Advanced Back & Neck Pain Center has been providing chiropractic services and treatment to the Newark, Delaware and surrounding areas since 1986. Under the guidance of founder, Dr. Richard McKay, the office has become synonymous with high level, affordable and efficient chiropractic care and pain management services that do not require the application of medications and/or surgery. Over the past five years, Dr. Richard McKay’s son, Dr. Travis McKay, has become an integral part of the practice and has taken over the role as clinical director of treatment. Together, the two Dr. McKay’s have established a treatment paradigm that ... View Profile
“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.

^ 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).

Some chiropractors oppose vaccination and water fluoridation, which are common public health practices.[32] Within the chiropractic community there are significant disagreements about vaccination, one of the most cost-effective public health interventions available.[221] Most chiropractic writings on vaccination focus on its negative aspects,[27] claiming that it is hazardous, ineffective, and unnecessary.[28] Some chiropractors have embraced vaccination, but a significant portion of the profession rejects it, as original chiropractic philosophy traces diseases to causes in the spine and states that vaccines interfere with healing.[28] The extent to which anti-vaccination views perpetuate the current chiropractic profession is uncertain.[27] The American Chiropractic Association and the International Chiropractors Association support individual exemptions to compulsory vaccination laws, and a 1995 survey of U.S. chiropractors found that about a third believed there was no scientific proof that immunization prevents disease.[28] The Canadian Chiropractic Association supports vaccination;[27] a survey in Alberta in 2002 found that 25% of chiropractors advised patients for, and 27% against, vaccinating themselves or their children.[222]

Sharp neck pain is not in itself a red flag. Believe it or not there is no common worrisome cause of neck pain that is indicated by a sharp quality. In fact, oddly, sharp pains are actually a bit reassuring, despite how they feel. In isolation — with no other obvious problem — they usually indicate that you just have a temporary, minor source of irritation in the cervical spine. Serious causes of neck pain like infections, tumours, and spinal cord problems tend grind you down with throbbing pains, not “stab” you.
Neck pain can also be associated with headache, facial pain, shoulder pain, and arm numbness or tingling (upper extremity paresthesias). These associated symptoms are often a result of nerves becoming pinched in the neck. Depending on the condition, sometimes neck pain is accompanied by upper back and/or lower back pain, as is common in inflammation of the spine from ankylosing spondylitis.
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.

The treatment of soft tissue neck and shoulder pain often includes the use of anti-inflammatory medication such as ibuprofen (Advil or Motrin) or naproxen (Aleve or Naprosyn). Pain relievers such as acetaminophen (Tylenol) may also be recommended. Depending on the source of pain, drugs like muscle relaxers and even antidepressants might be helpful. Pain also may be treated with a local application of moist heat or ice. Local corticosteroid injections are often helpful for arthritis of the shoulder. For both neck and shoulder pain movement, exercises may help. For cases in which nerve roots or the spinal cord are involved, surgical procedures may be necessary. Your doctor can tell you which is the best course of treatment for you.


MRI (or magnetic resonance imaging) scan is a radiology technique which uses magnetism, radio waves, and a computer to produce images of body structures. MRI scanning is painless and does not involve X-ray radiation. Patients with heart pacemakers, metal implants, or metal chips or clips in or around the eyes cannot be scanned with MRI because of the effect of the magnet.

Although it’s rare, once in a while neck pain may be a warning sign of cancer, infection, autoimmune disease, or some kind of structural problem like spinal cord injury or a threat to an important blood vessel. Some of these ominous situations cause hard-to-miss signs and symptoms other than pain and are likely to be diagnosed correctly and promptly — so, if it feels serious, go get checked out. Otherwise, if you are aware of the “red flags,” you can get checked out when the time is right — and avoid excessive worry until then.
Chiropractic doctors diagnose and treat patients whose health problems are associated with the body’s muscular, nervous and skeletal systems. Chiropractors believe that interference with these systems can impair normal functioning, cause pain and lower resistance to disease. They are most well known for the hands-on technique they practice to adjust imbalances in the patient’s skeletal system, particularly the spine.
One of the most common concerns about the neck that is not especially worrisome: signs of “wear and tear” on the cervical spine, arthritis, and degenerative disc disease, as revealed by x-ray, CT scans, and MRI. Many people who have clear signs of arthritic degeneration in their spines will never have any symptoms, or only minor, and/or not for a long time.10 For instance, about 50% of fortysomethings have clinically silent disk bulges, and even at age 20 there’s a surprising amount of spinal arthritis. The seriousness of these signs is routinely overestimated by patients and healthcare professionals alike.11
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
Chiropractic is well established in the United States, Canada, and Australia.[18] It overlaps with other manual-therapy professions such as osteopathy and physical therapy.[19] Most who seek chiropractic care do so for low back pain.[20] Back and neck pain are considered the specialties of chiropractic, but many chiropractors treat ailments other than musculoskeletal issues.[4] Many chiropractors describe themselves as primary care providers,[4][21] but the chiropractic clinical training does not support the requirements to be considered primary care providers,[2] so their role on primary care is limited and disputed.[2][21] Chiropractic has two main groups: "straights", now the minority, emphasize vitalism, "innate intelligence", and consider vertebral subluxations to be the cause of all disease; "mixers", the majority, are more open to mainstream views and conventional medical techniques, such as exercise, massage, and ice therapy.[22]
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.
Occupational employment projections are developed for all states by Labor Market Information (LMI) or individual state Employment Projections offices. All state projections data are available at www.projectionscentral.com. Information on this site allows projected employment growth for an occupation to be compared among states or to be compared within one state. In addition, states may produce projections for areas; there are links to each state’s websites where these data may be retrieved.
In 2009, a backlash to the libel suit filed by the British Chiropractic Association (BCA) against Simon Singh, has inspired the filing of formal complaints of false advertising against more than 500 individual chiropractors within one 24-hour period,[199][200] prompting the McTimoney Chiropractic Association to write to its members advising them to remove leaflets that make claims about whiplash and colic from their practice, to be wary of new patients and telephone inquiries, and telling their members: "If you have a website, take it down NOW." and "Finally, we strongly suggest you do NOT discuss this with others, especially patients."[199] An editorial in Nature has suggested that the BCA may be trying to suppress debate and that this use of British libel law is a burden on the right to freedom of expression, which is protected by the European Convention on Human Rights.[201] The libel case ended with the BCA withdrawing its suit in 2010.[202][203]
DCs may assess patients through clinical examination, laboratory testing, diagnostic imaging and other diagnostic interventions to determine when chiropractic treatment is appropriate or when it is not appropriate. Chiropractors will readily refer patients to the appropriate health care provider when chiropractic care is not suitable for the patient’s condition, or the condition warrants co-management in conjunction with other health care providers. 
In addition to practicing chiropractic, Dr. Robins has taught on the college/university level since 1999 instructing and developing courses in health sciences as well as health care management. Being in Indianapolis has provided the opportunity for Dr. Robins to actively participate in legislative bodies addressing issues that impact governmental health policies and regulations toward healthcare. She has also worked with health care lobbies to affect change in legislation and has had the opportunity to participate in a professional exchange to Korea with a U.S. Delegation.
Neck injuries can occur during motor vehicle accidents, other traumatic events or sports. Symptoms of these injuries include neck stiffness, shoulder or arm pain, headache, facial pain and dizziness. Pain from a motor vehicle injury may be caused by tears in muscles or injuries to the joints between vertebrae. Other causes of pain are ligament rupture or damage to a disc. Conservative treatment of these injuries includes pain medication, bed rest, reduction of physical activity and physical therapy.
In the U.S., chiropractors perform over 90% of all manipulative treatments.[210] Satisfaction rates are typically higher for chiropractic care compared to medical care, with a 1998 U.S. survey reporting 83% of respondents satisfied or very satisfied with their care; quality of communication seems to be a consistent predictor of patient satisfaction with chiropractors.[211]

Early chiropractors believed that all disease was caused by interruptions in the flow of innate intelligence, a vitalistic nervous energy or life force that represented God's presence in man; chiropractic leaders often invoked religious imagery and moral traditions.[23] D.D. Palmer said he "received chiropractic from the other world".[24] D.D. and B.J. both seriously considered declaring chiropractic a religion, which might have provided legal protection under the U.S. constitution, but decided against it partly to avoid confusion with Christian Science.[23][216] Early chiropractors also tapped into the Populist movement, emphasizing craft, hard work, competition, and advertisement, aligning themselves with the common man against intellectuals and trusts, among which they included the American Medical Association (AMA).[23]


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]
The next step in the process was an X-ray. Having an X-ray done of your spine can help the chiropractor determine your treatment plan and can aid in the adjustment. That said, not all chiropractors will recommend an X-ray at your appointment. It turns out some chiropractors say that X-rays should be part of routine chiropractic care, while others argue X-rays aren't necessary for every patient. When researching potential chiropractors, feel free to ask if they recommend X-rays for all patients and how the X-rays can benefit your treatment plan.
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