Dr. Grotzinger completed his pre-med at Drake university in Des Moines with a 4.0 GPA in 1976. He graduated from Palmer Chiropractic, Magna Cum Laude in 1981 having worked nights and fathering three children in the process. Since then he has worked both in solo practice and a number of multi-doctor clinics, gaining a wide variety of experience and proficiency. He prides himself on being an effective chiropractor who has balanced the ways of the old time chiropractors with today's emphasis on patient comfort.
Neck pain results when the spine is stressed by injury, disease, wear and tear, or poor body mechanics. Acute neck pain is abrupt, intense pain that can radiate to the head, shoulders, arms, or hands. It typically subsides within days or weeks with rest, physical therapy and other self-care measures. You play an important role in the prevention, treatment and recovery process of neck pain. However, if chronic, pain will persist despite treatment and need further evaluation.
Regulatory colleges and chiropractic boards in the U.S., Canada, Mexico, and Australia are responsible for protecting the public, standards of practice, disciplinary issues, quality assurance and maintenance of competency.[183][184] There are an estimated 49,000 chiropractors in the U.S. (2008),[185] 6,500 in Canada (2010),[186] 2,500 in Australia (2000),[28] and 1,500 in the UK (2000).[187]
Research suggests that not just sleep position, but sleep itself, can play a role in musculoskeletal pain, including neck and shoulder pain. In one study, researchers compared musculoskeletal pain in 4,140 healthy men and women with and without sleeping problems. Sleeping problems included difficulty falling asleep, trouble staying asleep, waking early in the mornings, and non-restorative sleep. They found that people who reported moderate to severe problems in at least three of these four categories were significantly more likely to develop chronic musculoskeletal pain after one year than those who reported little or no problem with sleep. One possible explanation is that sleep disturbances disrupt the muscle relaxation and healing that normally occur during sleep. Additionally, it is well established that pain can disrupt sleep, contributing to a vicious cycle of pain disrupting sleep, and sleep problems contributing to pain.
There are several schools of chiropractic adjustive techniques, although most chiropractors mix techniques from several schools. The following adjustive procedures were received by more than 10% of patients of licensed U.S. chiropractors in a 2003 survey:[73] Diversified technique (full-spine manipulation, employing various techniques), extremity adjusting, Activator technique (which uses a spring-loaded tool to deliver precise adjustments to the spine), Thompson Technique (which relies on a drop table and detailed procedural protocols), Gonstead (which emphasizes evaluating the spine along with specific adjustment that avoids rotational vectors), Cox/flexion-distraction (a gentle, low-force adjusting procedure which mixes chiropractic with osteopathic principles and utilizes specialized adjusting tables with movable parts), adjustive instrument, Sacro-Occipital Technique (which models the spine as a torsion bar), Nimmo Receptor-Tonus Technique, applied kinesiology (which emphasises "muscle testing" as a diagnostic tool), and cranial.[76] Chiropractic biophysics technique uses inverse functions of rotations during spinal manipulation.[77] Koren Specific Technique (KST) may use their hands, or they may use an electric device known as an "ArthroStim" for assessment and spinal manipulations.[78] Insurers in the US and UK that cover other chiropractic techniques exclude KST from coverage because they consider it to be "experimental and investigational".[78][79][80][81] Medicine-assisted manipulation, such as manipulation under anesthesia, involves sedation or local anesthetic and is done by a team that includes an anesthesiologist; a 2008 systematic review did not find enough evidence to make recommendations about its use for chronic low back pain.[82]

Determining a treatment strategy depends mainly on identifying the location and cause of the irritated nerve root. Although neck pain can be quite debilitating and painful, nonsurgical management can alleviate many symptoms. The doctor may prescribe medications to reduce the pain or inflammation and muscle relaxants to allow time for healing to occur. Reducing physical activities or wearing a cervical collar may help provide support for the spine, reduce mobility and decrease pain and irritation. Trigger point injection, including corticosteroids, can temporarily relieve pain. Occasionally, epidural steroids may be recommended. Conservative treatment options may continue for up to six or eight weeks.
Neck pain results when the spine is stressed by injury, disease, wear and tear, or poor body mechanics. Acute neck pain is abrupt, intense pain that can radiate to the head, shoulders, arms, or hands. It typically subsides within days or weeks with rest, physical therapy and other self-care measures. You play an important role in the prevention, treatment and recovery process of neck pain. However, if chronic, pain will persist despite treatment and need further evaluation.

Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Neck pain is just that – pain in the neck. Pain can be localized to the cervical spine or may travel down an arm (radiculopathy). All age groups are at risk of developing neck pain. People who sit in one location staring at computer screens for long periods of time may be at an increased risk. About 30% of the population has an episode of neck pain each year. Neck pain may occur slightly more frequently in women than men.
Many states also require applicants to pass a background check and state-specific law exams, called jurisprudence exams. All states require a practicing chiropractor to take continuing education classes to maintain his or her chiropractic license. Check with your state’s board of chiropractic examiners or health department for more specific information on licensure.
Chronic neck pain is pain, stiffness, and soreness in the neck, perhaps with decreased mobility, that lasts more than several weeks. The traditional medical response to neck pain is to recommend pain relievers, but drugs simply mask the symptoms – and taking them for an indefinite period can do more harm than good. Treating chronic pain through traditional means (including pain management, injections, chiropractic manipulation, and surgery) is not likely to resolve the true source of the pain.

“The current study provides the strongest evidence to date that chiropractic care is safe, effective, and results in high levels of patient satisfaction and perceived treatment benefit, thus strengthening our knowledge regarding this conservative nondrug option for low back pain,” Christine M. Goertz, DC, PhD, a chiropractor with the Spine Institute for Quality in Iowa, told Healthline.
Don’t medically investigate neck pain until it’s met at least three criteria: (1) it’s been bothering you for more than about 6 weeks; (2) it’s severe and/or not improving, or actually getting worse; and (3) there’s at least one other “red flag” (age over 55 or under 20, painful to light tapping, fever/malaise/nausea, weight loss, nasty headache, severe stiffness, very distinctive pain, and numbness and/or tingling and/or weakness anywhere else). Note that signs of arthritis are not red flags.
There are several schools of chiropractic adjustive techniques, although most chiropractors mix techniques from several schools. The following adjustive procedures were received by more than 10% of patients of licensed U.S. chiropractors in a 2003 survey:[73] Diversified technique (full-spine manipulation, employing various techniques), extremity adjusting, Activator technique (which uses a spring-loaded tool to deliver precise adjustments to the spine), Thompson Technique (which relies on a drop table and detailed procedural protocols), Gonstead (which emphasizes evaluating the spine along with specific adjustment that avoids rotational vectors), Cox/flexion-distraction (a gentle, low-force adjusting procedure which mixes chiropractic with osteopathic principles and utilizes specialized adjusting tables with movable parts), adjustive instrument, Sacro-Occipital Technique (which models the spine as a torsion bar), Nimmo Receptor-Tonus Technique, applied kinesiology (which emphasises "muscle testing" as a diagnostic tool), and cranial.[76] Chiropractic biophysics technique uses inverse functions of rotations during spinal manipulation.[77] Koren Specific Technique (KST) may use their hands, or they may use an electric device known as an "ArthroStim" for assessment and spinal manipulations.[78] Insurers in the US and UK that cover other chiropractic techniques exclude KST from coverage because they consider it to be "experimental and investigational".[78][79][80][81] Medicine-assisted manipulation, such as manipulation under anesthesia, involves sedation or local anesthetic and is done by a team that includes an anesthesiologist; a 2008 systematic review did not find enough evidence to make recommendations about its use for chronic low back pain.[82]

Vertebrobasilar artery stroke (VAS) is statistically associated with chiropractic services in persons under 45 years of age,[147] but it is similarly associated with general practitioner services, suggesting that these associations are likely explained by preexisting conditions.[146][148] Weak to moderately strong evidence supports causation (as opposed to statistical association) between cervical manipulative therapy (CMT) and VAS.[149] There is insufficient evidence to support a strong association or no association between cervical manipulation and stroke.[15] While the biomechanical evidence is not sufficient to support the statement that CMT causes cervical artery dissection (CD), clinical reports suggest that mechanical forces have a part in a substantial number of CDs and the majority of population controlled studies found an association between CMT and VAS in young people.[150] It is strongly recommended that practitioners consider the plausibility of CD as a symptom, and people can be informed of the association between CD and CMT before administrating manipulation of the cervical spine.[150] There is controversy regarding the degree of risk of stroke from cervical manipulation.[15] Many chiropractors state that, the association between chiropractic therapy and vertebral arterial dissection is not proven.[17] However, it has been suggested that the causality between chiropractic cervical manipulation beyond the normal range of motion and vascular accidents is probable[17] or definite.[16] There is very low evidence supporting a small association between internal carotid artery dissection and chiropractic neck manipulation.[151] The incidence of internal carotid artery dissection following cervical spine manipulation is unknown.[152] The literature infrequently reports helpful data to better understand the association between cervical manipulative therapy, cervical artery dissection and stroke.[153] The limited evidence is inconclusive that chiropractic spinal manipulation therapy is not a cause of intracranial hypotension.[154] Cervical intradural disc herniation is very rare following spinal manipulation therapy.[155]


Neck pain may result from abnormalities in the soft tissues—the muscles, ligaments, and nerves—as well as in bones and disks of the spine. The most common causes of neck pain are soft-tissue abnormalities due to injury (a sprain) or prolonged wear and tear. In rare instances, infection or tumors may cause neck pain. In some people, neck problems may be the source of pain in the upper back, shoulders, or arms.
Utilization of chiropractic care is sensitive to the costs incurred by the co-payment by the patient.[1] The use of chiropractic declined from 9.9% of U.S. adults in 1997 to 7.4% in 2002; this was the largest relative decrease among CAM professions, which overall had a stable use rate.[212] As of 2007 7% of the U.S. population is being reached by chiropractic.[213] They were the third largest profession in the US in 2002, following doctors and dentists.[214] Employment of U.S. chiropractors was expected to increase 14% between 2006 and 2016, faster than the average for all occupations.[185]
I lost my insurance last month because I switched jobs and my new employer does not offer insurance. Can I just get small look at my shoulder joints that I sprained 3 years ago. For cheap please. I don’t make much. It is a 3rd degree joint sprain between my left shoulder and clavicle. It has been really painful lately I’m afraid it could be getting worse.
Are you looking for a Philadelphia chiropractor? Are you suffering from daily pain or have been injured in an auto accident, in sports, in your garden or at work? Dr. Paul Rubin and Philadelphia Chiropractic can help you finally put a stop to aggravated pain, so you can sleep better, feel younger and be able to participate in the activities you enjoy. Philadelphia Chiropractic is a chiropractic clinic located in downtown Philadelphia in Center City. We look forward to helping you live a more active and healthy lifestyle with gentle, personalized rehabilitation and effective, lasting pain relief. ... View Profile
There are several schools of chiropractic adjustive techniques, although most chiropractors mix techniques from several schools. The following adjustive procedures were received by more than 10% of patients of licensed U.S. chiropractors in a 2003 survey:[73] Diversified technique (full-spine manipulation, employing various techniques), extremity adjusting, Activator technique (which uses a spring-loaded tool to deliver precise adjustments to the spine), Thompson Technique (which relies on a drop table and detailed procedural protocols), Gonstead (which emphasizes evaluating the spine along with specific adjustment that avoids rotational vectors), Cox/flexion-distraction (a gentle, low-force adjusting procedure which mixes chiropractic with osteopathic principles and utilizes specialized adjusting tables with movable parts), adjustive instrument, Sacro-Occipital Technique (which models the spine as a torsion bar), Nimmo Receptor-Tonus Technique, applied kinesiology (which emphasises "muscle testing" as a diagnostic tool), and cranial.[76] Chiropractic biophysics technique uses inverse functions of rotations during spinal manipulation.[77] Koren Specific Technique (KST) may use their hands, or they may use an electric device known as an "ArthroStim" for assessment and spinal manipulations.[78] Insurers in the US and UK that cover other chiropractic techniques exclude KST from coverage because they consider it to be "experimental and investigational".[78][79][80][81] Medicine-assisted manipulation, such as manipulation under anesthesia, involves sedation or local anesthetic and is done by a team that includes an anesthesiologist; a 2008 systematic review did not find enough evidence to make recommendations about its use for chronic low back pain.[82]

Headache. A 2011 systematic review found evidence that suggests that chiropractic SMT might be as effective as propranolol or topiramate in the prevention of migraine headaches.[110] A 2011 systematic review found evidence that does not support the use of SM for the treatment of migraine headaches.[111] A 2006 review found no rigorous evidence supporting SM or other manual therapies for tension headache.[112] A 2005 review found that the evidence was weak for effectiveness of chiropractic manipulation for tension headache, and that it was probably more effective for tension headache than for migraine.[113] A 2004 Cochrane review found evidence that suggests SM may be effective for migraine, tension headache and cervicogenic headache.[114]
This article gives a well-rounded picture about things that can cause neck and arm pain. However, a patient should consult with their own physician rather than doing a self-diagnosis.  Some conditions, such as coronary artery disease (angina) or even lung tumors may mimic these conditions.  It is best to have a skilled physician perform a thorough physical examination when the symptoms described are present.

Through manual manipulation of the spine delivered to the highest standards by licensed chiropractors, chiropractic care works to restore and maintain proper communication from your brain to your body by relieving what chiropractors refer to as a subluxation, or a misalignment, of the spine. Restoring proper alignment to the spine can assist with pain relief and prevention of:
One of the most common questions that people ask is around the safety of chiropractic care. So, how safe is it? According to the American Chiropractic Association, “Chiropractic is widely recognized as one of the safest drug-free, non-invasive therapies available for the treatment of back pain, neck pain, joint pain of the arms or legs, headaches, and other neuromusculoskeletal complaints.” While chiropractic is considered a safe complementary therapy, there can be some potential side effects, like soreness following a spinal manipulation.
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