Can the straight leg test help find the cause of back or hamstring pain in individuals experiencing it?
Straight Leg Test
The straight leg raise test is often used to diagnose sciatica/radiculopathy, herniated discs, and other spinal problems. The healthcare provider giving the test performs most of the movement as they assess what’s causing the leg and/or back pain. The patient lies on their back with the legs straight. The provider will have the patient perform specific movements and inform them of how it feels. Then, they’ll raise the leg to see if and at what point symptoms begin to show. Providers often use this test alongside imaging studies.
Some studies suggest the straight leg test helps diagnose sciatica and other causes. (Pesonen J. et al., 2021)
Purpose
The straight leg raise is one of the most common manual tests done during physical exams. The straight leg raise test seeks to reproduce the pain or other symptoms in a controlled fashion to provide clues to what’s happening. It is a manual exam, and the healthcare provider will:
Position the patient
Moves the patient
Create pressure to see how well the patient can resist it
This is often used alongside imaging tests, such as an X-ray or CT scan. (Allegri M. et al., 2016) Its goal is to check for nerve movement and sensitivity of nerve tissue to compression. The straight leg lift test is neurodynamic because it uses movement to diagnose nerve problems. (Baselgia L.T. et al., 2017)
During the Test
Expect to feel some pain during the test, as the whole point is to see what aggravates the symptoms. They may be caused by:
Most of the tests are passive, with the provider doing the lifting. The patient can help achieve the most accurate result by staying as relaxed as possible and being clear about what is felt. (Pande K. 2015) The procedure:
The patient lies on their back with their legs straight.
The provider will ask the patient to turn one of the legs in.
This tells them what hip position affects the lower back symptoms.
They’ll then ask you to bring the leg toward the body’s center.
Then, they’ll lift the straight leg until the patient experiences symptoms.
Pain suggests a herniated disc.
If there is no pain, this also provides valuable information.
The procedure is repeated with the other leg.
Modifications
It’s important to let the examiner know about any limitations. The straight leg raise test has modifications if the patient cannot lift their leg while it’s straight or if they have difficulty lying on their back, which can also help avoid an injury during the test.
Variations
The healthcare provider may repeat the test with the ankle in a dorsiflexed position/raising the foot. Then, they’ll have the patient do it with their chin tucked into their chest. (Young R. et al., 2013) These variations can help check for nerve involvement in specific locations, such as the spinal cord or the dura mater, the membrane covering the brain and spinal cord. (Venne G. et al., 2017) The spinal cord nerves are likely involved and affected if the usual pain is in the back or leg but not the chin, neck, or foot. (Camino Willhuber GO, Piuzzi NS. 2023)
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
From Injury to Recovery with Chiropractic Care
References
Casiano, V. E., Sarwan, G., Dydyk, A. M., & Varacallo, M. A. (2025). Back Pain. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30844200
Pesonen, J., Shacklock, M., Suomalainen, J. S., Karttunen, L., Mäki, J., Airaksinen, O., & Rade, M. (2021). Extending the straight leg raise test for improved clinical evaluation of sciatica: validity and diagnostic performance with reference to the magnetic resonance imaging. BMC musculoskeletal disorders, 22(1), 808. https://doi.org/10.1186/s12891-021-04649-z
Allegri, M., Montella, S., Salici, F., Valente, A., Marchesini, M., Compagnone, C., Baciarello, M., Manferdini, M. E., & Fanelli, G. (2016). Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Research, 5, F1000 Faculty Rev-1530. https://doi.org/10.12688/f1000research.8105.2
Baselgia, L. T., Bennett, D. L., Silbiger, R. M., & Schmid, A. B. (2017). Negative Neurodynamic Tests Do Not Exclude Neural Dysfunction in Patients With Entrapment Neuropathies. Archives of physical medicine and rehabilitation, 98(3), 480–486. https://doi.org/10.1016/j.apmr.2016.06.019
Pande K. (2015). The Use of Passive Straight Leg Raising Test: A Survey of Clinicians. Malaysian Orthopaedic Journal, 9(3), 44–48. https://doi.org/10.5704/MOJ.1511.012
Young, R., Nix, S., Wholohan, A., Bradhurst, R., & Reed, L. (2013). Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis. Journal of foot and ankle research, 6(1), 46. https://doi.org/10.1186/1757-1146-6-46
Venne, G., Rasquinha, B. J., Kunz, M., & Ellis, R. E. (2017). Rectus Capitis Posterior Minor: Histological and Biomechanical Links to the Spinal Dura Mater. Spine, 42(8), E466–E473. https://doi.org/10.1097/BRS.0000000000001867
Camino Willhuber, G. O., & Piuzzi, N. S. (2025). Straight Leg Raise Test. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30969539
Can physical therapy help individuals with a pinched nerve in the neck?
Pinched Nerve In The Neck
A pinched nerve in the neck can cause pain, numbness, and weakness that extends through the neck, shoulder, and arm. (American Academy of Orthopaedic Surgeons, 2024) Over-the-counter pain medications, resting the muscles, and gentle stretching can help. However, if you’re still in pain after a few days, see a healthcare provider. Common treatments include:
Rest
Over-the-counter (OTC) pain meds
Physical therapy
Steroid injections
Wearing a neck collar
Surgery is rarely needed, but it can provide relief if other treatments don’t help. Most of the time, a pinched nerve resolves within days or weeks.
Sharp pain that extends into the shoulder and arm.
The pain worsens, or there is a shooting sensation when turning the head.
Tingling or feeling of pins-and-needles in the fingers or hand.
Weakness in the arm, shoulder, or hand.
Numbness or loss of feeling.
Often, these symptoms occur only on one side. Some find their pain less when they lift their hand onto their head, which can relieve pressure on the nerve.
Causes
The cervical spine is the spinal cord area around the neck. It’s made up of seven vertebrae. Nerves branch off the spinal cords in the spaces between the vertebrae. Nerve compression occurs when the space between two vertebrae is reduced, putting pressure on the nerve, pinching it, and causing pain. Pinched nerves develop from age because the spinal discs between the vertebrae become compressed over time. Age causes about 70% to 80% of nerve compression. Other factors that cause pinched nerves include: (Harvard Health Publishing, 2021)
Degenerative disc disease
A herniated disc
Injuries like car accidents falls, or other trauma to the spine
Find a comfortable position and try to allow the muscles in your neck to relax and rest.
Heat or Ice
Warmth and coolness can relieve pain and inflammation.
Use a warm or cool compress for 15 minutes at a time.
Over-The-Counter Pain Medications
Pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), can help bring relief.
Treatment for Severe Symptoms
If pain doesn’t resolve within a few days, or if it is so bad that you can’t go about daily activities, it’s recommended to see a healthcare provider. They can diagnose a pinched nerve after a physical exam and may also recommend imaging, including an X-ray, CT scan, MRI, or EMG, to reveal what’s causing the symptoms. After diagnosing the condition, the healthcare provider will develop a personalized treatment plan, which may include the following (Harvard Health Publishing, 2021)
Physical Therapy
Physical therapy can help build strength and flexibility in the neck.
This is especially important if there is frequent nerve pain in the same spot.
Cervical Collar
A soft cervical collar is a brace that fits around the neck.
It supports your head so the neck muscles can relax, facilitating healing.
The collar can also keep the head from turning in painful ways.
Oral Corticosteroids
Oral steroids like prednisone can help reduce inflammation.
If inflammation or swelling in the neck puts more pressure on the nerve, they can help.
Steroid Injections
Steroid shots right into the painful tissue reduce inflammation right away.
Muscle Relaxers
These medications keep the muscles in the neck from seizing up.
As the muscles relax, this brings pain relief.
Narcotic Pain Medications
Narcotic pain medications can be used short-term by individuals who have severe pain.
A healthcare provider will inform the patient of the benefits and drawbacks of these medications, which include opiates.
Hold for 20 seconds, then return to a neutral position.
Do this five times.
Eyes to Sky
Lean your head back and look toward the sky.
Hold for 20 seconds, then return to your starting position.
Do this five times.
Side to Side
Turn your head to the right as far as possible, bringing your chin in line with your shoulder.
Hold for 20 seconds, then turn as far as possible toward the left.
Repeat four times.
Ear to Shoulder
Bring your ear down toward your shoulder.
Hold for 20 seconds, then repeat the exercise on the other side.
Alternate between the right and left, stretching each side five times.
While it’s normal for exercises to hurt from stretching the muscles, they should never hurt more than a five on a pain scale of 1 to 10. If they do, stop exercising (National Health Service, 2025)
Healing Time
Healing and recovery depend on the severity of the injury. Some individuals find that the pain from a pinched nerve goes away in days, while for others, it can last for weeks. The pain goes away and then returns. If pain doesn’t go away with the conservative treatments or lasts more than a few days, talk with a healthcare provider or return for a second visit. Rarely do individuals need surgery to bring pain relief. The healthcare provider will discuss whether surgery is the best option and what to expect regarding pain relief. (American Academy of Orthopaedic Surgeons, 2024)
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Revitalize and Rebuild with Chiropractic
References
American Academy of Orthopaedic Surgeons. OrthoInfo. (2024). Cervical radiculopathy (pinched nerve). https://orthoinfo.aaos.org/en/diseases–conditions/cervical-radiculopathy-pinched-nerve/
Harvard Health Publishing. Publishing, H. H. (2021). Treating a pinched nerve. https://www.health.harvard.edu/pain/treating-a-pinched-nerve
National Institute of Neurological Disorders and Stroke. (2025). Pinched Nerve Definition. Retrieved from https://www.ninds.nih.gov/health-information/disorders/glossary-neurological-terms#-P-
National Health Service. Service, N. H. (2025). Exercises for neck problems. https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/neck-and-back-problems-and-conditions/exercises-for-neck-problems
Triceps tendonitis can be frustrating, especially when you need to rest from normal activities. Can knowing the causes, symptoms, and diagnosis help individuals understand the treatment and prevention of the condition?
Triceps Tendonitis
Tendons are connective tissue that attach muscles to bones, enabling the joints to move. Triceps tendonitis is inflammation of the tendon at the back of the elbow. It is most often caused by overuse of the triceps muscles. The condition can cause pain, swelling, and loss of function. It’s common in jobs that require regular hammering, shoveling, and overhead reaching, as well as in weightlifters, gymnasts, and boxers.
Causes
The triceps muscle runs along the back of the upper arm and is attached to the point of the elbow by a tendon. This muscle straightens the elbow. Tendonitis develops from repeatedly straightening the elbow against resistance. This causes tiny tears in the tissue, which leads to inflammation. Triceps tendonitis commonly occurs from repetitive manual labor tasks or sports activities like throwing sports, gymnastics, or boxing. Exercises that target the triceps muscle can cause tendonitis to develop, including kickbacks, dips, push-ups, and bench presses. For this reason, triceps tendonitis is also known as weightlifter’s elbow. (Orthopedic & Spine Center, N.D.)
Symptoms
Inflammation leads to a series of chemical reactions in the area of the injury. There are five main symptoms of inflammation:
Redness
Warmth
Swelling
Pain
Loss of function
With triceps tendonitis, the pain and stiffness are felt at the back of the elbow. Weakness may also present when using the affected arm. Tendonitis usually causes more pain with movement than when resting. Pain can occur when straightening the elbow, which puts tension on the triceps, or bending the elbow, which stretches the tendon.
Diagnosis
A healthcare provider will ask questions and perform a physical exam to diagnose tendonitis. (Harvard Health Publishing, 2014) A healthcare provider will ask you to describe the pain and the activities that make it better or worse. The elbow will be assessed for movement issues, swelling, or deformities that could indicate a worse injury, like a tendon tear. A healthcare provider will order X-rays or other imaging, such as MRI, to assess for a bone fracture or more extensive damage to the tendon.
Treatment
Several types of treatments include self-care, physical therapy, and medications.
Self Care
Triceps tendonitis can be treated at home if symptoms are addressed early. These include:
Rest
Rest the triceps tendon by avoiding activities that cause pain for a few days.
Ice
Apply ice to the triceps tendon for 15 to 20 minutes, two to three times daily.
Massage the area with an ice cube for several minutes.
Range of Motion Exercises
Decrease stiffness in the elbow with gentle range of motion exercises.
Slowly bend and straighten the elbow in a pain-free range, 10 times.
Repeat several times per day.
Physical Therapy
Physical therapists use various therapies and tools when treating tendonitis, including (Prall J. & Ross M. 2019)
PT Modalities
Physical therapy modalities are used to decrease pain, inflammation, and stiffness.
Examples include ultrasound, electrical stimulation, and light therapy.
Manual Therapy
Manual techniques for tendonitis include soft tissue massage, friction massage, stretching, and joint mobilization.
Exercise
Stretching and strengthening exercises that target the triceps muscle and any other muscle weakness that might have contributed to the condition.
Activity Modification
A therapist will look at the activities that led to the tendonitis and ensure you use the correct form and proper body mechanics.
Sometimes, a physical therapist can make on-site changes in the work environment to help prevent further injury.
Nonsteroidal anti-inflammatory medications are often used to treat tendonitis.
Many are available over-the-counter, including Aleve, Bayer, and Advil.
These medications can also be prescribed in higher doses by a healthcare provider.
Pain-Relievers
Additional over-the-counter medications such as Tylenol can help decrease pain.
Oral Steroids
These medications might be prescribed for short-term use to decrease inflammation if over-the-counter medications are ineffective in treating symptoms.
Tendonitis is frequently treated with an injection of steroid medication to decrease inflammation.
However, having multiple injections in the same area can eventually cause tendons to weaken more. (NYU Langone Health, 2024)
Platelet-Rich Plasma
PRP is made by taking a small amount of blood and separating the platelets or cells that release growth factors to promote healing.
The liquid is then injected into the tendon.
PRP is controversial; some studies support its use, while others do not.
While PRP may show some promise, insurance may not cover PRP treatments because of the ambiguity in the clinical data.
Injury Medical Chiropractic and Functional Medicine Clinic
Prevention is key. Warming up before a workout, stretching, and using the proper form can help prevent triceps tendonitis. Temporarily halting activities to address symptoms can prevent more serious injury. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Harvard Health Publishing. (2014). Tendonitis. https://www.health.harvard.edu/diseases-and-conditions/tendonitis
Prall, J., & Ross, M. (2019). The management of work-related musculoskeletal injuries in an occupational health setting: the role of the physical therapist. Journal of Exercise Rehabilitation, 15(2), 193–199. https://doi.org/10.12965/jer.1836636.318
Aurora Health Care. (2025). Tendonitis symptoms & treatment. https://www.aurorahealthcare.org/services/orthopedics/conditions/tendonitis
Spoendlin, J., Meier, C., Jick, S. S., & Meier, C. R. (2015). Oral and inhaled glucocorticoid use and risk of Achilles or biceps tendon rupture: a population-based case-control study. Annals of Medicine, 47(6), 492–498. https://doi.org/10.3109/07853890.2015.1074272
NYU Langone Health. (2024). Therapeutic injections for bursitis & tendinitis in adults. https://nyulangone.org/conditions/bursitis-tendinitis/treatments/therapeutic-injections-for-bursitis-tendinitis
Could older individuals who do not have symptoms of shoulder pain or loss of shoulder and arm function have a rotator cuff tear?
Rotator Cuff Tear Physical Therapy
A rotator cuff tear is a common injury to the four muscles and tendons surrounding and stabilizing the shoulder joint. Studies have shown that (Geary M. B., & Elfar J. C. 2015)
30% of those under the age of 70
70% of those over age 80 have a rotator cuff tear.
Physical therapy is often recommended as a first-line initial treatment for rotator cuff pain. In most cases, a rotator cuff tear will not need surgical treatment. Determining when surgery is necessary depends on several factors a patient can discuss with their healthcare provider.
Causes
Overuse and repetitive motions
Trauma (e.g., falls, collisions)
Age-related degeneration
Symptoms
Shoulder pain, especially with overhead or rotational movements
Weakness and difficulty raising the arm
Clicking or grinding sounds in the shoulder
Limited range of motion
Treatment
The goal of physical therapy for a rotator cuff tear is not necessarily to heal the torn tendon but to relieve pain and improve strength by reducing inflammation and restoring shoulder joint mechanics. This is achieved through physical therapy, ice application, anti-inflammatory treatments like medications, and cortisone injections.
Physical Therapy
The goal of physical therapy is to improve the function of the muscles that surround the shoulder. Physical therapy targets the smaller muscles around the shoulder that are commonly neglected. By strengthening these muscles, the treatment can help compensate for damaged tendons and improve the mechanics of the shoulder joint. A chiropractic physical therapy team will develop a personalized exercise program. Generally, rehabilitation will start with gentle range of motion exercises that can be accomplished using the arms to lift a mobility stick/wand overhead.
Shoulder Pulleys
These improve shoulder range of motion and flexibility.
Isometric Exercises
These exercises are for the rotator cuff muscles and may then be started.
This exercise can improve the contracting of the muscles around the shoulder and offer more support to the shoulder joint.
Scapular Stabilization Exercises
These can also be done to improve the muscles surrounding the shoulder blade’s function.
This can help improve how the shoulder joint, arm, and scapulae move together when using the arm.
Advanced Strengthening
Advanced exercises can be done with a dumbbell or resistance band.
Consult your healthcare provider or physical therapist before starting these or any other exercises for a rotator cuff tear. Doing exercises correctly prevents further pain, injury, or shoulder problems. Specific, focused exercises can help expedite and regain normal shoulder function.
Injury Medical Chiropractic and Functional Medicine Clinic
The prognosis for rotator cuff tears depends on the severity of the tear and the individual’s overall health. With proper treatment, most people can regain the full function of their shoulders. However, some may experience ongoing pain or limitations in severe cases. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Shoulder Pain Chiropractic Treatment
References
Geary, M. B., & Elfar, J. C. (2015). Rotator Cuff Tears in the Elderly Patients. Geriatric orthopaedic surgery & rehabilitation, 6(3), 220–224. https://doi.org/10.1177/2151458515583895
Could individuals who are having headaches with neck pain need emergency treatment or need to get started with sustained physical therapy?
Headaches and Neck Pain
Headaches and neck pain are two very common symptoms. They often occur together and signal common health issues, including fatigue, sinus headaches, and migraines. The combination can also occur due to serious health issues such as a concussion or meningitis. Causes of headaches with neck pain range from various causes, such as not getting enough sleep, having the neck in an awkward position, or having a hangover, to life-threatening issues like fluid buildup in the brain. It is recommended that individuals see a healthcare provider as soon as possible to rule out any life-threatening issues. Discuss the symptoms of neck pain with headache, what can cause these symptoms, and discuss treatment and prevention.
Symptoms
Symptoms are similar to what they feel like when they occur alone. Headache can present as:
A feeling of fullness in the head
Head soreness
Sharp head pain
Throbbing head pain
Pounding head pain
Neck pain can present as:
Pain in the back of the neck
Pain and/or aching of the upper back and/or shoulders
Associated Symptoms
Additional symptoms are common. Symptoms associated with headaches and neck pain include:
Neck stiffness
Trouble concentrating
Exhaustion or sleepiness
Aching throughout the body
Nausea
Dizziness
Vertigo – feeling like the room is spinning.
Photophobia – discomfort when looking at bright lights.
A feeling of numbness or tingling down the arm
Generally, associated symptoms suggest a more severe cause and can help a healthcare provider make a diagnosis.
Emergency Help
New symptoms of headache or neck pain can indicate a serious condition. If you develop these symptoms together, get prompt medical attention.
Causes
There are a variety of medical conditions that can cause headaches and neck pain. Both of these conditions are caused by irritation of sensory nerve fibers. Sometimes, head or neck pain can spread to other areas because the sensory nerves of these structures are so close together. (Côté P. et al., 2019) Additionally, a medical condition like an infection can affect the other due to proximity. Causes of headaches with neck pain include:
Headaches
Sinus headaches, tension headaches, and cervicogenic headaches are usually associated with head pain, but they can also involve neck pain. (Côté P. et al., 2019)
Migraine
Migraines are commonly associated with headaches and often cause neck pain as well.
In addition, they can cause nausea and body aches.
Fatigue
Being tired commonly leads to temporary headaches and neck pain until thorough rest is achieved.
Alcohol Consumption and/or a Hangover
For many, drinking can trigger a headache.
This is a common migraine trigger, but it can also trigger headaches for those who don’t have migraines.
Muscle Strain
Prolonged or recurrent positions that strain the neck muscles, like lifting or sitting at a desk, can cause aching or pain that involves both the head and neck. (Houle M. et al., 2021)
Injuries
Trauma such as whiplash or falling can cause soreness in the head and neck.
Bruises or other injuries may be present.
Severe injuries can cause damage to the skull, brain, spine, spinal nerves, or spinal cord.
Concussion
A concussion often causes trouble concentrating, persistent headaches, and neck pain.
Usually, these symptoms improve within a few weeks after a mild concussion.
Meningitis
Inflammation or infection of the lining around the brain and spinal cord causes pain or tenderness in the head, back, and neck.
Neck stiffness and fever are commonly associated symptoms.
Pinched Nerve
Arthritis is a common cause of pressure on spinal nerves.
A pinched nerve in the upper spine can cause pain in the head and neck and tingling down the arm.
Herniated Disc
Degenerative arthritis or trauma can cause a spinal disc to press on a nerve and possibly on the spinal cord.
This may cause loss of sensation or weakness of the arm.
Subarachnoid Hemorrhage
This is a serious condition caused by bleeding of a blood vessel in the brain.
Irritation and inflammation can cause severe head and neck pain, possibly with seizures and loss of consciousness.
Hydrocephalus
Fluid can accumulate around the brain, causing pain-inducing pressure.
Causes include obstruction of cerebrospinal fluid flow due to brain tumors, brain infections, or congenital malformations. (Langner S. et al., 2017)
Increased Intracranial Pressure
Pressure on the brain and the brain’s blood vessels can cause pain.
Causes of pressure within the skull include hydrocephalus, head trauma, brain tumors, or swelling from a stroke.
Severe cases can cause lethargy or loss of consciousness.
Brain or Spine cancer
Cancer of the brain or within the spine can cause pain affecting the head and neck, often with other symptoms, like loss of vision.
Treatment
Talk to a healthcare provider about the following treatments. Treating headaches with neck pain includes methods that address symptoms and methods that treat the underlying cause. The medications used for headaches with neck pain often reduce both symptoms, but this depends on the cause. Treatments that can relieve both headaches and neck pain when they occur together include:
Getting proper sleep to alleviate fatigue.
Rest and rehabilitation after a concussion or another injury.
Physical therapy to keep muscles flexible and relaxed.
Fluids for meningitis treatment and antibiotics for bacterial meningitis.
Surgical procedures for a tumor or subarachnoid hemorrhage.
A surgical procedure to relieve hydrocephalus.
Headache Treatment
You can do a few things to relieve your headaches, and although they won’t directly take away your neck pain, your headache relief might also decrease your neck pain. These include:
Avoiding loud noises
Cranial massage
Applying gentle cranial pressure
Avoiding bright lights as much as possible
Using specialized migraine sunglasses
Neck Pain Treatment
Some treatments that can specifically treat neck pain include:
Injury Medical Chiropractic and Functional Medicine Clinic
Knowing whether a serious problem is causing headaches and neck pain can be difficult. The more dangerous conditions don’t necessarily cause more severe pain. This is why getting medical attention is crucial if you have these symptoms together. If you frequently have both headaches and neck pain, it can have a substantial impact on your quality of life. There are ways to manage the symptoms, including preventative measures such as physical therapy, exercises, and avoiding triggers. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Tension Headaches
References
Côté, P., Yu, H., Shearer, H. M., Randhawa, K., Wong, J. J., Mior, S., Ameis, A., Carroll, L. J., Nordin, M., Varatharajan, S., Sutton, D., Southerst, D., Jacobs, C., Stupar, M., Taylor-Vaisey, A., Gross, D. P., Brison, R. J., Paulden, M., Ammendolia, C., Cassidy, J. D., … Lacerte, M. (2019). Non-pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration. European journal of pain (London, England), 23(6), 1051–1070. https://doi.org/10.1002/ejp.1374
Houle, M., Lessard, A., Marineau-Bélanger, É., Lardon, A., Marchand, A. A., Descarreaux, M., & Abboud, J. (2021). Factors associated with headache and neck pain among telecommuters – a five days follow-up. BMC Public Health, 21(1), 1086. https://doi.org/10.1186/s12889-021-11144-6
Langner, S., Fleck, S., Baldauf, J., Mensel, B., Kühn, J. P., & Kirsch, M. (2017). Diagnosis and Differential Diagnosis of Hydrocephalus in Adults. Diagnostik und Differenzialdiagnostik des Hydrozephalus beim Erwachsenen. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, 189(8), 728–739. https://doi.org/10.1055/s-0043-108550
Petersen, S. M., Jull, G. A., & Learman, K. E. (2019). Self-reported sinus headaches are associated with neck pain and cervical musculoskeletal dysfunction: a preliminary observational case-control study. The Journal of manual & manipulative therapy, 27(4), 245–252. https://doi.org/10.1080/10669817.2019.1572987
Excessive alcohol consumption: what is alcoholic peripheral neuropathy?
Alcoholic Peripheral Neuropathy
Alcoholic peripheral neuropathy (ALN) is a condition that damages the nerves in the body due to chronic alcohol consumption. It can cause sensory, motor, and autonomic dysfunction, which can lead to disability. This damage prevents the nerves from communicating information. Most symptoms generally start as mild but typically worsen over time as the neuropathy progresses. The most common symptoms are: (National Library of Medicine, 2023)
Numbness or tingling sensation in the extremities
Pain or a burning sensation in the extremities
Difficulty walking
Difficulty urinating
Difficulty talking or swallowing
Affected nerves include the peripheral and autonomic nerves, which help regulate internal body functions. Around 46% of chronic alcohol users will eventually develop the condition. (Julian T., Glascow N., Syeed R., & Zis P. 2019)
Causes
The exact cause of alcoholic neuropathy is unclear. But it is directly related to heavy and long-term alcohol consumption. (Julian T., Glascow N., Syeed R., & Zis P. 2019) It is believed overconsumption of alcohol can directly harm and hinder the nerves’ ability to communicate information. Unhealthy nutritional habits are often associated with it as well. Research shows that decreased thiamine/B vitamin plays a role, while others suggest an overall dietary deficiency may play a role. (Julian T., Glascow N., Syeed R., & Zis P. 2019) However, alcoholic neuropathy can also occur without the presence of malnutrition. (Julian T., Glascow N., Syeed R., & Zis P. 2019)
Neuropathy Development and Progression
Alcoholic peripheral neuropathy develops depending on many factors, including the amount of daily/nightly alcohol consumed, age and overall health, nutritional intake, and other individual factors. In most cases, the neuropathy takes several years or decades to develop, depending on the amount of alcohol consumed.
Pain or burning sensation in the arms, legs, or feet.
Symptoms that occur in the arms and legs typically affect both sides.
Cramps, aches, or weakness of the muscles.
Constipation or diarrhea.
Nausea and vomiting.
Difficulty urinating or incontinence.
Difficulty walking.
Difficulty talking or swallowing.
Heat intolerance.
Erection difficulties.
Most symptoms begin as mild and usually worsen over time as the neuropathy progresses. Alcoholic neuropathy affects individuals who consume excessive amounts of alcohol over a long time. (Julian T., Glascow N., Syeed R., & Zis P. 2019)
Healthcare providers will collect data involving past medical history and all current symptoms.
Physical Exam
This exam looks at other medical conditions contributing to symptoms, like diabetes or high blood pressure.
Neurological Exam
This is a noninvasive exam to determine the location and extent of neurological damage.
Healthcare providers may ask patients several questions and have them complete a series of small movements to check neurological function.
Blood and Urine Tests
These tests can detect diabetes, liver and kidney problems, infections, vitamin deficiencies, and other conditions that can cause neuropathic conditions.
Chronic alcohol use can also affect how the body stores and uses vitamins necessary for healthy nerve function. Vitamin levels that a healthcare provider may check include: (National Library of Medicine, 2023)
Vitamin A
Biotin
Folic acid
Niacin, or vitamin B3
Pyridoxine, or vitamin B6
Pantothenic acid
Liver Disease
Individuals with chronic liver disease often have neuropathy. The severity and stage are associated with a higher incidence of neuropathy. (Pasha MB, Ather MM, Tanveer MA, et al. 2019)
Treatment
Alcoholic neuropathy is not reversible, even when quitting drinking. However, individuals with the condition can make healthy changes to minimize symptoms and receive help for chronic alcohol use. The first step is stopping alcohol consumption. (Chopra K., & Tiwari V. 2012) Talk to a healthcare provider about what options are available. Treatment can include:
In-patient or outpatient rehab
Therapy
Medication
Social support from groups like Alcoholics Anonymous
A combination of treatments will likely be utilized. Other treatment options involve symptom management and preventing further injuries and may include:
Physical therapy
Keeping the head elevated while sleeping.
Orthopedic splints to maintain limb function and positioning.
Wearing compression stockings.
Adding vitamins and supplements.
Eating extra salt for those without hypertension
Medications to reduce pain and discomfort.
Intermittent catheterization or manual expression of urine for those with difficulty urinating.
Individuals with neuropathy may have reduced sensitivity in the arms and legs. If this occurs, additional steps need to be taken to prevent other injuries, that include (National Library of Medicine, 2023)
Wear special footwear to prevent foot injuries.
Checking feet daily for wounds.
Prevent burns by ensuring that bath and shower water is not too hot.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Peripheral Neuropathy Myths and Facts
References
National Library of Medicine. (2023). Alcoholic neuropathy. Retrieved from https://medlineplus.gov/ency/article/000714.htm
Julian, T., Glascow, N., Syeed, R., & Zis, P. (2019). Alcohol-related peripheral neuropathy: a systematic review and meta-analysis. Journal of Neurology, 266(12), 2907–2919. https://doi.org/10.1007/s00415-018-9123-1
National Institute of Neurological Disorders and Stroke. (2024). Peripheral neuropathy. Retrieved from https://www.ninds.nih.gov/health-information/disorders/peripheral-neuropathy
Pasha MB, A. M., Tanveer MA, et al. (2019). Frequency of peripheral neuropathy in chronic liver disease. Med Forum Monthly, 30(8), 23-26. https://medicalforummonthly.com/index.php/mfm/article/view/3761
Chopra, K., & Tiwari, V. (2012). Alcoholic neuropathy: possible mechanisms and future treatment possibilities. British journal of clinical pharmacology, 73(3), 348–362. https://doi.org/10.1111/j.1365-2125.2011.04111.x
For individuals who have to be in one position for long periods, have poor postural alignment, and perform repetitive motions, what are myofascial pain syndrome spasm cycles?
Myofascial Pain Syndrome Spasm Cycles
Myofascial pain syndrome is a common condition that causes pain symptoms in a particular body area (Jafri M. S. 2014). A myofascial pain syndrome spasm cycle is a recurring pattern in which muscle tension and spasms in affected regions, caused by myofascial pain syndrome, lead to pain, triggering more muscle spasms. This creates a vicious cycle of discomfort and tightness that can be difficult to break without treatment; the pain perpetuates muscle spasms and vice versa.
Spasm Pain Cycle
Left untreated, myofascial pain is often experienced as a recurring cycle of spasm, pain, and spasm. (Kojidi M. M. et al., O2016) The exact cause of the spasm is not known. It may be related to excessive accumulation and release of acetylcholine, which causes sustained muscle contraction. (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Another theory is that repetitive small muscle trauma helps create a trigger point or knot in the muscle. (Thorne. 2021)
Active trigger points in muscles characterize myofascial pain syndrome. (Shah J. P. et al., 2015) These trigger points cause pain in the area where they are located and sometimes in other places, known as referred pain. Each muscle has a particular referral pattern of pain that goes from a trigger point in that muscle to another place in the body. (Shah J. P. et al., 2015) Medical providers and massage therapists trained in this area can identify trigger points by their pain patterns. With myofascial pain syndrome, muscles tense, and joint range of motion may decrease. (Jafri M. S. 2014)
Trigger Points
Myofascial pain syndrome is characterized by trigger points and sensitive knots within muscles that can cause referred pain when pressed, contributing to the spasm cycle.
Muscle Tension
A repeatedly tense or injured muscle can develop trigger points, which can lead tocle tightness and potential spasms.
Pain-Spasm-Pain Cycle
The pain from a trigger point can cause the muscle to further contract and spasm, leading to even more pain and perpetuating the cycle.
How Spasms and Pain Present
Myofascial pain is often caused by long periods of poor postural alignment, muscle injury, and repetitive motions. (Cleveland Clinic, 2023) For example, the upper body slumps forward when sitting at a desk workstation all day. The upper section of the trapezius muscle is located on the back of the neck and the top of the shoulder. The upper trapezius muscle works to raise the head. (Yoo W. G. 2015) The trapezius muscle now has to work more than it is used to. This overuse may cause microscopic muscle injury, leading to muscle spasms and pain. (Bron C., & Dommerholt J. D. 2012) (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Without treatment, the muscle spasms, pain, and microscopic muscle injury may persist or worsen, leading to trigger points and chronic pain. (Jafri M. S. 2014)
Causes
Repetitive Motions
Repeating the same movement, like typing on a computer, can trigger muscle tension and points.
Poor Posture
Maintaining incorrect posture for extended periods can strain muscles and contribute to trigger point development.
Muscle Injury
Past injuries can leave muscles susceptible to developing trigger points and pain cycles.
Stress
Psychological stress can lead to muscle tension and exacerbate existing trigger points.
Break the Cycle
Physical Therapy
A physical therapist can use stretching, massage, and trigger point therapy to release muscle tension and address trigger points.
Exercise
Regular exercise, including gentle stretching, can help improve muscle flexibility and reduce tension.
Heat Therapy
Applying heat to affected areas can help relax muscles and alleviate pain.
Ergonomics
Modifying work habits and posture to reduce strain on muscles.
Stress Management
Techniques like deep breathing and meditation can help reduce stress-related muscle tension.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.
Personal Injury Rehabilitation
References
Jafri M. S. (2014). Mechanisms of Myofascial Pain. International scholarly research notices, 2014, 523924. https://doi.org/10.1155/2014/523924
Kojidi, M. M., Okhovatian, F., Rahimi, A., Baghban, A. A., & Azimi, H. (2016). Comparison Between the Effects of Passive and Active Soft Tissue Therapies on Latent Trigger Points of Upper Trapezius Muscle in Women: Single-Blind, Randomized Clinical Trial. Journal of Chiropractic Medicine, 15(4), 235–242. https://doi.org/10.1016/j.jcm.2016.08.010
Nicol A, C. M., Hsu E, Ferrante M. (2018). Myofascial Pain Syndrome. Science Direct, 207-212. https://doi.org/https://doi.org/10.1016/B978-0-323-40196-8.00025-5
THORNE. (2021). Understanding Muscle Pain, Fascia, and Myofascial Release. https://www.thorne.com/take-5-daily/article/understand-muscle-pain-fascia-and-myofascial-release?srsltid=AfmBOop3Pp0wWEeiQEqpfPgAaTOpLvU7lOAGUv5VRYQdoH8OBcW4D_wk
Shah, J. P., Thaker, N., Heimur, J., Aredo, J. V., Sikdar, S., & Gerber, L. (2015). Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM & R: the journal of injury, function, and rehabilitation, 7(7), 746–761. https://doi.org/10.1016/j.pmrj.2015.01.024
Yoo W. G. (2015). Comparison of activation and change in the upper trapezius muscle during painful and non-painful computer work. Journal of Physical Therapy Science, 27(10), 3283–3284. https://doi.org/10.1589/jpts.27.3283
Bron, C., & Dommerholt, J. D. (2012). Etiology of myofascial trigger points. Current pain and headache reports, 16(5), 439–444. https://doi.org/10.1007/s11916-012-0289-4
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