Thursday, April 7, 2011

"My Neck is Killing Me"

When patients present with neck pain, they always ask, “where is the pain coming from?” Of course, this can only be answered after a careful history and thorough evaluation is completed, which is what we do in this office. Let’s take a closer look at what this involves.

The History: This includes a careful description of how the injury occurred, if there was an injury. For example, in a slip and fall injury, it makes a difference if the patient fell forwards, sideways, or backwards; if they landed on their knees, hips, buttocks, back or if they hit their head on the ground. Also, if there was a dazed feeling or loss of consciousness in the process. If there was a head strike, were there any signs of concussion: fatigue, mental “fog,” headache, difficulty communicating or forming words or sentences. When there is no specific injury, we will ask if there were perhaps one or more, “mini-“ or “micro-“ injuries that may have occurred sometime within 2-3 days prior to the onset of the neck pain. The cumulative effect of several small “micro-injuries” can result in a rather significant onset of symptoms several days later. The next batch of information gathered includes factors that increase and decrease the pain, the type of pain quality (sharp, dull, throb, burn, itch, etc.), pain location – “…put your finger on where it hurts and “does it radiate into the arms or legs, severity (pain level 0-10), and timing such as, “it’s worse for the 1st 30 min. in the morning and then loosens up.” Information regarding past history, family history, medical history (surgeries, medications), social history, habits (caffeine, tobacco, alcohol, etc.), and a systems review (heart, lungs, stomach, nervous system, etc.).

The Physical Exam: This includes vital signs (blood pressure, etc), observation – the way the head is positioned (forwards, to the side, rotated, etc.); palpation – touch/feel for muscle spasm, trigger points, spinal vertebra position and motion; range of motion, orthopedic and neurological tests. The exam procedure may also include x-ray, depending on each case.

The Diagnosis: This is determined after taking all your information and “…putting the puzzle pieces together” to determine what is causing your pain.

The Treatment: Chiropractic spinal manipulation (often referred to as “adjustments”) is performed by applying energy or force to the misaligned or fixed vertebra structures by one of many methods depending on the patient’s size, pain level, tolerance, and so on. Other “manual” treatment approaches include soft tissue therapy such as trigger point therapy, active release, massage, vibration, and others. The use of physical therapy modalities such as ice, heat, electrical stimulation, ultrasound, light – laser therapy, and/or others, again, depending on your specific situation and needs can also be very helpful. Similarly, exercises to teach you how to hold your proper posture, to improve flexibility or range of motion, and to strengthen the muscles that are weak really help to make the adjustments “hold” and the beneficial effects last longer. A work station/job assessment may also be needed if that appears to be irritating your condition.

We realize you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.