Maruyama et al: “All but one patient [of seven] with migraine considered the pain to be unique and unusual compared with previously experienced headache or neck pain episodes. Nevertheless, pain was often interpreted initially as migraine or musculoskeletal in nature by the patient or the treating doctor.” Arnold et al: “Pain was different from earlier episodes in all but one case [of 20].” BACK TO TEXT

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
^ Jump up to: a b c d e f g h i Nelson CF, Lawrence DJ, Triano JJ, Bronfort G, Perle SM, Metz RD, Hegetschweiler K, LaBrot T (2005). "Chiropractic as spine care: a model for the profession". Chiropr Osteopat. 13 (1): 9. doi:10.1186/1746-1340-13-9. PMC 1185558. PMID 16000175. The length, breadth, and depth of chiropractic clinical training do not support the claim of broad diagnostic competency required of a PCP. Studies of chiropractic intern clinical experience provides no evidence that chiropractors are trained to a level of a diagnostic generalist for non-musculoskeletal conditions. For chiropractors to describe themselves as PCP diagnosticians is to invite comparisons to other PC diagnosticians, i.e., family practitioners, pediatricians and internists. Such comparisons will not reflect favorably on chiropractic. PCP: primary care providers
Although mixers are the majority group, many of them retain belief in vertebral subluxation as shown in a 2003 survey of 1100 North American chiropractors, which found that 88% wanted to retain the term "vertebral subluxation complex", and that when asked to estimate the percent of disorders of internal organs (such as the heart, the lungs, or the stomach) that subluxation significantly contributes to, the mean response was 62%.[38] A 2008 survey of 6,000 American chiropractors demonstrated that most chiropractors seem to believe that a subluxation-based clinical approach may be of limited utility for addressing visceral disorders, and greatly favored non-subluxation-based clinical approaches for such conditions.[39] The same survey showed that most chiropractors generally believed that the majority of their clinical approach for addressing musculoskeletal/biomechanical disorders such as back pain was based on subluxation.[39] Chiropractors often offer conventional therapies such as physical therapy and lifestyle counseling, and it may for the lay person be difficult to distinguish the unscientific from the scientific.[40]
In the U.S., chiropractic schools are accredited through the Council on Chiropractic Education (CCE) while the General Chiropractic Council (GCC) is the statutory governmental body responsible for the regulation of chiropractic in the UK.[176][177] The U.S. CCE requires a mixing curriculum, which means a straight-educated chiropractor may not be eligible for licensing in states requiring CCE accreditation.[65] CCEs in the U.S., Canada, Australia and Europe have joined to form CCE-International (CCE-I) as a model of accreditation standards with the goal of having credentials portable internationally.[178] Today, there are 18 accredited Doctor of Chiropractic programs in the U.S.,[179] 2 in Canada,[180] 6 in Australasia,[181] and 5 in Europe.[182] All but one of the chiropractic colleges in the U.S. are privately funded, but in several other countries they are in government-sponsored universities and colleges.[25] Of the two chiropractic colleges in Canada, one is publicly funded (UQTR) and one is privately funded (CMCC). In 2005, CMCC was granted the privilege of offering a professional health care degree under the Post-secondary Education Choice and Excellence Act, which sets the program within the hierarchy of education in Canada as comparable to that of other primary contact health care professions such as medicine, dentistry and optometry.[169][170]
Integrated Sport, Spine & Rehab is proud to be the first and only evidence-based chiropractic clinic in Olney, MD! We incorporate the latest in chiropractic care, physical therapy, sports performance enhancement, and overall health. Years of serving patients across the country, excellent credentials, current knowledge and training in physical therapy modalities, and a passion for patients and their wellness is what sets Dr. Mozafari apart from other chiropractors in the area. Whether it is simply getting rid of your pain, improving athletic performance, or for a simple evaluation, Integrated Sport, Spine & Rehab is uniquely positione ... View Profile

Qaseem, A., Wilt, T. J., McLean, R. M., & Forciea, M. A. (2017, April 4). Noninvasive treatments for acute, subacute, and chronic low back pain: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 166(7), 514–530. Retrieved from http://annals.org/aim/fullarticle/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice
Reviews of research studies within the chiropractic community have been used to generate practice guidelines outlining standards that specify which chiropractic treatments are "legitimate" (i.e. supported by evidence) and conceivably reimbursable under managed care health payment systems.[70] Evidence-based guidelines are supported by one end of an ideological continuum among chiropractors; the other end employs antiscientific reasoning and makes unsubstantiated claims.[2][52][43][85][86] Chiropractic remains at a crossroads, and that in order to progress it would need to embrace science; the promotion by some for it to be a cure-all was both "misguided and irrational".[87] A 2007 survey of Alberta chiropractors found that they do not consistently apply research in practice, which may have resulted from a lack of research education and skills.[88]
Doctors who treat neck pain can include general medicine physicians, including family medicine doctors and internists, as well as orthopedists, rheumatologists, neurosurgeons, neurologists, ENT specialists, emergency physicians, physiatrists, and chiropractors. Other ancillary health professionals who treat neck pain include physical therapists, massage therapists, and acupuncturists.
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.
The World Health Organization found chiropractic care in general is safe when employed skillfully and appropriately.[46] There is not sufficient data to establish the safety of chiropractic manipulations.[13] Manipulation is regarded as relatively safe but complications can arise, and it has known adverse effects, risks and contraindications.[46] Absolute contraindications to spinal manipulative therapy are conditions that should not be manipulated; these contraindications include rheumatoid arthritis and conditions known to result in unstable joints.[46] Relative contraindications are conditions where increased risk is acceptable in some situations and where low-force and soft-tissue techniques are treatments of choice; these contraindications include osteoporosis.[46] Although most contraindications apply only to manipulation of the affected region, some neurological signs indicate referral to emergency medical services; these include sudden and severe headache or neck pain unlike that previously experienced.[138] Indirect risks of chiropractic involve delayed or missed diagnoses through consulting a chiropractor.[4]
What's to know about cervical spondylosis? Cervical spondylosis is a type of osteoarthritis. It is very common, and it happens as people get older, and the vertebrae and discs in the neck deteriorate. Minor symptoms include neck pain and stiffness, but numbness and more severe effects are possible. Symptoms often resolve alone, but treatment is available. Read now
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.
Our office is not only about adjusting your spine. I am certified in treating a wide range of conditions and focus on muscles and soft tissue that may need to be lengthened or strengthened. I am certified in soft tissue techniques called Trigenics and Instrument Assisted Soft Tissue Mobilization (Scraping). We are getting better and faster results since implementing both techniques. I have extensive training with the Advanced Functional Neurology Institute. All of these trainings have allowed me to treat conditions such as Peripheral Neuropathy, bone on bone degenerative knees and rotator cuff conditions/Frozen Shoulder, among others.
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Symptoms caused by spinal cord trouble are called “myelopathy.” And there are a lot of possible symptoms: it depends on which part of the spinal cord is affected. And many of them can have other causes. And it may worsen slowly and erratically over long periods. You can’t really confirm a myelopathy diagnosis without professional help, so please consult a doctor if you’re suspicious. BACK TO TEXT
At Whole Family Chiropractors, we strive to serve everyone in our diverse community, helping people attain their individual health, wellness and fitness goals. Mueller chiropractors Dr. Michelle Paris, Dr. Merrick Fisher and Dr. Brian Gore offer a welcoming space in which you can discuss any topics that affect your physical and mental well-being without judgment, and get answers to your questions. Our array of services include:
The word “Chiropractic” is derived from the Greek words “cheir” (hand) and “praktos” (done) combined to mean “done by hand.” It was chosen by the developer of chiropractic care, Daniel David Palmer. In 1895, D.D. Palmer performed a chiropractic adjustment on a partially deaf janitor, Harvey Lillard, who later reported that his hearing had improved due to the change.
Chiropractors are not normally licensed to write medical prescriptions or perform major surgery in the United States,[62] (although New Mexico has become the first US state to allow "advanced practice" trained chiropractors to prescribe certain medications.[63][64]). In the US, their scope of practice varies by state, based on inconsistent views of chiropractic care: some states, such as Iowa, broadly allow treatment of "human ailments"; some, such as Delaware, use vague concepts such as "transition of nerve energy" to define scope of practice; others, such as New Jersey, specify a severely narrowed scope.[65] US states also differ over whether chiropractors may conduct laboratory tests or diagnostic procedures, dispense dietary supplements, or use other therapies such as homeopathy and acupuncture; in Oregon they can become certified to perform minor surgery and to deliver children via natural childbirth.[62] A 2003 survey of North American chiropractors found that a slight majority favored allowing them to write prescriptions for over-the-counter drugs.[38] A 2010 survey found that 72% of Swiss chiropractors considered their ability to prescribe nonprescription medication as an advantage for chiropractic treatment.[66]
Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic services are used most often to treat neuromusculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.

As with so many things, when it comes to neck pain, an ounce of prevention may be worth a pound of cure. It's true that some causes of neck pain, such as age-related wear and tear, are not under your control. On the other hand, there are many things you can do to minimize your risk. One place to start is to look at how you sleep and what effect this may have on neck pain.

The site navigation utilizes arrow, enter, escape, and space bar key commands. Left and right arrows move across top level links and expand / close menus in sub levels. Up and Down arrows will open main level menus and toggle through sub tier links. Enter and space open menus and escape closes them as well. Tab will move on to the next part of the site rather than go through menu items.


Symptoms caused by spinal cord trouble are called “myelopathy.” And there are a lot of possible symptoms: it depends on which part of the spinal cord is affected. And many of them can have other causes. And it may worsen slowly and erratically over long periods. You can’t really confirm a myelopathy diagnosis without professional help, so please consult a doctor if you’re suspicious. BACK TO TEXT
This guideline provides guidance on the assessment and management of major trauma, including resuscitation following major blood loss associated with trauma. For the purposes of this guideline, major trauma is defined as an injury or a combination of injuries that are life-threatening and could be life changing because it may result in long-term disability. This guideline covers both the pre-hospital and immediate hospital care of major trauma patients but does not include any management after definitive lifesaving intervention. It has been developed for health practitioners and professionals, patients and carers and commissioners of health services.
Chiropractors, like other primary care providers, sometimes employ diagnostic imaging techniques such as X-rays and CT scans that rely on ionizing radiation.[156] Although there is no clear evidence for the practice, some chiropractors may still X-ray a patient several times a year.[6] Practice guidelines aim to reduce unnecessary radiation exposure,[156] which increases cancer risk in proportion to the amount of radiation received.[157] Research suggests that radiology instruction given at chiropractic schools worldwide seem to be evidence-based.[48] Although, there seems to be a disparity between some schools and available evidence regarding the aspect of radiography for patients with acute low back pain without an indication of a serious disease, which may contribute to chiropractic overuse of radiography for low back pain.[48]
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
Dr. V.J. Maddio is a Helena native. He attended Montana Statev1173c.jpg University on a wrestling scholarship and studied five years of Associated Sciences with an emphasis in Exercise/Physiology and Sports Medicine. He graduated with his degree in chiropractic from Northwestern College of Health Sciences in Bloomington, MN. Dr. Maddio began his own practice in Helena, Montana in January of 1992. He and his wife, Maureen, have enjoyed raising their 3 children in the Helena community. He is involved in several community activities ranging from youth sports to service organizations. Dr. Maddio is certified in Active Release Technique (ART), is a Certified Impairment Evaluator in the State of Montana, currently serves on the the Board of Chiropractors for the State of Montana, and is past President of the Montana Chiropractic Association.

Most patients don't realize how much education chiropractors in Dagsboro 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. In other words you don't have to have a referral to see a chiropractor.
Neck pain is commonly associated with dull aching. Sometimes pain in the neck is worsened with movement of the neck or turning the head. Other symptoms associated with some forms of neck pain include numbness, tingling, tenderness, sharp shooting pain, fullness, difficulty swallowing, pulsations, swishing sounds in the head, dizziness or lightheadedness, and lymph node (gland) swelling.

Dr. Alexandra (Alex) Robins holds both BS and DC degrees, graduating from National College of Chiropractic in 1991. She practiced in Chicago for a couple of years before buying a practice in Indianapolis in1993, which focused on neuromusculoskeletal conditions as well as acupuncture. After 21 years of practice in Indianapolis, Dr. Robins closed her office and became involved with The Joint in 2016. As Dr. Robins states, “Being with The Joint has provided me with a wonderful opportunity to once again treat patients.”
Dr. Jeffrey Fife is also a Helena native. He graduated from Montana State University in 1989 with a degree in Chemical Engineerin8912__4x_color.jpgg and practiced for 15 years. He returned to school and received his Doctor of Chiropractic degree from Logan College of Chiropractic in Saint Louis Missouri in December 2007. He practiced independently in Helena from 2008 to 2011 before joining Town Center Chiropractic. He and his wife have 2 daughters and reside in Helena. In addition to traditional chiropractic, Dr. Fife specializes in the Active Release Technique and is a certified Impairment Evaluator in Montana.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

A small number of neck pain patients, particularly those with arm pain or signs of spinal cord compression, require cervical spine surgery. A new option for neck surgery is an artificial disc. This device made of metal and plastic, is the correct choice for a very small number of individuals with neck pain only and no other abnormality in the cervical spine than a worn out disc.


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.
Important! None of these are dangerous! Although some are quite unpleasant. Reading about medical problems on the Internet can easily freak us out,13 so the goal here is to identify possible causes of neck pain that are not so scary. If you can get a positive ID on one of these conditions, then you get to stop worrying about the threat of something worse.
A 2008 commentary proposed that the chiropractic profession actively regulate itself to combat abuse, fraud, and quackery, which are more prevalent in chiropractic than in other health care professions, violating the social contract between patients and physicians.[32] According to a 2015 Gallup poll of U.S. adults, the perception of chiropractors is generally favourable; two-thirds of American adults agree that chiropractors have their patient's best interest in mind and more than half also agree that most chiropractors are trustworthy. Less than 10% of US adults disagreed with the statement that chiropractors were trustworthy.[193][194]
Holism assumes that health is affected by everything in an individual's environment; some sources also include a spiritual or existential dimension.[34] In contrast, reductionism in chiropractic reduces causes and cures of health problems to a single factor, vertebral subluxation.[32] Homeostasis emphasizes the body's inherent self-healing abilities. Chiropractic's early notion of innate intelligence can be thought of as a metaphor for homeostasis.[30]
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