CFN – Flavors of Chiropractic: Mechanical Neck Pain
It might seem a surprise to many a Health Care Consumer, but there are many flavors and styles of Chiropractic Care. A quick look at Wikipedia on chiropractic will provide the reader with a good background history of the Chiropractic profession. Modern Chiropractic was founded in 1895. Chiropractors emphasize manual and manipulative therapy of the joints of the body, and analyze joint dysfunction. There are many styles of practice: this link to a Wikipedia page demonstrates the over 60 common techniques out there, and there are many more fringe techniques.
Personally I have practiced 32 years, and moving all the joints of the body, has been the primary skill that I use in practice. Sadly, modern chiropractic has often gotten away from its basic teachings and as there has been a great diversity of new graduates, so has the diversity of practice techniques. It is not uncommon to visit a chiropractor and not get any spinal or peripheral joint manipulation. Physical Therapists mobilize joints within their range of motion. Joints taken outside of their normal active and passive range of motions will Cavitate, or pop. This is called a vacuum phenomena. As the joint is manipulated it will be placed under negative pressure, nitrogen gas in the joint fluid will come out of solution to fill the vacuum. This High-Velocity low amplitude (HVLA) manipulation is the most common event that will occur with a chiropractic adjustment. This is the resulting, Pop/Crack.
The key goal of the adjustment or the SMT, is to improve and restore joint function. As our last column on Mechanical Low Back Pain, demonstrated, inflammation from joint overload is one the primary causes of Pain. Restoring joint function is the primary goal of the Chiropractic visit. However, there are many patients who do not like this physical brand of chiropractic technique commonly called, diversified technique. There are many accomodations that can be made in treatment to work around this fear, however, if there is a long standing joint fixation, or subluxation, that is adhesive and scarified, then HVLA spinal manipulation is the answer to your problem.
Today I am going to elaborate on Mechanical pain syndromes to include the common causes of Mechanical Neck Pain.
Arthritis of the neck, usually occurs at the C4/5 and C5/6 levels.
(Pain is an unpleasant sensation; nociception). Mechanical Neck pain usually is a response to joint or soft tissue overload. The most mobile joint in the neck(Cervical spine) is the C1/C2 joint.(Atlas/Axis). This joint supplies 50% of global rotation of the neck. 50% of Flexion and Extension(forward/backward motion) is supposed to occur at the C0/C1 joint, the Occiput(base of skull) and first vertebra(C1). Because this joint is next to the most mobile joint in the neck it has a tendency to become lazy and restricted or fixated.
Most individuals demonstrate restriction at the Transition zones. The transition zones are regions where Mechanical function changes dramatically. The Second Transition zone is where the rib cage attaches at the base of the neck. C7/T1/1st rib. The neck joints/segments in the middle of the neck tend to become Hyper-mobile (Too much mobility at the C4/5, C5/6. C6/7 Motion Segments). These are the areas where we see Osteoarthritic changes(Lipping and Spurring on X-ray). It is important when getting adjustments to the Cervical spine to have the correct joints Adjusted. Most of the time we start with adjustments to the two transition zones mentioned above. Once mobility to the Transition Zones are restored the cause of the pain and nerve root irritation is eliminated. Adjusting the hypermobile joints will not get long term results and will often increase the pain.
Another Common pain sydrome of the lower neck with radiation to the arm is called Thorasic Outlet Syndrome. (Pain is an unpleasant sensation; nociception). Mechanical Neck pain usually is a response to joint or soft tissue overload. The most mobile joint in the neck(Cervical spine) is the C1/C2 joint.(Atlas/Axis). This joint supplies 50% of global rotation of the neck. 50% of Flexion and Extension(forward/backward motion) is supposed to occur at the C0/C1 joint, the Occiput(base of skull) and first vertebra(C1). Because this joint is next to the most mobile joint in the neck it has a tendency to become lazy and restricted or fixated.
Most individuals demonstrate restriction at the Transition zones. The transition zones are regions where Mechanical function changes dramatically. The Second Transition zone is where the rib cage attaches at the base of the neck. C7/T1/1st rib. The neck joints/segments in the middle of the neck tend to become Hyper-mobile (Too much mobility at the C4/5, C5/6. C6/7 Motion Segments). These are the areas where we see Osteoarthritic changes(Lipping and Spurring on X-ray). It is important when getting adjustments to the Cervical spine to have the correct joints Adjusted. Most of the time we start with adjustments to the two transition zones mentioned above. Once mobility to the Transition Zones are restored the cause of the pain and nerve root irritation is eliminated. Adjusting the hypermobile joints will not get long term results and will often increase the pain.
The Scalene Triangle & elevation of the first Rib can cause nerve impingement & Vascular impingement.
Arterial Compression of the Subclavian artery.
For a more detailed explanation visit my website here.
Remember … You Don’t have to Live with the Pain