Back Clinic Chiropractic Neck Pain Treatment Team. Dr. Alex Jimenez’s collection of neck pain articles cover an assortment of medical conditions and/or injuries pertaining to pain and other symptoms surrounding the cervical spine. The neck consists of various complex structures; bones, muscles, tendons, ligaments, nerves, and other 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 individual experiences can be debilitating.
Depending on the underlying cause, neck pain symptoms can take on many different forms. They include:
Pain when holding your head in one place for long periods of time
Inability to move your head freely
Muscle tightness
Muscle spasms
Headache
Frequent cracking and crunching
Numbness and nerve pain radiating from the neck down to the upper arm and hand
Through chiropractic care, Dr. Jimenez explains how the use of manual adjustments to 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.
TMJ dysfunction: The temporomandibular joints, TMJ, are the lower jaw hinges that sit on either side of the head in front of each ear. They are responsible for the lower jaw opening, closing, sliding, and rotating. The TMJs are the most body�s most complex joints. The typical person uses them more than 5,000 times a day by talking, laughing, yawning, chewing, eating, smiling, and swallowing.
What Is TMJ Dysfunction?
TMJ dysfunction occurs when one or both joints become inflamed or injured causing pain and immobility in the jaw area. Because these joints are used so often and tend to be far more mobile than most other joints in the body, they can be prone to pain.
It is important that both joints work together because if they don�t it could result in more pressure on one joint than the other and this could cause the pain and discomfort that is associated with TMJ dysfunction.
What Are The Symptoms Of TMJ Dysfunction?
There are many symptoms of TMJ dysfunction and they may vary depending on the patient, the extent of inflammation or injury, and the cause of the dysfunction. The symptoms may appear suddenly when there is injury to the joint, or they can gradually develop over a period of months or even years. They may be mild and barely noticeable or they can be severe and debilitating. The most common symptoms of TMJ dysfunction include:
Jaw pain
Jaw pain when moving the joint such as chewing or talking
Popping or clicking of the joint
Pain in the face or side of the neck
Locking jaw
Headaches
Toothache
Earache
Clogged or �stopped up� ear
Ringing in the ears (tinnitus)
TMJ dysfunction can significantly impact a person�s quality of life because the pain prevents them from doing many things they normally do, and often the jaw itself simply no longer functions as it should.
What Causes TMJ Dysfunction?
Damage to the joint is the primary cause of pain associated with TMJ dysfunction. This can be the result of trauma such as:
Subtle movements done repetitively can also cause TMJ dysfunction:
Grinding teeth
Holding a phone between the head and shoulder
Clenching teeth
Nail biting
Gum chewing (excessive)
Eating hard or tough foods
How Can Upper Neck Misalignment Cause TMJ Dysfunction?
When the upper neck sustains trauma such as whiplash it can cause a misalignment. This can also cause TMJ dysfunction in a couple of ways. It can cause one side to work harder or sustain more pressure than the other, or it can put excess pressure on the trigeminal nerve. This causes irritation and inflammation.
When left untreated, the condition can become severe. The misalignment keeps the joints from working as they should because opening and closing the jaw pinches the disc. This results in painful spasms in the shoulder and neck muscles when the patient does simple, everyday activities like talking, smiling, eating, or laughing.
Chiropractic For TMJ Dysfunction
Chiropractic can be a very effective treatment for TMJ dysfunction, especially if it is due to neck misalignment. A chiropractor will perform spinal adjustments in order to realign the spine and neck, bringing the body back into balance. This will allow the jaw to work as it should, minimizing rubbing or friction in the joint.
The patient may also be told to apply heat, massage, and do special exercises for TMJ dysfunction that will help the joints heal and help to minimize the pain.
This condition is not always easy to diagnose so it is wise to talk to your chiropractor and get a diagnosis before attempting any treatment or home remedies for TMJ. Regular chiropractic treatment can not only relieve the pain of TMJ and help to heal it, it can also help prevent it. Your chiropractor can be a great ally in this endeavor.
Injury Medical Clinic: Shoulder Pain Chiropractic Treatment
Many headaches that people classify as migraines are actually not migraines at all. Two of the most common headaches confused with migraines are sinus headaches and occipital neuralgia.
The condition can be debilitating but there are treatments, including chiropractic, that are very effective. Understanding occipital neuralgia can help patients better manage it so they can minimize the pain and symptoms of the condition.
What Is Occipital Neuralgia?
Occipital neuralgia is a neurological condition that affects the occipital nerves which run from the top portion of the spinal cord, through the scalp, transmitting messages to and from the brain. There are two greater occipital nerves, one on each side of the head, from between the vertebrae located in the upper neck through the muscles that are located at the base of the skull and back of the head.
While they do not cover the areas on or near the ears or over the face, they can extend over the scalp as far as the forehead. When those nerves are injured or become inflamed, occipital neuralgia is the result. A person with this condition may experience pain at the base of their skull or the back of their head.
What Are The Symptoms Of Occipital Neuralgia?
Pain is the prevalent symptom of occipital neuralgia. It often mimics the pain of migraine headaches or cluster headaches and is described as throbbing, burning, and aching.
There may also be intermittent shooting or shocking pain. Typically, the pain begins at the base of the skull but may radiate along the side of the scalp or in the back of the head. Other symptoms include:
Pain is experienced on one side (but sometimes both sides)
Pain behind the eye of the side that is affected
Tenderness in the scalp
Sensitivity to light
Pain triggered by neck movement
What Causes Occipital Neuralgia?
Irritation or pressure to the occipital nerves are what actually cause the pain. This may be due to tight muscles in the neck that squeeze or trap the nerves, injury, or inflammation.
However, much of the time doctors are unable to determine the cause. There are several medical conditions linked to occipital neuralgia:
Tight neck muscles
Diabetes
Trauma or injury to the back of the head
Gout
Tension in the neck muscles
Whiplash
Inflammation of the blood vessels in and around the neck
Infection
Neck tumors
Cervical disc disease
Osteoarthritis
What Are The Treatments For Occipital Neuralgia?
Occipital neuralgia treatment focuses on pain relief. It often begins with conservative treatments that include:
In more severe cases the patient may be prescribed a stronger anti-inflammatory medication, muscle relaxants or in some cases an anticonvulsant medication.
If these therapies are not effective or do not bring about the desired level of pain relief, then doctors may recommend percutaneous nerve blocks and steroids. Sometimes surgery is recommended in cases where the pain is severe, chronic, and is unresponsive to more conservative treatments.
Chiropractic For Occipital Neuralgia
Chiropractic was once considered an �alternative� treatment for occipital neuralgia, but now it is often a regular part of recommended patient care. The advantage of chiropractic over medication or surgery is that chiropractic does not come with the side effects of drugs or the risks of surgery.
Another advantage is that chiropractic seeks to correct the root of the problem, not just manage the pain like other treatments.
Chiropractic treatment for occipital neuralgia may include lift adjustments, heat, massage, and traction. This will bring the body back into proper alignment and take the pressure off of the nerves as it loosens the neck muscles.
The patient stands a better chance of staying pain free when taking this treatment route.
Injury Medical Clinic: Doctor Of Chiropractic Near Me
The spine is made of bones called vertebrae, with the spinal cord running through the spinal canal in the center. The cord is made up of nerves. These nerve roots split from the cord and travel between the vertebrae into various areas of the body. When these nerve roots become pinched or damaged, the symptoms that follow are known as, radiculopathy. El Paso, TX. Chiropractor, Dr. Alexander Jimenez breaks down�radiculopathies,�along with their causes, symptoms and treatment.
The entire length of the spine, at each level, nerves exit through holes in the bone of the spine (foramen) on each side of the spinal column. These nerves are called nerve roots, or radicular nerves and�branch out from the spine and supply different parts of the body.
Nerves exiting the cervical spine travel down through the arms, hands, and fingers. This is where neck problems affecting a cervical nerve root can cause pain, as well as, other symptoms through the arms and hands, one form of (radiculopathy). Another is low back problems that affect a lumbar nerve root. This can radiate through the leg and into the foot, another form of (radiculopathy, or sciatica), which creates leg pain and/or foot pain.
The spinal cord does not go into the lumbar spine and because the spinal canal has space in the lower back, problems in the lumbosacral region often cause nerve root problems and not a spinal cord injury. Serious conditions i.e. disc herniation or fracture in the lower back are also not likely to cause permanent loss of motor function in the legs.
Cervical Spine – This nerve root is named according to the Lower spinal segment that the nerve root runs between.�
Example – The nerve at C5-C6 level is called the C6 nerve root.
It’s named like this because as it exits the spine, it passes Over the C6 pedicle (a piece of bone part of the spinal segment).
Lumbar Spine – These nerve roots are named according to the Upper spinal segment that the nerve runs between.
Example – The nerve at L4-L5 level is called the L4 nerve root.
The nerve root is named this way because as it exits the spine it passes Under the L4 pedicle.
Two Nerve Roots
Two nerves cross each disc level
Only one exits�the spine (through the foramen) at that level.
Exiting Nerve Root –�This is the nerve root exiting the spine at a certain level.
Example: L4 nerve root exits the spine at L4-L5 level.
Traversing Nerve Root –�This nerve root goes across the disc and exits the spine at the level below.
Example: L5 nerve is the traversing nerve root at L4-L5 level, and is the exiting nerve root at L5-S1 level.
There is some confusion when a nerve root is compressed by disc herniation or other cause to refer both to the intervertebral level (where the disc is) and to the nerve root that is affected. This depends on where the disc herniation or protrusion is happening. It could impinge upon either the exiting nerve�or the traversing nerve.
If The Traversing Nerve Is Affected
Lumbar Radiculopathy
In the lumbar spine, there is a weak area in the disc space right in front of the traversing nerve root, so lumbar discs tend to herniate or leak out and impinge on the traversing nerve.
If The Exiting Nerve Is Affected
Cervical Radiculopathy
The opposite is true in the neck. In the cervical spine, the disc tends to herniate to the side, rather than toward the back and the side. If the disc material herniates to the side, it will compress or impinge the exiting nerve root.
Radiculopathy & Sciatica
Nerve root goes by another name Radicular Nerve, and when a herniated or prolapsed disc presses on a radicular nerve, this is referred to as a radiculopathy. A medical physician might say there is herniated disc at L4-L5, which creates an L5 radiculopathy or an L4 radiculopathy. It all depends on where the disc herniation occurs (the side or the back of the disc) and which nerve is affected. And the term for radiculopathy in the low back is the ever famous Sciatica.
Radiculopathy
A pinched nerve can occur at different areas of the spine (cervical, thoracic or lumbar).
Common causes are narrowing of the hole where the� nerve roots exit, which can result from stenosis, bone spurs, disc herniation and other conditions.
Symptoms vary but often include pain, weakness, numbness and tingling.
Symptoms can be managed with nonsurgical treatment, but minimal surgery can also help.
Prevalence & Pathogenesis
A herniated disc can be defined as herniation of the nucleus pulposus through the fibers of the annulus fibrosus.
Most disc ruptures occur during the third and fourth decades of life while the nucleus pulposus is still gelatinous.
The most likely time of day associated with increased force on the disc is the morning.
In the lumbar region, perforations usually arise through a defect just lateral to the posterior midline, where the posterior longitudinal ligament is weakest.
Epidemology
Lumbar Spine:
Symptomatic lumbar disc herniation occurs during the lifetime of approximately 2% of the general population.
Approximately 80% of the population will experience significant back pain during the course of a herniated disc.
The groups at greatest risk for herniation of intervertebral discs are younger individuals (mean age of 35 years)
True sciatica actually develops in only 35% of patients with disc herniation.
Not infrequently, sciatica develops 6 to 10 years after the onset of low back pain.
The period of localized back pain may correspond to repeated damage to annular fibers that irritates the sinuvertebral nerve but does not result in disc herniation.
Epidemology
Cervical Spine:
The average annual incidence of cervical radiculopathies is less than 0.1 per 1000 individuals.
Pure soft disc herniations are less common than hard disc abnormalities (spondylosis) as a cause of radicular arm pain.
In a study of 395 patients with nerve root abnormalities, radiculopathies occurred in the cervical and lumbar spine in 93 (24%) and 302 (76%), respectively.
Pathogenesis
Alterations in intervertebral disc biomechanics and biochemistry over time have a detrimental effect on disc function.
The disc is less able to work as a spacer between vertebral bodies or as a universal joint.
Pathogenesis – LUMBAR SPINE
The two most common levels for disc herniation are L4-L5 and L5-S1, which account for 98% of lesions; pathology can occur at L2-L3 and L3-L4 but is relatively uncommon.
Overall, 90% of disc herniations are at the L4-L5 and L5-S1 levels.
Disc herniations at L5-S1 will usually compromise the first sacral nerve root, a lesion at the L4-L5 level will most often compress the fifth lumbar root, and herniation at L3-L4 more frequently involves the fourth lumbar root.
Disc herniation may also develop in older patients.
Disc tissue that causes compression in elderly patients is composed of the annulus fibrosus and and portions of the cartilaginous endplate (hard disc.)
The cartilage is avulsed from the vertebral body.
Resolution of some of the compressive effects on neural structures requires resorption of the nucleus pulposus.
Disc resorption is part of the natural healing process associated with disc herniation.
The enhanced ability to resorb discs has the potential for resolving clinical symptoms more rapidly.
Resorption of herniated disc material is associated with a marked increase in infiltrating macrophages and the production of matrix metalloproteinases (MMPs) 3 and 7.
Nerlich and associates identified the origins of phagocytic cells in degenerated intervertebral discs.
The investigation identified cells that are transformed local cells rather than invaded macrophages.
Degenerative discs contain the cells that add to their continued dissolution.
Pathogenesis – CERVICAL SPINE
In the early 1940s, a number of reports appeared in which cervical intervertebral disc herniation with radiculopathies was described.
There is a direct correlation between the anatomy of the cervical spine and the location and pathophysiology of disc lesion.
The eight cervical nerve roots exit via intervertebral foramina that are bordered anteromedially by the intervertebral disc and posterolaterally by the zygapophyseal joint.
The foramina are largest at C2-C3 and decrease in size until C6-C7.
The nerve root occupies 25% to 33% of the volume of the foramen.
The C1 root exits between the occiput and the atlas (C1)
All lower roots exit above their corresponding cervical vertebrae (the C6 root at the C5-C6 interspace), except C8, which exits between C7 and T1.
A differential growth rate affects the relationship of the spinal cord and nerve roots and the cervical spine.
Most acute disc herniations occur posterolaterally and in patients around the forth decade of life, when the nucleus is still gelatinous.
The most common areas of disc herniations are C6-C7 and C5-C6.
C7-T1 and C3-C4 disc herniations are infrequent ( less than 15 %).
Disc herniation of C2-C3 is rare.
Patients with upper cervical disc protrusions in the C2-C3 region have symptoms that include suboccipital pain, loss of hand dexterity, and paresthesias over the face and unilateral arm.
Unlike lumbar herniated discs, cervical herniated discs may cause myelopathy in addition to radicular pain because of the anatomy of the spinal cord in the cervical region.
The uncovertebral prominences play a role in the location of ruptured discs material.
The uncovertebral joint tends to guide extruded disc material medially, where cord compression may also occur.
Disc herniations usually affect the nerve root numbered most caudally for the given disc level; for example, the C3 � C4 disc affects the fourth cervical nerve root; C4- C5, the fifth cervical nerve root; C5 � C6, the sixth cervical nerve root; C6 � C7, the seventh cervical nerve root; and C7 � T1, the eighth cervical nerve root.
Not every herniated disc is symptomatic.
The development of symptoms depends on the reserve capacity of the spinal canal, the presence of inflammation, the size of the herniation, and the presence of concomitant disease such as osteophyte formation.
In disc rupture, protrusion of nuclear material results in tension on the annular fibers and compress?on of the dura or nerve root causing pain.
Also important is the smaller size of the sagittal diameter, the bony cervical spinal canal.
Individuals in whom a cervical herniated disc causes motor dysfunction have a complication of cervical disc herniation if the spinal canal is stenotic.
Clinical History – LUMBAR SPINE
Clinically, the patient�s major complaint is a sharp, lancinating pain.
In many cases there may be a previous history of intermittent episodes of localized low back pain.
The pain not only in the back but also radiates down the leg in the anatomic distribution of the affected nerve root.
It will usually be described as deep and sharp and progressing from above downward in the involved leg.
Its onset may be insidious or sudden and associated with a tearing or snapping sensations of the spine.
Occasionally, when sciatica develops, the back pain may resolve because once the annulus has ruptured, it may no longer be under tension.
Disc herniation occurs with sudden physical effort when the trunk is flexed or rotated.
On occasion, patients with L4-L5 disc herniation have groin pain. In a study of 512 lumbar disc patients, 4.1% had groin pain.
Finally, the sciatica may vary in intensity; it may be so severe that patients will be unable to ambulate and they will feel that their back is “locked”.
On the other hand, the pain may be limited to a dull ache that increases in intensity with ambulation.
Pain is worsened in the flexed position and relieved by extension of the lumbar spine.
Characteristically, patients with herniated discs have increased pain with sitting, driving, walking, couching, sneezing, or straining.
Clinical History – CERVICAL SPINE
Arm pain, not neck pain, is the patient� s major complaint.
The pain is often perceived as starting in the neck area and then radiating from this point down to shoulder, arm and forearm and usually into the hand.
The onset of the radicular pain is often gradual, although it can be sudden and occur in association with a tearing or snapping sensation.
As time passes, the magnitude of the arm pain clearly exceeds that of the neck or shoulder pain.
The arm pain may also be variable in intensity and preclude any use of the arm; it may range from severe pain to a dull, cramping ache in the arm muscles.
The pain is usually severe enough to awaken the patient at night.
Additionally, a patient may complain of associated headaches as well as muscle spasm, which can radiate from the cervical spine to below the scapulae.
The pain may also radiate to the chest and mimic angina (pseudoangina) or to the breast.
Symptoms such as back pain, leg pain, leg weakness, gait disturbance, or incontinence suggest compression of the spinal cord (Myelopathy).
Physical Examination – LUMBAR SPINE
Physical examination will demonstrated a decrease in range of motion of the lumbosacral spine, and patients may list to one side as they try to bend forward.
The side of the disc herniation typically corresponds to the location of the scoliotic list.
However, the specific level or degree of herniation does not correlate with the degree of list.
On ambulation, patients walk with an antalgic gait in which they hold the involved leg flexed so that they put as little weight as possible on the extremity.
Neurologic Examination:
The neurologic examination is very important and may yield objective evidence of nerve root compression (We should evaluate of reflex testing, muscle power, and sensation examination of the patient).
In addition, a nerve deficit may have little temporal relevance because it may be related to a previous attack at a different level.
Compression of individual spinal nerve roots results in alterations in motor, sensory, and reflex function.
When the first sacral root is compressed, the patient may have gastrocnemius-soleus weakness and be unable to repeatedly raise up on the toes of that foot.
Atrophy of the calf may be apperent, and the ankle (Achilles) reflex is often diminished or absent.
Sensory loss, if present, is usually confined to the posterior aspect of the calf and the lateral side of the foot.
Involvement of the fifth lumbar nerve root can lead to weakness in extension of the great toe and, in a few cases, weakness of the everters and dorsiflexors of the foot.
A sensory deficit can appear over the anterior of the leg and the dorsomedial aspect of the foot down to the big toe
With compression of the fourth lumbar nerve root, the quadriceps muscle is affected; the patient may note weakness in knee extension, which is often associated with instability.
Atrophy of the thigh musculature can be marked. Sensory loss may be apparent over the anteromedial aspect of the thigh, and the patellar tendon reflex can be diminished.
Nerve root sensitivity can be elicited by any method that creates tension.
The straight leg-raising (SLR)test is the one most commonly used.
This test is performed with the patient supine.
Physical Examination – CERVICAL SPINE
Neurologic Examination:
A neurologic examination that shows abnormalities is the most helpful aspect of the diagnostic work-up, although the examination may remain normal despite a chronic radicular pattern.
The presence of atrophy helps document the location of the lesion, as well as its chronicity.
The presence of subjective sensory changes is often difficult to interpret and requires a coherent and cooperative patient to be of clinical value.
When the third cervical root is compressed, no reflex change and motor weakness can be identified.
The pain radiates to the back of the neck and toward the mastoid process and pinna of the ear.
Involvement of the fourth cervical nerve root leads to no readily detectable reflex changes or motor weakness.
The pain radiates to the back of the neck and superior aspect of the scapula.
Occasionally, the pain radiates to the anterior chest wall.
The pain is often exacerbated by neck extension.
Unlike the third and the fourth cervical nerve roots, the fifth through eighth cervical nerve roots have motor functions.
Compression of the fifth cervical nerve root is characterized by weakness of shoulder abduction, usually above 90 degree, and weakness of shoulder extension.
The biceps reflexes are often depressed and the pain radiates from the side of the neck to the top of the shoulder.
Decreased sensation is often noted in the lateral aspect of the deltoid, which represents the autonomous area of the axillary nerve.
Involvement of the sixth cervical nerve root produces biceps muscles weakness as well as diminished brachioradial reflex.
The pain again radiates from the neck down the lateral aspect of the arm and forearm to the radial side of hand (index finger, long finger, and thumb).
Numbness occurs occasionally in the tip of the index finger, the autonomous area of the sixth cervical nerve root.
Compression of the seventh cervical nerve root produces reflex changes in the triceps jerk test with associated loss of strength in the triceps muscles, which extend the elbow.
The pain from this lesion radiates from the lateral aspect of the neck down the middle of the area to the middle finger.
Sensory changes occur often in the tip of the middle finger, the autonomous area for the seventh nerve.
Patients should also be tested for scapular winging, which may occur with C6 or C7 radiculopathies.
Finally, involvement of the eighth cervical nerve root by a herniated C7-T1 disc produces significant weakness of the intrinsic musculature of the hand.
Such involvement can lead to rapid atrophy of the interosseous muscles because of the small size of these muscles.
Loss of the interossei leads to significant loss of fine hand motion.
No reflexes are easily found, although the flexor carpi ulnaris reflex may be decreased.
The radicular pain from the eighth cervical nerve root radiates to the ulnar border the hand and the ring and little fingers.
The tip of the little finger often demonstrates diminished sensation.
Radicular pain secondary to a herniated cervical disc may be relieved by abduction of the affected arm.
Although these signs are helpful when present, their absence alone does not rule out a nerve root lesion.
Laboratory Data
Medical screening laboratory test (blood counts, chemistry panels erythrocyte sedimentation rate [ESR]) are normal in patients with a herniated disc.
Electro diagnostic Testing
Electromyography(EMG)is an electronic extension of the physical examination.
The primary use of EMG is to diagnose radiculopathies in cases of questionable neurologic origin.
EMG findings may be positive in patients with nerve root impingement.
Radiographic Evaluation – LUMBAR SPINE
Plain x-rays may be entirely normal in a patient with signs and symptoms of nerve root impingement.
Computed Tomography
Radigraphic evaluation by CT scan may demonstrate disc bulging but may not correlate with the level of nerve damage.
Magnetic Resonance Imaging
MR imaging also allows visualization of soft tissues, including discs in the lumbar spine.
Herniated discs are easily detected with MR evaluation.
MR imaging is a sensitive technique for the detection of far lateral and anterior disc herniations.
Radiographic Evaluation – CERVICAL SPINE
X-rays
Plain x-rays may be entirely normal in patients wit han acute herniated cervical disc.
Conversely,�70% of asymptomatic women and 95% of asymptomatic men between the ages of 60 and 65 years have evidence of degenerative disc disease on plain roentgenograms.
Views to be obtained include anteroposterior, lateral, flexion, and extension.
Computed Tomography
CT permits direct visualization of compression of neural structures and is therefore more precise than myelography.
Advantages of CT over myelography include better visualization of lateral abnormalities such as foraminal stenosis and abnormalities caudal to the myelographic block, less radiation exposure, and no hospitalization.
Magnetic Resonance
MRI allows excellent visualization of soft tissues, including herniated discs in the cervical spine.
The test is noninvasive.
In a study of 34 patients with cervical lesions, MRI predicted 88% of the surgically proven lesions versus 81% for myelography-CT, 58% for myelography, and 50% for CT alone.
Differential Diagnosis – LUMBAR SPINE
The initial diagnosis of a herniated disc is ordinarily made on the basis of the history and physical examination.
Plain radiographs of the lumbosacral spine will rarely add to the diagnosis but should be obtained to help rule out other causes of pain such as infection or tumor.
Other tests such as MR, CT, and myelography are confirmatory by nature and can be misleading when used as screening tests.
Spinal Stenosis
Patient with spinal stenosis may also suffer from back pain that radiates to the lower extremities.
Patients with spinal stenosis tend to be older than those in whom herniated discs develop.
Characteristically, patients with spinal stenosis experience lower extremity pain (pseudoclaudication=neurogenic claudication) after walking for an unspecified distance.
They also complain of pain that is exacerbated by standing or extending the spine.
Radiographic evaluation is usually helpful in differentiating individuals with disc herniation from those with bony hypertrophy associated with spinal stenosis.
In a study of 1,293 patients, lateral spinal stenosis and herniated intervertebral discs coexisted in 17.7% of individuals.
Radicular pain may be caused by more than one pathologic process in an individual.
Facet Syndrome
Facet syndrome is another cause of low back pain that may be associated with radiation of pain to structures outside the confines of the lumbosacral spine.
Degeneration of articular structures in the facet joint causes pain to develop.
In most circumstances, the pain is localized over the area of the affected joint and is aggravated by extension of the spine (standing).
A deep , ill-defined, aching discomfort may also be noted in the sacroiliac joint, the buttocks, and the legs.
The areas of sclerotome affected show the same embryonic origin as the degenerated facet joint.
Patients with pain secondary to facet joint disease may have relief of symptoms with apophyseal injection of a long-acting local anesthetic.
The true role of facet joint disease in the production of back and leg pain remains to be determined.
Other mechanical causes of sciatica include congentenial abnormalites of the lumbar nerve roots, external compression of the sciatic nerve (wallet in a back pants pocket), and muscular compression of the nerve (piriformis syndrome).
In rare circumstances, cervical or thoracic lesion should be considered if the lumbar spine is clear of abnormalities.
Medical causes of sciatica (neural tumors or infections, for example) are usually associated with systemic symptoms in addition to nerve pain in a sciatic distribution.
Differential Diagnosis – CERVICAL SPINE
No diagnostic criteria exist for the clinical diagnosis of a herniated cervical disc.
The provisional diagnosis of a herniated cervical disc is made by the history and physical examination.
The plain x-ray is usually nondiagnostic, although occasionally disc space narrowing at the suspected interspace or foraminal narrowing on oblique films is seen.
The value of x-rays is to exclude other causes of neck and arm pain, such as infection and tumor.
MR imaging and CT-myelography are the best confirmatory examinations for disc herniation.
Cervical disc herniations may affect structures other than nerve roots.
Disc herniation may cause vessel compression (vertebral artery) associated with vertebrobasilar artery insufficiency and be manifested as blurred vision and dizziness.
Other mechanical causes of arm pain should be excluded.
The most common is some form of compression on a peripheral nerve.
Such compression can occur at the elbow, forearm, or wrist. An example is compression of the median nerve by the carpal ligament leading to carpal tunnel syndrome.
The best diagnostic test to rule out these peripheral neuropathies is EMG.
Excessive traction on the arm secondary to heavy weights may cause radicular pain without disc compression of nerve roots.
Spinal cord abnormalities must be considered if signs of myelopathy are present in conjunction with radiculopathies.
Spinal cord lesions such as syringomyelia are identified by MRI, and motor neuron disease is identified by EMG.
Multiple sclerosis should be considered in a patient with radiculopathies if the physical signs indicate lesions above the foramen magnum (optic neuritis).
In very rare circumstances, lesions of the parietal lobe corresponding to the arm can mimic the findings of cervical radiculopathies.
Technology makes life more convenient, but it has also made our lifestyles more sedentary. Poor posture’s stress places unnecessary amounts of pressure and tension in the neck and back. We know neck pain and back pain can be debilitating, especially after years of improper posture and a sedentary lifestyle. Chiropractic care can help reduce pain and discomfort from the spine with spinal adjustments and manual manipulations, as well as several lifestyle modifications. Chiropractic can help treat a variety of injuries and conditions affecting spine health. Before further discussing what chiropractic care can do for you, we’ll first discuss the common causes of neck and back pain.
Back Pain
Back pain is common, but it doesn’t have to be permanent. Whether your pain has been brought on by years of heavy lifting or a single mishap or fall, a doctor of chiropractic, or chiropractor, will do their very best to discover which type of treatment method will guarantee you relief from your symptoms. Strengthening exercises help to train your heart to support your weight and spinal adjustments and manual manipulations are ways to relieve inflammation, reduce pressure and restore the proper alignment of the spine to decrease pain and discomfort. Pain relief methods will address your symptoms, but chiropractic care can promote recovery for long term spine pain relief.
Neck Pain
If you experience pain or discomfort in your neck, you may want to address the symptoms with safe and effective alternative treatment options. While the solutions that may assist with your pain are determined by the underlying cause of the distress, a chiropractor can properly diagnose the source of the symptoms, identifying the causes and giving a personalized treatment plan to assist with the situation. Chiropractic care can also provide treatment for a variety of issues causing symptoms of neck pain.
What Causes Pain?
Pain stems from a number of situations and problems. It may relate trauma from an injury or due to an aggravated condition along the length of the spine or it may even relate to posture and the way you sleep during the night. Depending on the origin of the pain and the regions affected by the discomfort, the specific treatments may vary.�Common reasons for your pain include:
A sedentary lifestyle or having a computer on your office, which causes long intervals of holding your head in the same place
Looking down in a tablet, computer, telephone or other device for extended periods
Whiplash or injuries to your neck and back in an automobile accident
A herniated disc in the neck or back
Injuries to the spine
Poor posture
Stress on several regions of the spine, or compression
Certain diseases or conditions, like degenerative disc disease or arthritis
5 Causes of Neck and Back Pain or Discomfort
If you have suffered from pain or discomfort in your neck or back, you may very well be aware of how debilitating the symptoms can become. We are able to complete all of our daily activities and tasks on a regular basis because the spine offers rigidity, stability, and endurance at the same exact time. Through the structure and function of the ligaments, tendons, intervertebral discs and facet joints, the mechanical connection that your body needs is provided by the spine. Just like any sort of apparatus, breakdowns can happen at any time, resulting in symptoms of neck and back pain or discomfort. Next, we will discuss the five common causes of neck and back pain.
Disc Herniation
Disc herniation is among the most frequent causes of neck and back pain. It goes by several names like a pinched nerve, and bulging or burning disc, but regardless of what you call it, it can be intense and long-lasting. Pain in the legs, also called sciatica, is often the first indication of a herniated disc in the lumbar spine, or low back. Since 90 percent of herniated discs occur within this region, leg pain is the most frequent symptom. Other signs may include severe pain, weakness and tingling sensations down one of both legs. Chiropractic care, physical therapy and gentle stretches and exercises are the most common kinds of treatment for a herniated disc. These conservative treatments can cut the need for more aggressive interventions and can be remarkably powerful. For surgical procedures, it might be considered in scenarios where non-operative remedies are ineffective.
Spinal Stenosis
Spinal stenosis is defined as an abnormal narrowing of the bony channel which contains the spinal cord or the spinal nerves. Unlike other spinal problems, spinal stenosis tends to come on slowly and gradually gets worse. Spinal stenosis is treated with a combination of gentle exercises and lifestyle modifications. You will see that some symptoms of spinal stenosis can be relieved by sitting or lying down, maintaining a proper posture, or preventing certain activities that cause the stenosis symptoms. In acute cases, spinal epidural shots may be used to deal with the pain and alleviate discomfort. Chiropractic care can also be used to treat spinal stenosis symptoms.
Sprains and Strains
When you have a sudden onset of pain or discomfort in your neck or back, the problem could be a sprain or strain. Moving the wrong way, overdoing an exercise regime, or decreasing physical activity frequency can lead to a sprain or strain. The good news is that if the time and appropriate treatment are performed, the pain and distress usually go away in a determined amount of time. It’s ideal to see a healthcare professional in case you’ve suffered a sprain or strain to your neck or back. Do not let what you believe is a small sprain or strain turn out to be a bigger issue. Healthcare professionals recommend rest and limited activity until you are feeling better if the issue is a sprain or strain. You may benefit from physical therapy and exercise like water aerobics and stretching exercises to help you heal and recover faster.
Spinal Osteoarthritis
Spinal osteoarthritis is� defined as the breakdown of cartilage in discs or the joints in the neck or back. In some cases, it can cause bone wane causing painful pressure on the nerves going into the spine. If diagnosed with spinal osteoarthritis, you may receive conservative or very aggressive treatment depending on the issue; for example, rest and hot or cold packs or specific medications. However, chiropractic care may be a safe and effective alternative treatment option for some people with spinal osteoarthritis. It’s essential to first talk to a qualified and experienced healthcare professional regarding the recommended treatment for you. If unsuccessful, surgery may be needed, which is usually recommended only as a last resort for patients with spinal osteoarthritis.
Vertebral Compression Fracture
A vertebral compression fracture can be a serious condition that creates pain in the neck or back, depending on where the fracture occurs. Vertebral compression fractures occur as a result of tiny cracks from the vertebrae; the bones of the spine. As time passes, hairline fractures may cause the vertebrae to collapse, which is what is known as a spinal or vertebral compression fracture. The symptoms of a compression fracture can be acute and sudden back pain during a change of posture or movement. Rather than standing tall, you might see that you have a stooped appearance. This sign should not be ignored by you; as with any medical illness, early intervention may often make it much easier to deal with.
There are several choices for treating your vertebral compression fracture, which can include some types of drugs and/or medications to temporarily relieve symptoms while ongoing with treatment. Other treatment choices are bracing of the neck, physical activity or exercise that is limited and bed rest. Understanding the causes of neck and back pain can offer you a head start on receiving the appropriate treatment option for your specific spine health issue. If you suffer from any type of pain or discomfort, please contact a healthcare professional who specializes in the diagnosis, treatment and prevention of spinal health issues, such as a chiropractor.
How Can a Chiropractor Help?
When you find chiropractic care for neck and back pain, they will first diagnose the source of your symptoms, utilizing the appropriate diagnostic tools to find out the underlying causes of the distress. Chiropractors supply treatments after determining the reasons to address the factors. A chiropractor helps with pain relief by correcting the compression or inadequate alignment on your own neck and back. When your spine is misaligned or subluxated, it can lead to a variety of spinal health issues, such as the ones mentioned above. Injuries and/or conditions which are left untreated for an extended period of time may worsen without proper treatment.
Chiropractic care utilizes spinal adjustments and manual manipulations to reduce the pressure in your spine and improve the alignment of the neck and back, in order to restore the original integrity of your spine. A doctor of chiropractic, or doctor will concentrate on helping your body heal and recuperate through natural solutions. They might also recommend nutritional advice and exercises, in addition to stretches to assist with the healing procedure. Chiropractors may additionally create a personalized treatment program based on the possible complications associated with the injuries on your own neck and back as well as the reason for your pain and discomfort.
Dr. Alex Jimenez’s Insight
Neck and back pain or discomfort are some of the most common types of issues frequently treated by a chiropractor. Although neck and back pain can be caused by a wide variety of spinal health problems, chiropractic care is a safe and effective, alternative treatment option that can help ease the symptoms associated with many injuries and/or conditions related to the musculoskeletal and nervous system. As an experienced chiropractor, spinal adjustment and manual manipulations can help reduce painful symptoms by allowing the body to naturally heal itself, restoring the quality of life of patients.
When to Seek Chiropractic Therapy
Seeking chiropractic treatment for pain and discomfort is a personal decision, nevertheless, you should consider treatment immediately after a car accident or some other type of injury or aggravated condition. We advise seeking treatment for persistent and chronic issues. You might want to consider chiropractic care if you notice symptoms due to using electronics throughout the day or sitting at your work, since it may worsen over time if left untreated, even if it is simply a slight soreness in your muscles.
Treating pain and discomfort in your body starts with improving the health and wellness of your spine. To learn more about addressing problems on your neck and spine or to set an appointment with a chiropractor, please make sure to talk to your primary care provider or healthcare professional. The scope of our information is limited to chiropractic as well as to spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
Curated by Dr. Alex Jimenez
Additional Topics: Back Pain
According to statistics, approximately 80% of people will experience symptoms of back pain at least once throughout their lifetimes. Back pain is a common complaint which can result due to a variety of injuries and/or conditions. Often times, the natural degeneration of the spine with age can cause back pain. Herniated discs occur when the soft, gel-like center of an intervertebral disc pushes through a tear in its surrounding, outer ring of cartilage, compressing and irritating the nerve roots. Disc herniations most commonly occur along the lower back, or lumbar spine, but they may also occur along the cervical spine, or neck. The impingement of the nerves found in the low back due to injury and/or an aggravated condition can lead to symptoms of sciatica.
Sandra Rubio discusses the symptoms, causes and treatments of neck pain. Headaches, migraines, dizziness, confusion and weakness in the upper extremities are some of the most common symptoms associated with neck pain. Trauma from an injury, such as that from an automobile accident or a sports injury, or an aggravated condition due to improper posture can commonly cause neck pain and other symptoms. Dr. Alex Jimenez utilizes spinal adjustments and manual manipulations, among other chiropractic treatment methods like deep-tissue massage, to restore the alignment of the cervical spine and improve neck pain. Chiropractic care with Dr. Alex Jimenez is the non surgical choice for improving overall health and wellness.
Cervical Pain Treatment
Neck pain is a common health issue, with approximately two-thirds of the population being affected by neck pain at any time throughout their lives. Neck pain originating in the cervical spine, or upper spine, can be caused by numerous other spinal health issues. Neck pain can result due to the pinching of the nerves emanating from the vertebrae, or because of muscular tightness in both the upper spine and the neck. Joint disruption in the neck can generate a variety of other common symptoms, including headache, or head pain, and migraines, as does joint disturbance in the back. Neck pain affects about 5 percent of the global population as of 2010, according to statistics.
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Chiropractic treatment is a nonsurgical option that can help reduce neck pain and related symptoms. Below are some of the different types of neck (cervical) conditions that Doctors of Chiropractic (DC’s) treat:
Chiropractors also use manual therapies to treat neck pain:
Cervical intervertebral disc injuries that don�t require surgery
Cervical sprain injuries
Degenerative joint syndrome of the neck (eg, facet joints)
A chiropractor evaluates the spine as a whole because other regions of the neck (cervical), mid back (thoracic) and low back (lumbar) can be affected as well. Along with treating the spine as a whole, chiropractic medicine treats the entire person and not just a specific symptom/s. Chiropractors may educate on nutrition, stress management, and lifestyle goals in addition to treating neck pain.
A chiropractor will do a thorough examination to diagnose the specific cause of the neck pain before deciding on which approach/technique to use.
They will determine any areas of restricted movement and will look at a walking cycle along with posture and spinal alignment. Doing these things can help the chiropractor understand the body’s mechanics.
In addition to the physical exam, a chiropractor will want to go over past medical history, and they may order imaging tests (eg, an x-ray or MRI) to help them diagnose the exact cause of the neck pain.
All these steps in the diagnostic process will give a chiropractor more information about the neck pain, which will help the� chiropractor create a customized treatment plan for the individual patient.
A chiropractor will rule out neck pain conditions that require surgery. If they believe surgery is the best treatment for the neck pain, then the patient will be referred to a spine surgeon.
Chiropractic Treatment: Neck Pain
A chiropractor may use a combination of spinal manipulation, manual therapy, and other techniques as part of the treatment plan.
Spinal Manipulation Techniques Used:
Flexion-Distraction Technique:�Gentle hands-on spinal manipulation that involves a pumping action on the intervertebral disc rather than direct force.
Instrument Assisted Manipulation:�Uses hand-held instruments, which allow the chiropractor to apply force without thrusting into the spine.
Specific Spinal Manipulation:�Restores joint movement with a gentle thrusting technique.
Chiropractors also use manual therapies to treat neck pain.
Instrument Assisted Soft Tissue Therapy: uses special instruments to diagnose and treat muscle tension.
Trigger Point Therapy is used to relieve tight, painful points on a muscle.
Other therapies used to ease neck pain symptoms.
Inferential Electrical Stimulation:�Is a low frequency electrical current used to stimulate neck muscles.
Ultrasound:�Sound waves travel into the muscle tissues to help stiffness and pain in the neck.
Therapeutic Exercises:�Helps improve overall range of motion in the neck and prevent neck pain from progressing.
The treatments listed are examples of possible chiropractic treatment for neck pain; The actual treatment plan will depend on the diagnosis. A chiropractor will thoroughly explain the treatment options available along with the actual customized treatment for the individual patient.
Chiropractic Clinic Extra: Neck Pain Care & Treatments
Nearly everyone has a smartphone or mobile device these days, and while there is some merit to this technology by keeping us more connected � at least virtually � it is wreaking havoc on our bodies. When you look at the posture that people assume when texting, reading email, or browsing social media while on their mobile device or smartphone, you will see their head bent forward and rounded shoulders. They typically hold the device either at chest level or waist level meaning that their hands are together, forming an almost crouch position.
This is very bad for the spine but it creates problems for other parts of the body even beyond the spine. Let�s take a look at some of the common issues that come with bad smartphone posture.
Mobile Device Injuries
Text Neck
The more you tilt your head downward (just as you do when looking at a smartphone), the more pounds of pressure you put on your neck and back. Your spine supports the weight of your head. The more it is thrust forward, looking down, the heavier your head gets. Doctors are seeing many young people with this problem, some even as young as 8 years old.
It is characterized by tightness or tension in the neck and shoulders as well as the upper back. Some patients report pain while others feel pressure, and others feel tightness. Sometimes the pain will spread throughout the body or from the neck to the arms and hands.
Forearm & Wrist Pain
Even the way you hold your phone in your hands can cause problems. Since you keep your hand in one position for long periods of time your muscles never have a chance to relax. You have several muscles engaged to do this: the forearms, the wrist, and the neck.
If you are experiencing pain, sometimes shooting, in your elbow or wrist your smartphone use may be the culprit. So put the phones away or leave them at home.
Sore Upper & Lower Back
As your neck struggles to support your head which is rolled forward, it stands to reason that you will experience back pain. In fact, both upper and lower back pain have been attributed to smartphone use.
Think about the muscles that run along your spine. They help stabilize it and help control and support your head. When you hunch over you strain those muscles in your upper back. What you may not realize is that similar strain is being put on the muscles in your lower back as well.
Blackberry Thumb
The muscles in your hand are very small but they can cause you a great deal of pain if you frequently use a mobile device. As you type on the keyboard of your smart phone, it can cause problems with tendons and ligament as well as the muscles.
This repetitive stress of the body is caused daily by people who stay hunched over their small phone screen. The repetitive movement of your thumb as it manipulates the device can cause inflammation in the thumb and hand.
Headaches From Tension In Neck & Back
One of the most common ailments associated with mobile device usage is headaches. These headaches can come from tension in the neck, strained muscled in the back, or overworked muscles through the hand and arm into the shoulder. It can also come from eyestrain caused by staring at the screen for extended amounts of time, looking at tiny text.
There is no doubt that mobile device usage is becoming a serious problem in our society today. While there are the people who text while driving or while walking, posing a significant threat to their own and others� safety, what they are doing to their own bodies is enough to cause alarm.
Chiropractic care can ease the pain and reverse a good portion of the damage that has been done, but if when people continue with the same bad habits the treatment is only temporary. There needs to be a focused effort made to pull people out of their mobile devices, at least a portion of the time, to minimize the structural spinal damage they are doing to themselves.
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Lumbar Spine:
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A chiropractor may use a combination of spinal manipulation, manual therapy, and other techniques as part of the treatment plan.
