Chiropractic care (also simply “chiropractic”) is a health care discipline that emphasizes the inherent power of the body to heal itself without the use of drugs or surgery. It focuses on the relationship between the body’s structure (primarily the spine) and function (as coordinated by the nervous system) and how that relationship affects the preservation and restoration of health. When appropriate, doctors of chiropractic work in cooperation with the patient’s other health care practitioners.
A 2012 systematic review suggested that the use of spine manipulation in clinical practice is a cost-effective treatment when used alone or in combination with other treatment approaches. A 2011 systematic review found evidence supporting the cost-effectiveness of using spinal manipulation for the treatment of sub-acute or chronic low back pain; the results for acute low back pain were insufficient.
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A large number of chiropractors fear that if they do not separate themselves from the traditional vitalistic concept of innate intelligence, chiropractic will continue to be seen as a fringe profession. A variant of chiropractic called naprapathy originated in Chicago in the early twentieth century. It holds that manual manipulation of soft tissue can reduce "interference" in the body and thus improve health.
Your neck is a complex interlocking structure consisting of bones, joints, nerves, muscles, tendons and ligaments. Its main job is to hold up the weight of your head which, at around 5 kilograms, is no mean task. Add to this the requirement that the head must be able to move from side to side and up and down (and do these simultaneously), plus the fact that the neck has to form a conduit for the spinal cord, carry blood vessels to and from the head, and contain passageways for air and food, and you have quite a complex feat of engineering. No wonder then that our necks cause us pain and discomfort, not only on occasion, but for some people in an ongoing fashion.The main physical structures in the neck are the seven interlocking vertebrae. They are called the cervical vertebrae, numbered C1 through to C7. C1, also known as the atlas, is the closest one to your head, followed by C2, which is also known as the axis. Each vertebra is connected to the next by facet joints, and between the vertebrae are intervertebral discs — rubbery cushions made mostly of cartilage that act as shock-absorbers.When should I seek immediate medical treatment for neck pain?Severe neck pain that occurs after a neck injury can be a serious problem, and you should see your doctor immediately. Also, if you have problems with neck pain and experience symptoms such as loss of bladder or bowel control, shooting pains, numbness, tingling, or weakness in the arms or legs, especially if these symptoms come on suddenly or get worse quickly, you should see your doctor straight away.Neck pain and stiffness that’s associated with headache and fever can be a sign of meningitis (an infection of the membranes surrounding your brain and spinal cord). Meningitis is a serious disease, and you should seek immediate medical treatment if you or your child are experiencing these symptoms.Symptoms of neck painSymptoms of neck pain and the sensations you feel can help your doctor to diagnose the cause. Here are some symptoms.Muscle spasmA spasm is a sudden, powerful, involuntary contraction of muscles. The muscles feel painful, stiff and knotted. If you have neck muscle spasms, you may not be able to move your neck — sometimes people call it a crick in the neck. Your doctor or physiotherapist may call it acute torticollis or wry neck.Muscle acheThe neck muscles are sore and may have hard knots (trigger points) that are tender to touch. Pain is often felt up the middle of the back of the neck, or it may ache on one side only.StiffnessThe neck muscles are tight and if you spend too long in one position they feel even tighter. Neck stiffness can make it difficult or painful to move your neck.Nerve painPain from the neck can radiate down the arms, and sometimes, the legs. You may feel a sensation of pins and needles or tingling in your arms, which can be accompanied by numbness, burning or weakness. This pain is typically worse at night.HeadachesHeadaches are common in conjunction with neck problems. They are usually a dull aching type of headache, rather than sharp pain. While the headaches are often felt at the back of the head, the pain may also radiate to the sides, and even the front of the head.Reduced range of motionIf you can’t turn your head to the side to the same degree towards each shoulder, or you feel limited in how far forward you can lower your head to your chest, or how far you can tilt your head back, you may have reduced range of motion. Your doctor will be able to test this.Common causes of neck painWhiplashThis commonly follows a car accident in which the person’s car is hit from behind while it is stationary or slowing down. The person’s head is first thrown backwards and then when their body stops moving, the head is thrust forward. This type of injury can strain your neck muscles and cause ligaments in the neck to stretch or tear.The pain from whiplash, which is usually worse with movement, does not always start immediately — it may take several days to come on. Neck pain and stiffness may be accompanied by muscle spasm, dizziness, headaches, nerve pain and shoulder pain.Muscle strainOngoing overuse of your neck muscles (which can be caused by a poor neck position during everyday activities, particularly computer work) can trigger neck muscle strain, causing chronic neck pain and stiffness. The pain is often worse with movement and may be associated with headaches, muscle spasms and restriction of neck movements.Degenerative disc diseaseAs we grow older, the soft gelatinous centre of the shock-absorbing discs in our spines dries out. This causes the discs to become narrowed, and the distance between the vertebrae to decrease.Herniated discIf the tough outside layer of one of the cervical discs tears, the soft gelatinous centre may bulge outwards — this is known as a herniated disc. Herniated discs can put pressure on nerve roots as they leave the spinal cord, causing pain in the neck as well as pain, numbness and weakness in the arms.Cervical spondylosisThis degenerative condition of the cervical spine is due to normal ageing and wear and tear on the cervical discs and the vertebrae. It is also known as cervical osteoarthritis, and is more common among older people.The development of bone spurs often accompanies this degeneration of the spine. Bone spurs, also known as osteophytes, are small outgrowths of bone tissue that are formed when the cartilage covering bone is worn away and bone starts to rub on adjacent bone. The bone spur is the body’s attempt to protect the bone surface. Unfortunately, the bone spur can sometimes pinch or press upon the nerve roots as they leave the spinal canal.Symptoms associated with cervical spondylosis include neck pain and stiffness that often improves with rest. The pain may radiate to the shoulders or between the shoulder blades. If there is nerve root compression, there may be numbness, pain or weakness in the arms.Cervical spinal canal stenosisDegenerative changes in the vertebrae can lead to narrowing of the canal in which your spinal cord lies — this is known as cervical spinal canal stenosis. As the canal becomes narrower, it can put pressure on the spinal cord. The associated neck pain is usually worse with activity, and may radiate to the arms or legs. Arm or leg weakness can also occur. Sometimes people with cervical spinal canal stenosis have no symptoms. Occasionally, it may give rise to Lhermitte's sign — an electric shock-like feeling down the body when the neck is bent forward.Tests and diagnosisYour doctor may be able to determine the cause of your neck pain from your history and physical examination, but sometimes tests such as X-rays, MRI scans and CT scans are required to find the exact cause of your symptoms. These scans can assess the spine and be used to show disc problems, spinal cord problems or compression of your nerve roots.Sometimes doctors will order electromyography (EMG) or nerve conduction studies — tests that evaluate the electrical activity in nerves and muscles to help determine if there is any nerve damage related to your neck problems.It can be difficult to identify the precise source of neck pain even after investigations. Generally, X-ray abnormalities do not correlate well with pain. Some people have severe spondylosis on X-rays, but have no pain. The key thing that your doctor should be able to tell is if the pain is involving pressure on the nerve roots or spinal cord. Last Reviewed: 18 December 2012
A 2016 study Goertz contributed to showed that about 14 percent of people have seen a chiropractor in the last year. Of those with significant neck or back pain, 33 percent said chiropractic care was safest compared with 12 percent who say pain medications are safer (physical therapy was perceived as safest), according to Gallup data. Also, 29 percent say chiropractic care is more effective than pain medication for those who have neck or back pain, while 22 percent preferred medication over chiropractic care.
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.
Most patients don't realize how much education chiropractors in Cincinnati have. Chiropractors are held to some of the most intense educational standards of any health field. In fact their education standards are very comparable to that of a medical doctor. After completing a strong emphasis of basic sciences in college, chiropractors attend a four year chiropractic college. This means that chiropractors are primary care physicians.
Palmer hypothesized that vertebral joint misalignments, which he termed vertebral subluxations, interfered with the body's function and its inborn ability to heal itself. D. D. Palmer repudiated his earlier theory that vertebral subluxations caused pinched nerves in the intervertebral spaces in favor of subluxations causing altered nerve vibration, either too tense or too slack, affecting the tone (health) of the end organ. D. D. Palmer, using a vitalistic approach, imbued the term subluxation with a metaphysical and philosophical meaning. He qualified this by noting that knowledge of innate intelligence was not essential to the competent practice of chiropractic. This concept was later expanded upon by his son, B. J. Palmer, and was instrumental in providing the legal basis of differentiating chiropractic from conventional medicine. In 1910, D. D. Palmer theorized that the nervous system controlled health:
Other Disease Processes: Although neck pain is commonly caused by strain, prolonged pain and/or neurologic deficit may be an indication of something more serious. These symptoms should not be ignored. Spinal infection, spinal cord compression, tumor, fracture, and other disorders can occur. If head injury has been sustained, more than likely the neck has been affected too. It is wise to seek medical attention promptly.
Some symptoms associated with neck pain could indicate the health of a nerve root or the spinal cord is at risk, or perhaps there is an underlying disease or infection. These symptoms can include radiating pain, tingling, numbness, or weakness into the shoulders, arm, or hands; neurological problems with balance, walking, coordination, or bladder and bowel control; fever or chills; and other troublesome symptoms.
Check all that apply. Most people will not be able to check many of these! But the more you can check, the more worthwhile it is to ask your doctor if it’s possible that there’s something more serious going on than just neck pain. Most people who check off an item or two will turn out not to have an ominous health issue. But red flags are reasons to check… not reasons to worry.
In 2005, the chiropractic subluxation was defined by the World Health Organization as "a lesion or dysfunction in a joint or motion segment in which alignment, movement integrity and/or physiological function are altered, although contact between joint surfaces remains intact. It is essentially a functional entity, which may influence biomechanical and neural integrity." This differs from the medical definition of subluxation as a significant structural displacement, which can be seen with static imaging techniques such as X-rays. This exposes patients to harmful ionizing radiation for no evidentially supported reason. The 2008 book Trick or Treatment states "X-rays can reveal neither the subluxations nor the innate intelligence associated with chiropractic philosophy, because they do not exist." Attorney David Chapman-Smith, Secretary-General of the World Federation of Chiropractic, has stated that "Medical critics have asked how there can be a subluxation if it cannot be seen on X-ray. The answer is that the chiropractic subluxation is essentially a functional entity, not structural, and is therefore no more visible on static X-ray than a limp or headache or any other functional problem." The General Chiropractic Council, the statutory regulatory body for chiropractors in the United Kingdom, states that the chiropractic vertebral subluxation complex "is not supported by any clinical research evidence that would allow claims to be made that it is the cause of disease."
The most common cause of shoulder pain and neck pain is injury to the soft tissues, including the muscles, tendons, and ligaments within these structures. There is nearly double the risk for developing neck pain for people who spend most of their day sitting at work. Neck pain is twice as likely for those sitting in poor posture with the head in a flexed forward position.
In most circumstances, a medical history and physical examination are the key parts of an evaluation required to diagnose neck pain/disorders. In some cases, individuals who do not respond to starting therapy may undergo specialized radiographic tests, such as plain X-rays, magnetic resonance imaging (MRI), or computerized tomography to screen for additional problems of soft tissues, herniated discs, spinal stenosis, tumors, or nerve injuries.
Neck pain can have a number of causes, for example: simple muscle strain; injuries as a result of accidents or sports; repetitive or unusual movements; and degenerative conditions such as osteoporosis and arthritis. If you experience neck pain that persists for more than a few days, it would be advisable to consult you medical doctor or health professional.
I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.
D.D. Palmer opened the first chiropractic school two years later, and in the century since, chiropractic professionals have used spinal adjustments to help people prevent and cope with back pain, carpal tunnel, muscle strain, headaches and migraines, and a variety of other physical ailments. Millions of people benefit from the work of Dr. Palmer today.
Extremity conditions. A 2011 systematic review and meta-analysis concluded that the addition of manual mobilizations to an exercise program for the treatment of knee osteoarthritis resulted in better pain relief than a supervised exercise program alone and suggested that manual therapists consider adding manual mobilisation to optimise supervised active exercise programs. There is silver level evidence that manual therapy is more effective than exercise for the treatment of hip osteoarthritis, however this evidence could be considered to be inconclusive. There is a small amount of research into the efficacy of chiropractic treatment for upper limbs, limited to low level evidence supporting chiropractic management of shoulder pain and limited or fair evidence supporting chiropractic management of leg conditions.
There is no good evidence that chiropractic is effective for the treatment of any medical condition, except perhaps for certain kinds of back pain. Generally, the research carried out into the effectiveness of chiropractic has been of poor quality. Numerous controlled clinical studies of treatments used by chiropractors have been conducted, with conflicting results. Research published by chiropractors is distinctly biased. For reviews of SM for back pain chiropractic authors tend to have positive conclusions, while others did not show any effectiveness.
As noted, ratings sites or websites with a certified list of doctors, like PainDoctor.com, can help verify a chiropractor’s license and give you an idea of their philosophy and practice areas. Each site has slightly different information to give you a better picture of your chiropractor before your first visit. Find the best chiropractor for you by looking for ones who share lots of information and knowledge, whether on their website or on social media.
^ Jump up to: a b c McDonald WP, Durkin KF, Pfefer M, et al. (2003). How Chiropractors Think and Practice: The Survey of North American Chiropractors. Ada, OH: Institute for Social Research, Ohio Northern University. ISBN 0-9728055-5-9.[page needed] Summarized in: McDonald WP, Durkin KF, Pfefer M (2004). "How chiropractors think and practice: the survey of North American chiropractors". Semin Integr Med. 2 (3): 92–8. doi:10.1016/j.sigm.2004.07.002. Lay summary – Dyn Chiropr (2003-06-02).
The neck supports the full weight of the head and is very susceptible to muscle strain and the misalignment of, or damage to, the vertebra in the spinal column. Almost everyone experiences neck pain at some time. These pains can be simple, which disappear after a few days, or they can be chronic. Chronic neck pain is defined as pain that persists for 3 months or more.
The percentage of the population that utilizes chiropractic care at any given time generally falls into a range from 6% to 12% in the U.S. and Canada, with a global high of 20% in Alberta in 2006. In 2008, chiropractors were reported to be the most common CAM providers for children and adolescents, consuming up to 14% of all visits to chiropractors. In 2008, there were around 60,000 chiropractors practicing in North America. In 2002–03, the majority of those who sought chiropractic did so for relief from back and neck pain and other neuromusculoskeletal complaints; most do so specifically for low back pain. The majority of U.S. chiropractors participate in some form of managed care. Although the majority of U.S. chiropractors view themselves as specialists in neuroleptic malignant syndrome conditions, many also consider chiropractic as a type of primary care. In the majority of cases, the care that chiropractors and physicians provide divides the market, however for some, their care is complementary.
Analysis of a clinical and cost utilization data from the years 2003 to 2005 by an integrative medicine independent physician association (IPA) which looked the chiropractic services utilization found that the clinical and cost utilization of chiropractic services based on 70,274 member-months over a 7-year period decreased patient costs associate with the following use of services by 60% for in-hospital admissions, 59% for hospital days, 62% for outpatient surgeries and procedures, and 85% for pharmaceutical costs when compared with conventional medicine (visit to a medical doctor primary care provider) IPA performance for the same health maintenance organization product in the same geography and time frame.
To be completely honest, I was still a little nervous before my chiropractor performed the spinal manipulation. But I really had nothing to worry about. We discussed the potential side effects, which can include mild soreness (like you might feel after a workout). If you do feel sore, you can use a cold pack to help reduce any temporary soreness you might experience.