What Exercises Are Best for Neck Pain?

Past research has demonstrated that combining spinal manipulative therapy (SMT) with exercise yields the best long-term results for individuals with neck pain. So what neckpain-e1464705188848exercises should we consider when neck pain rears its ugly head?

In the acute phase of an injury, rest and ice may be appropriate, but patients will often benefit from lightly applied isometric exercises. Place your hand against the side of your head and lightly push your head into your hand for a count of five seconds. If tolerated, tip your head sideways five to ten degrees and repeat the process. This can be repeated multiple times at progressively greater angles until you’ve accessed your full range of motion (ROM).

The above isometric exercise can be repeated in the opposite direction as well as forwards, backwards, and into left and right rotation directions. The KEY is to always stay within reasonable pain boundaries—no sharp/”bad” pain allowed!

You can then move on to isotonic neck exercises. Using the same amount of light pressure, gently push your head into your hand as you did before, but this time, allow the head to move slowly toward the shoulder against the pressure of the hand. This too can be repeated on the opposite side, forwards, backwards, and into left and right rotation.

Using only one or two fingers rather than the whole hand helps to prevent you from pushing too hard with your hand or head when performing isometrics or isotonic exercises. Also, the same movements of the head can be done without any hand/finger resistance, but faster results seem to occur when pressure is applied.

Studies also show that weakness of the deep neck flexor muscles is

very common in people with chronic (more than three months) neck pain. These are deep, involuntary muscles, so to properly strengthen them, look straight ahead, tuck in your chin as far as you can, hold for five to ten seconds, and repeat five to ten times.

Beyond treatment options for neck pain such as spinal manipulation, mobilization, and exercise, your doctor of chiropractic may utilize soft tissue therapies such as myofascial release, active release technique, as well as various physical therapy modalities, ergonomic modifications, and more in the effort to help you get out of pain and return to your normal activities.

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How Does Chiropractic Help Whiplash Patients?

Whiplash associated disorder (WAD) injuries usually result from rear-end, low-impact crashes with about 90% occurring at speeds less than 14 mph. Approximately 40% of all WAD patients develop long-term, chronic problems. Let’s look at how chiropractic care can help crash-injured patients recover and return to their normal lives…

neck painREDUCE INFLAMMATION: Inflammation occurs when ligaments and muscles are injured. However, the pain associated with inflammation may be delayed and not show up right away. Rather, you may wake up the next morning with acute neck and/or back pain, as WAD injuries are NOT limited to only the neck. Several studies have shown that chiropractic spinal manipulation results in the release of anti-inflammatory Interleukin 6 (IL-6), which helps reduce inflammation.

RESTORE MOVEMENT: Injured joints quickly become stiff from pain and swelling. Muscles often “splint” in response to pain as a way to protect a deeper ligament or joint-related injury. Both factors can lead a patient to unnecessarily restrict their movement, weakening that area of the body, and increasing the risk of further injury down the road.

REDUCE SCAR TISSUE: As injured tissue heals, the body’s “Band-Aid” is actually scar tissue that is made up of similar cells as the surrounding tissue but is laid down quickly and in an unorganized way. Scar tissue reduces the ability for the injured tissue to stretch and can lead to tissue shortening. If it is performed early enough, Chiropractic adjustments help to stretch out and—in a sense—break up the scar tissue.

RELIEVE LOCALIZED PAIN: Many studies report spinal manipulation (SM) to be a safe, fast, and effective way to reduce pain. As a result, SM is now strongly recommended in treatment guidelines published throughout the world.

REDUCE WIDESPREAD PAIN: Some WAD-injured patients develop pain not just in the neck or back but more widespread throughout their body. This is thought to be caused by “sensitization” of parts of our nervous system. Spinal adjustments have been shown to stimulate the nervous system in such a way as to reduce this hypersensitized effect.

REDUCE STRESS & CHRONIC PAIN: Due to initial high pain intensity, stress and anxiety levels often soar following a WAD injury. Chiropractic care includes patient education, exercise, nutrition, and more to help patients cope with ongoing problems. The importance of  cannot be overemphasized in quest of preventing chronic, long-term pain and disability.

Manipulation vs. Other Treatments?

Mechanical neck pain affects an estimated 70% of people at some point in life. Because many different treatment approaches are available for neck pain, it can be very difficult for those suffering from neck pain to know which treatment approach(es) to choose. Research on this topic has revealed some very interesting information that places chiropractic and spinal manipulation in a VERY STRONG POSITION—in fact, at the TOP OF THE HEAP!

neck

One such study looked at benefits of spinal manipulative therapy (SMT) in patients with acute and subacute neck pain. This study compared three study groups:

  1.  SMT only
  2.  medication only
  3.  home exercise and advice (HEA)

This study randomized 272 neck pain patients suffering from neck pain for 2 to 12 weeks into a twelve-week treatment period using 1 of the 3 treatment approaches tracking the results with the participant-rated pain as the primary treatment outcome measure. Secondary outcome data was obtained from other approaches. The results showed that the group treated with SMT, “…had a statistically significant advantage over medication after 8, 12, 26 and 52 weeks. HEA also had a statistical advantage over medication. Lastly, similar benefits were calculated between the SMT and exercise group. The conclusions support SMT and exercise/advise to be the choice over medication for acute and subacute neck pain patients. Regarding exercise, a similar study showed that “high-dosed supervised strengthening exercise” with and without SMT, was superior to a “low dose home mobilization exercise and advice group at 4, 12, 26, and 52 weeks.”

Regarding chronic neck pain patients (that means pain that has been present for greater than 3 months), another study evaluated the changes that occurred in 191 patients. These patients were randomly assigned to 1 of 3 treatment groups for eleven weeks and evaluated 3, 6, 12, & 24 months after treatment. The 3 treatment options included: 1. Spinal manipulative therapy (SMT) only; 2. SMT with low-tech neck exercises; or 3. a form of exercise using a MedX rehab machine. The results show the highest level of patient satisfaction was found in the 2nd group (SMT with low-tech exercise), suggesting that when individuals present for treatment, spinal manipulation with low-tech exercises results in the most satisfied patient. These findings are important as this study evaluated the LONG-TERM benefits among patients who have had neck pain for a long time (i.e., “chronic”), where as most studies only look at the short-term benefits.

Similar conclusions were reported from perhaps the largest scale study on neck pain based on research from 1980 to 2006 on the use, effectiveness, and safety of non-invasive treatment approaches for neck pain and associated disorders. This review that looked at over 350 published articles found manual therapy (manipulation and mobilization) and supervised exercise to again, SHINE when compared with other treatment options.

What is important is that ALL these studies support what chiropractors do: manipulate the neck and give supervised exercises! So, what are you waiting for? SPREAD THE WORD to everyone that you know who has neck pain—CHIROPRACTIC MAY BE THE BEST CHOICE!!!

Neck Pain – Chiropractic and the Older Patient

NeckPain_N1606_ts140306319People of all ages suffer from neck pain, and many frequently turn to chiropractors for care because it’s been found to be one of the most effective and efficient forms of treatment available, and it carries minimal side effects! It has been projected that by 2030, nearly one in five residents in the United States will be 65 or older. Currently, approximately 14% of the patients treated by chiropractors are 65 or older, making it one of the most frequently utilized forms of complementary and alternative care used by older adults. What kind of care can a senior citizen expect when seeking treatment from a chiropractor? Let’s take a look…

Musculoskeletal pain—pain in the neck, back, arms, and/or legs—drives the majority of elderly patients to chiropractors. While low back and neck pain are the most common complaints, it’s not unusual for patients to also have one or two other conditions (or more) that they did NOT know chiropractic care could help. In fact, common “goals” for managing every patient (not just the elderly) include services related to patient assessment, maintenance of health, and prevention of illness, in addition to treatment of illness or injury. Common chiropractic treatment approaches include spinal manipulation and/or mobilization, nutritional counseling, physical activity/exercise, and (especially important for the elderly population) fall prevention.

Neck Pain 90We will now focus on neck pain as it relates to the elderly population and the various chiropractic management strategies that might be encountered by an elderly patient. Common reasons patients present regarding the neck include limited movement, stiffness, and pain. Neck pain can also interfere with sleep, as finding a comfortable position in bed can be quite challenging! Lifting, carrying, and playing with grandchildren is a very common issue for either causing a new complaint or irritating an existing one. Neck pain may also interfere with reaching and lifting. Thus, activities like yard or garden work may become more difficult and less enjoyable. Neck pain is often associated with headaches, which can make daily tasks even more challenging.

When an elderly patient visits a chiropractor for the first time or for a new complaint, he/she can expect to fill out some initial paperwork, as well as provide a history of the main complaint and any lesser complaints. This may also include providing a family and medical history. The examination usually includes general observations, palpating or feeling for muscle tightness, tenderness, warm/cool, range of spinal motion (neck, back, extremities), orthopedic tests, neurological tests, and possibly x-rays. Treatment of the neck may include massage or mobilization to loosen up the neck, manipulation to free up restricted joint motion, and even exercise training. The goal of treatment is to improve neck motion, activity tolerance, and quality of life (less pain, improved sleep, etc.). So, whether you are 10, 20, 50, 70, or 90 years old, give chiropractic a chance to help you manage your neck pain.