Neck Pain

Understanding what your neck pain treatment options are is essential for finding the right solution.

As a practicing chiropractic physician, we provide a wide array of neck pain treatments right here in Boca Raton, all depending of course, on what is going on.

Just the other day, I had an existing patient come back to the office (let’s call him Jim), whom I probably hadn’t seen for about 6 weeks or so. When I greeted him, Jim says:

“Doc, I don’t know what is going on, but my neck pain is getting worse, I can hardly turn my neck, and it feels like the pain is going into the back of my left arm.”

So I shook his hand and walked back to my office so that I could perform a thorough, (and private) “investigation”.

So that is the starting point with every neck pain treatment option: A detailed and comprehensive history and comprehensive examination.

Unfortunately in these difficult health insurance times, doctors simply don’t spend enough time putting on their thinking caps.
But the simple truth is doctors MUST think of themselves as private investigators trying to methodically piece all the clues together to solve the case.

And that takes time.

Especially in Jim’s case.

If not investigated properly and diagnosed accurately, the wrong neck pain treatment may be life threatening.

Neck Pain Treatment: Musculoskeletal vs. Non-Musculoskeletal
When going to the hospital, the emergency room staff will “triage” the patient: from life-threatening illnesses/injuries, to very minimal concerns.
While in my office, when it comes to neck pain treatment, the goal is to discriminate neck pain conditions that are musculoskeletal in nature versus neck pain conditions that are not.

Neck pain treatment options are different for each.

Examples of a neck pain condition that is musculoskeletal are:

  • Degenerative Disc Disease or Arthritis
  • Torticollis and intense spasms of the neck muscles
  • Disc Bulging, Disc herniation or Disc Compression
  • Cervical Radiculitis or radiating pain down one arm
  • Spinal Stenosis
  • Cervical Spine Sprain Strain or Whiplash
  • Cervical Spine Chiropractic Subluxation or minor joint misalignment
    Migraine Headache, Tension Headache, Cluster Headache, or Common Tendons
  • many more

Examples of neck pain conditions or conditions that mimic common neck pain symptoms are:

  • Spinal Meningitis
  • Referral Pain From Angina, or Myocardial Infarction (or heart attacks)
  • Pancoast Tumor
  • Herpes Zoster and/or Shingles
  • Intracranial Tumor or Elevated Intracranial Pressure
  • Multiple sclerosis
  • Syringomyelia
  • and many more

As such, the neck pain treatment for neck pain caused by an acute bout of shingles is going to be vastly different then the neck pain treatment for an acute onset of cervical radiculopathy, or pain radiating down the arm because of pressure on a nerve root.

Like any good investigation, it’s about gathering all the facts.

Facts like what, when, where, why, and how.

In Jim’s case, these are the facts that I gathered:

  • I know he is in his mid fifties,
  • He works in a Car Show Room over 60 hours/week
  • Spends most of his time in front of a computer (up to 6 hours/day,
  • Had a prior motor vehicle accident, over 15 years ago, when he was rear-ended,
  • The pain began about a week and half ago, and just awoke with it even though it had been bothering him somewhat prior
  • Has continued to get worse, and is constant now
  • Certain movement hurt while others do not,
  • He can reproduce it mechanically, especially when he bends his neck forward, and side to side, or with sudden quick movements,
  • Difficult to get comfortable in certain positions but not in others
  • The pain feels like a tingling/numb pain intermittently into the back of the left tricep
  • He does have an associated headache, and pain widespread across the shoulders
  • It is worse first thing in the morning when he wakes up, and feels better when as he gets going
  • He rates it a 7/10 with 10 being the worse pain he has ever felt
    Next, my examination findings revealed:
  • Noticeable inspection of a forward head carriage when viewing Jim from the side, as well as a rounded thoracic kyphosis/curvature like a humpback posture
  • Diminished and painful ranges of motion for all direction of his neck, especially in flexion/extension and lateral flexion
  • Pain reproduced with cervical depression test or pushing the ear to each shoulder, left sided worse then right
  • Reduction of pain with cervical distraction test, or gently lifting the head upwards off the shoulders
  • Normal upper extremity reflexes
  • Normal upper extremity muscle strength except for the left C7 muscle test (triceps)
  • normal sensation into both upper extremities
  • Negative brudzinski’s sign, a test to implicate meningitis.
  • Palpable tenderness across the C5-7 vertebra

With our thorough investigation we determined Jim’s problem is a musculoskeletal one.

Because we determined that Jim’s neck pain was a musculoskeletal problem, the best/easiest/quickest way to evaluate Jim’s structural integrity is with X-rays.

Although I do not have an x-ray unit, I did go ahead and order Jim a routine 3 view neck x-ray series.

While he did not have any trauma that instigated the pain, he did have a prior trauma 15 years ago in his neck.

As well, he has a series of repetitive “micro-trauma’s” on a daily basis with spending the up to 6 hours a day which have resulted in visual changes in Jim’s posture.

As well, Jim is in his 50’s and the older we get, the more likely that other health problems/red flags (such as growths, masses’s or bone destruction processes) can cause his pain.

While we were waiting for Jim to get his x-ray’s performed and given a DVD of the results, I initiated my passive neck pain treatment protocol.

Musculo-skeletal Neck Pain Treatment Options:

Because Jim had a 7/10 on a pain scale into his neck, as well as pain and limitation with moving his neck in certain direction, our first neck pain treatment goal is to reduce his pain and spasms, and increase his range of motion.

So, I performed 6 minutes of therapeutic ultrasound (pulsed) on Jim’s neck muscles on either side of the spine, as well as into his upper trapezius muscles.
Ultrasound is a great treatment that creates a mechanical wavelength of vibration, which works penetrate the deeper layers of muscle tissue in order to breakup muscle spasms, trigger points and reduce pain.

Electric Stimulation was next utilized passively to reduce muscle spasms and pain.

Lastly, gentle mobilization of the neck with passively turning the head when laying down in all directions will the patient relaxes also is helpful.
Additional neck pain treatment can included spinal manipulation to establish proper motion and biomechanics of the neck joints may be performed.

As well, traction, spinal decompression, and cervical spine rehabilitation using thera-bands and resistance bands can also be utilized to strengthen the supporting muscles of the neck, and help re-establish proper posture.