Although both medication and chiropractic are utilized by neck pain sufferers, not everyone wants to or can take certain medications due to unwanted side effects. For those who aren’t sure what to do, wouldn’t it be nice if research was available that could answer the question posted above? Let’s take a look!

When people have neck pain, they have options as to where they can go for care. Many seek treatment from their primary care physician (PCP). The PCP’s approach to neck pain management usually results in a prescription that may include an anti-inflammatory drug (like ibuprofen or Naproxen), a muscle relaxant (like Flexeril / cyclobenzaprine), and/or a pain pill (like hydrocodone / Vicodin). The choice of which medication a PCP recommends hinges on the patient’s presentation, patient preference (driven from advertisements or prior experiences), and/or the PCP’s own preference.

Although it’s becoming increasingly common to have a PCP refer a neck pain patient for chiropractic care, this still does not happen for all neck pain patients in spite of strong research supporting the significant benefits of spinal manipulation to treat neck pain. One such study compared spinal manipulation, acupuncture, and anti-inflammatory medication with the objective of assessing the long-term benefits (at one year) of these three approaches in patients with chronic (>13 weeks) neck pain. The study randomly divided 115 patients into one of three groups that were all treated for nine weeks. Comparison at the one-year point showed that ONLY those who received spinal manipulation had maintained long-term benefits based on a review of seven main outcome measures. The study concludes that for patients with chronic neck pain, spinal manipulation was the ONLY treatment that maintained a significant long-term (one-year) benefit after nine weeks of treatment!

In a 2012 study published in medical journal The Annals of Internal Medicine, 272 acute or sub-acute neck pain patients received one of three treatment approaches: medication, exercise with advice from a health care practitioner, or chiropractic care. Participants were treated for twelve weeks, with outcomes assessed at 2, 4, 8, 12, 26, and 52 weeks. The patients in the chiropractic care and exercise groups significantly outperformed the medication group at the 26-week point AND had more than DOUBLE the likelihood of complete neck pain relief. However, at the one-year point, ONLY the chiropractic group continued to demonstrate long-term benefits! The significant benefits achieved from both exercise and chiropractic treatments when compared with medication make sense as both address the cause of neck pain as opposed to only masking the symptoms.

With results of these studies showing acute, subacute, as well as chronic neck pain responding BEST to chiropractic care, it only makes sense to TRY THIS FIRST!

Some of you may have heard about how a modified form of boxing is helping patients with Parkinson’s disease (PD). If you haven’t, it’s been observed that people with Parkinson’s disease (PD) who engage in this boxing-like exercise routine can enhance their quality of life and even build impressive gains in posture, strength, flexibility, and speed. Proponents of the program report that regardless the degree of severity of PD, participants have a happier, healthier, and higher quality of life.

But must it be boxing? Maybe not. A report presented at the International Congress of Parkinson’s Disease and Movement Disorders in San Diego in June 2015 found that patients with Parkinson’s disease who began regular exercise early into the PD process had a much slower decline in their quality of life when compared with those who started exercising later. The researchers found just 2.5 hours per week of exercise is needed to improve quality of life scores. According to the report, it didn’t matter what exercise the participants did — simply getting up and moving for a total of 2.5 hours/week was reportedly enough (that’s only 20-25 minutes / day)!

Looking beyond Parkinson’s, other chronic conditions also benefit from adding exercise into a person’s lifestyle. Studies show that regular exercise as simple as walking helps reduce one’s risk for memory loss, and it slows down functional decline in the elderly. Incorporating aerobic exercise into one’s lifestyle can also improve reaction time in people at ALL AGES. Exercise has also been shown to improve both physical and emotional well-being in those afflicted with Alzheimer’s disease with as little as 60 minutes/week of moderate exercise! Patients with multiple sclerosis (MS) have also reported less stiffness and less muscle wasting when using exercise machines, aquatic exercise, and/or walking.

Research has shown just 30 minutes of brisk exercise three times a week can help reduce depressive symptoms in patients with mild-to-moderate depression. In a study involving teenagers, those who engaged in sports reported a greater level of well-being than their sedentary peers, and the more vigorous the exercise, the better their emotion health! In kids 8-12 years old, physical inactivity is strongly linked to depression. Even anxiety, stress, and depression associated with menopause are less severe in those who exercise! So LET’S ALL GET OUT THERE AND EXERCISE!!!

Cervical spondylosis (CS) is another term for osteoarthritis (OA) of the neck. It is a common, age-related condition that you will probably develop if you live long enough. Or, if you suffered a neck injury as a youth, it can develop within five to ten years of the injury, depending on the severity.

It is basically caused by the “wear and tear” associated with normal daily living to which some refer to as “the natural history of degeneration.” According to the Mayo Clinic, CS or OA affects more than 85% of people over 60 years old, and that is probably a conservative estimate!

Common symptoms associated with CS/OA vary widely from no symptoms whatsoever to debilitating pain and stiffness. For example, when CS crowds the holes through which the nerves and/or spinal cord travel, it creates a condition called spinal stenosis that can result in numbness, tingling, and/or weakness. In severe cases, this can even affect bowel or bladder control (which is an EMERGENCY)!

CS occurs when the normal slippery, shiny cartilage surfaces of the joint(s) gradually thin and eventually wear away from excessive friction caused by years of repetitive use related to a job, sport, or just time. Bone spurs often form, which results from the body trying to stabilize an unstable joint. In some cases, the spurs can actually fuse a joint, which often helps reduce pain. (Bone spurs can also form if the intervertebral disks or shock-absorbing pads between the vertebrae are injured or become dehydrated due to arthritic conditions.)

Risk factors associated with CS include: aging, injury, years of heavy lift/carry job demands, and jobs and/or hobbies that require the neck to be outside of a neutral position (like years of pinching a phone between the ear and shoulder). Genetics and bad habits (like smoking) also play a role in CS. Obesity and inactivity also worsens the severity of CS symptoms.

The good news is that even though most of us will have CS, it is usually NOT a disabling condition. However, CS may interfere with our normal activities. Depending on its location, pain may feel worse in certain positions, like when sneezing or coughing or with movements like rotation or looking upwards.

Stiffness is a common symptom, which can vary with weather changes. Too little as well as too much activity can be a problem, but the BEST way to self-manage CS is to keep active! Range of motion exercises, strength training, and walking all help reduce the symptoms of CS.

Doctors of chiropractic are trained to identify CS/OA. Gentle manipulation, mobilization, nutritional counseling, exercise training, modalities (and more) can REALLY HELP!

Chiropractic is the most widely accepted and most frequently used type of “alternative” healthcare in the United States. This is largely due to the fact that it works, and because of that, there has been a steady increase in acceptance by the public, third-party payers, and the Federal government. Since the mid-1990s, a number of outside (non-chiropractic) observers have suggested that chiropractic has now entered mainstream healthcare.

One can position chiropractic as being BOTH alternative and mainstream. It is “alternative” since it approaches healthcare from an entirely different direction compared to the primary care medical profession. Chiropractic is non-surgical and promotes diet and nutritional approaches vs. drugs and surgery. Chiropractic is also arguably “mainstream” as it has evolved into a strongly utilized form of primary care through popular acceptance and utilization by the public.

So, what role does chiropractic play in today’s health delivery system? This question is still being debated, but there appears to be three camps: 1) Specialist—limited to musculoskeletal (MSK) complaints on an interdisciplinary primary healthcare team; 2) Primary healthcare “gatekeepers” that focus on ambulatory MSK complaints; 3) Generalist primary healthcare provider of “alternative or complementary” medicine that manage and/or co-manage both MSK AND non-MSK conditions.

Looking at this from the patient or “consumer” perspective, chiropractic already plays an important role in the healthcare delivery for many patients. In 1993, a report claimed 7% of American adults had received chiropractic care during the prior year. According to a 2015 Gallup poll (that included 5,442 adults, aged 18+, surveyed between 2/16/15 and 5/6/15) entitled, Majority in U.S. Say Chiropractic Works for Neck, Back Pain, “Chiropractic care has a positive reputation among many US adults for effective treatment of neck and back pain, with about six in 10 adults either strongly agreeing (23%) or agreeing somewhat (38%) that chiropractors are effective at treating these types of pain.”

The “highlights” from this Gallup poll include: 1) Two-thirds say chiropractic is effective for neck and back pain. 2) Many adults say chiropractors think of the patient’s best interest. 3) More than 33 million adults in the United States (US) saw a chiropractor in the twelve months before the survey was conducted. That means roughly 14% of U.S. adults saw a chiropractor in the 12 months prior to the survey (vs. 7% in 1993). An additional 12% who responded to the Gallup pollsters saw a chiropractor in the last five years but not in the last 12 months. Overall, 51% of those polled had previously seen a chiropractor.

Whether or not you have personally utilized chiropractic, the educational process, licensing requirements, public interest, third-party payer systems, and interprofessional cooperation ALL support firm ground for which you can comfortably and confidently seek chiropractic care for your complaints.

We realize you have a choice in whom you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend, or family member requires care, we would be honored to render our services.

There have been MANY studies conducted on the benefits and efficacy of spinal manipulation to treat back pain—so much so that many medical doctors frequently refer patients with back pain to chiropractors for this service. But what about neck pain?

Although it’s taken a little longer to compile the evidence, there is now substantial research to support that spinal manipulation for neck pain is equally effective as it is for low back pain in regards to improving pain levels, function, and quality of life.

Multiple reviews and meta-analyses (studies that evaluate the research over a series of years) indicate that mobilization, manipulation, and exercise all work alone but appear to give the best long-term benefits when used in combination with each other.

In the acute and subacute stages of neck pain, studies show cervical manipulation is more effective than various combinations of analgesics, muscle relaxants, and nonsteroidal anti-inflammatory drugs (NSAIDs) for improving pain and function in both the short and intermediate term.

Studies show that thoracic or mid-back manipulation is also very helpful for patients with neck pain. Chiropractic approaches often include a combination of spinal manipulation, manual cervical traction, figure-8 mobilization, and deep tissue trigger point/active release forms of therapy.

As noted above, the inclusion of exercise yields the best long-term benefits, especially for chronic neck pain.

One such exercise is Cranio-cervical flexion (deep neck flexor strengthening): Tuck the chin inwards, pushing the mid part of the neck backward with or without resisting into your fingers/hands or a towel wrapped around the neck. A gradual crescendo of pressure followed by a gradual release (or decrescendo) works well!

Another great exercise is Fiber Stretching: Side-bend the head and neck while applying gentle over-pressure while simultaneously reaching downward with the opposite arm/hand, searching for tight muscle fibers. Try combining forward and backward rotations and chin glide head movements while applying the over-pressure/reach combinations, and work each tight fiber until it loosens up.

There are many other exercises your doctor of chiropractic can show you, but these are a great start!

In 2010, Dr. Gert Bronfort published a pinnacle report that reviewed studies published up to 2009 and identified 26 categories of conditions for which there is evidence that manual therapies (including spinal manipulation, mobilization, and massage) are beneficial. These 26 categories included thirteen musculoskeletal (MSK) conditions (like low back and neck pain), four types of chronic headache, and nine non-MSK conditions (like infantile colic).

In 2014, the 2010 study was “updated” by Dr. Christine Clar and five colleagues from the Warwick Medical School in the United Kingdom using the same methodologies. They concentrated on the conditions that resulted in a “negative” or an “inconclusive” result in 2010 and either confirmed, updated, or added a new category based on the results of newer research.

After reviewing 25,539 studies, other conditions such as shoulder rotator cuff disorder, cervicogenic headache, and other types of headaches were added to the list. They also added a large number of non-MSK conditions they had not previously considered, of which most were rated ‘inconclusive.’

The 2014 study pointed out the continued need for more high-quality research on many conditions, but it shed light on a significant number of conditions not previously reported in the 2010 study such as TMD (jaw pain), myofascial pain syndrome, active upper trapezius trigger points and neck pain, carpal tunnel syndrome, tennis elbow, shoulder disorders, nerve and muscle pain in the shoulder, plantar fasciitis, arthritis with and without angulation of the great toe (big toe), and many more!

The non-MSK conditions that Dr. Clar and her team found that are in need of further high-quality studies include: asthma, cervicogenic dizziness, hypertension, infantile colic, enuresis, pneumonia/respiratory disorders, dysmenorrhoea, and PMS.  “NEW” categories include: ADHD/learning disorders, cancer care, cerebral palsy, chronic fatigue, chronic pelvic pain, cystic fibrosis, gastrointestinal, menopause, Parkinson’s disease, pregnancy and neonatal and post-natal care, rehabilitation, and peripheral arterial disease.

Obviously, these two studies have taken the quest of determining the current “science” behind many of the claims that doctors of chiropractic have made for many conditions HEAD ON. This is a VERY important step in the right direction so we as healthcare professionals can tell our patients which conditions are likely or not likely to respond to this form of care based on research!

In 2016, researchers at Curtin University in Perth examined the seated posture and health data of 1,108 17-year olds in an effort to determine if any particular posture increased the risk of headaches/neck pain among late adolescents.

Among four posture subgroups—upright, intermediate, slumped thorax, and forward head—the researchers observed the following: participants who were slumped in their thoracic spine (mid-back region) and had their head forward when they sat were at higher odds of having mild, moderate, or severe depression; participants classified as having a more upright posture exercised more frequently, females were more likely to sit more upright than males; those who were overweight were more likely to sit with a forward neck posture; and taller people were more likely to sit upright.

While they found biopsychosocial factors like exercise frequency, depression, and body mass index (BMI) ARE associated with headaches and neck pain, their data did not suggest any one particular posture increased the risk of neck pain or headaches more than any other posture among the teenagers involved in the study.

This is noteworthy as studies with adults do indicate the risk for neck pain and headaches is greater in individuals with poor neck posture. In particular, postures such as forward head carriage, pinching a phone between the ear and shoulder, and prolonged neck/head rotation outside of neutral can all increase the risk of cervical disorders. This suggests that in younger bodies, the cause of neck pain and headaches may be multifactoral and not limited to just poor posture and that treatment must address all issues that may increase one’s risk for neck pain/headaches in order to reach a desired outcome.

The good news is that chiropractic has long embraced the biopsychosocial model of healthcare, looking at ALL factors that affect back and neck pain and quality of life. Through patient education, spinal manipulation, mobilization, exercise training, the use of modalities, and more, chiropractors can greatly help those struggling with neck pain and headaches!