At each vertebral level, a pair of spinal nerves exit through small openings called foramina (one to the left and one to the right). These nerves serve the muscles, skin and tissues of the body and thus provide sensation and movement to all parts of the body. The delicate spinal cord and nerves are further supported by strong muscles and ligaments that are attached to the vertebrae.
The disk acts as a shock absorber between the bones in the neck. In cervical disk degeneration (which typically occurs in people age 40 years and older), the normal gelatin-like center of the disk degenerates and the space between the vertebrae narrows. As the disk space narrows, added stress is applied to the joints of the spine causing further wear and degenerative disease. The cervical disk may also protrude and put pressure on the spinal cord or nerve roots when the rim of the disk weakens. This is known as a herniated cervical disk.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Health professionals may know better in theory, but often underestimate how easily patients are alarmed by hard evidence of spinal degeneration. To the average person, if something like that shows up on a scan, it’s like proof: it has got to hurt. But the evidence clearly contradicts that! Pain has many possible minor causes; degeneration is often painless and rarely serious even when it is causing trouble. BACK TO TEXT
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.
Your chiropractor will ask questions about your current condition, plus any potential causes. They will then gather a complete medical history that includes not only your current status but also any previous injuries or underlying medical conditions. If your imaging is out of date or your condition has changed since your last MRI or X-ray was taken, your chiropractor may order additional imaging.
Because the neck is so flexible and because it supports the head, it is extremely vulnerable to injury. Motor vehicle or diving accidents, contact sports, and falls may result in neck injury. The regular use of safety belts in motor vehicles can help to prevent or minimize neck injury. A "rear end" automobile collision may result in hyperextension, a backward motion of the neck beyond normal limits, or hyperflexion, a forward motion of the neck beyond normal limits. The most common neck injuries involve the soft tissues: the muscles and ligaments. Severe neck injuries with a fracture or dislocation of the neck may damage the spinal cord and cause paralysis.
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. D.D. Palmer said he "received chiropractic from the other world". 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. 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).
Vertebrobasilar artery stroke (VAS) is statistically associated with chiropractic services in persons under 45 years of age, but it is similarly associated with general practitioner services, suggesting that these associations are likely explained by preexisting conditions. Weak to moderately strong evidence supports causation (as opposed to statistical association) between cervical manipulative therapy (CMT) and VAS. There is insufficient evidence to support a strong association or no association between cervical manipulation and stroke. 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. 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. There is controversy regarding the degree of risk of stroke from cervical manipulation. Many chiropractors state that, the association between chiropractic therapy and vertebral arterial dissection is not proven. However, it has been suggested that the causality between chiropractic cervical manipulation beyond the normal range of motion and vascular accidents is probable or definite. There is very low evidence supporting a small association between internal carotid artery dissection and chiropractic neck manipulation. The incidence of internal carotid artery dissection following cervical spine manipulation is unknown. The literature infrequently reports helpful data to better understand the association between cervical manipulative therapy, cervical artery dissection and stroke. The limited evidence is inconclusive that chiropractic spinal manipulation therapy is not a cause of intracranial hypotension. Cervical intradural disc herniation is very rare following spinal manipulation therapy.
Age, injury, poor posture or diseases such as arthritis can lead to degeneration of the bones or joints of the cervical spine, causing disc herniation or bone spurs to form. Sudden severe injury to the neck may also contribute to disc herniation, whiplash, blood vessel destruction, vertebral injury and, in extreme cases, permanent paralysis. Herniated discs or bone spurs may cause a narrowing of the spinal canal or the small openings through which spinal nerve roots exit. Pressure on a nerve root by a herniated disc or a bone spur may result in:
Some skin problems on the neck can cause neck pain, but are usually obvious — most people will identify them as “skin problems on the neck” and not “a neck problem affecting the skin.” Herpes zoster (shingles) [CDC] causes a painful rash, cellulitis [Mayo] is extremely painful but superficial, and a carbuncle[Wikipedia] … well, it’s just a super zit, basically. If you can’t diagnose that one on your own, I can’t help you!
We provide advanced spinal correction utilizing “state of the art” chiropractic techniques. Never in the history of chiropractic have we been able to provide the level of help and expertise that now exists. These newer correction methods are even safer, more comfortable and more effective than ever before. Our Orlando Chiropractic team has years of training and experience in spinal adjustment.
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.
I finally met the chiropractor! We started out by talking a little about the reason for my visit, and what my goals were. Next, he performed a Selective Functional Movement Assessment, which basically helps the chiropractor find the root and cause of any symptoms—they do this by breaking down dysfunctional patterns logically rather than simply finding the obvious source of the pain.