments and other tissues around it, causing symptoms such as neck pain. Neck pain is a common symptom after an automobile accident, which may require immediate medical attention to determine its source and follow up with the appropriate treatment.
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