Neck Pain — What is the spine?

To help us understand how neck pain can occur, let’s ask ourselves, what is the spine? Your spine, or backbone, **is your body's central support structure**. It connects different parts of your musculoskeletal system. Your spine helps you sit, stand, walk, twist and bend. Back injuries, spinal cord conditions and other problems can damage the spine and cause back pain.

Some of most important structures in the neck/cervical spine:

Spinal Cord

In the cervical spine, the spinal cord connects to the brain at the base of the skull. The cervical bones protect the spinal cord, a bundle of nerves, which relays messages from the brain to other areas of the body.

Nerves

Nerve roots exit the spinal cord in the neck and provide control and sensation to different parts of the body based on the spinal level from where they exit, including signals for movement of the head, neck, arms and fingers, breathing, and skin sensation in the upper body.

Cervical Bones (Vertebrae)

The shape of the each of seven cervical vertebrae allows the vertebral arteries to move blood to the brain, protect the spinal cord, and allow the nerve roots to exit from the spinal cord. Additionally, the joints in the back of the cervical vertebrae (facets) are shaped to allow movement: rotation front-to-back, side-to-side, and left-to-right.

A major difference in the cervical vertebrae versus the other bones of the spine is that the cervical vertebrae have openings (foramen) for vertebral arteries to exit to bring blood to the brain.

Vertebral Discs

Vertebral discs are located between each vertebra. The discs are responsible for absorbing pressure, while also enabling movement and flexibility in the neck.

Muscles

The head is supported by several muscles in the neck, enabling movement.

Roles of the cervical spine:

The cervical spine performs several crucial roles, including:

Protecting the spinal cord. The spinal cord is a bundle of nerves that extends from the brain and runs through the cervical spine and thoracic spine (upper and middle back) prior to ending just before the lumbar spine (lower back). Each vertebra has a large hole (vertebral foramen) for the spinal cord to pass through. Together, these vertebrae keep the spinal cord shielded inside a bony tunnel called the spinal canal.
Watch Cervical Spinal Cord Anatomy Animation
Supporting the head and its movement. The cervical spine handles a heavy load, as the head weighs on average between 10 and 13 pounds. In addition to supporting the head, the cervical spine allows for the neck’s flexibility and head’s range of motion.
Facilitating flow of blood to the brain. Small holes (foramina in the transverse processes) in the cervical spine provide a passageway for vertebral arteries to carry blood to the brain. These openings for the blood vessels are present only in the vertebrae of the cervical spine from C1 down to C6 (not in C7 or lower).

The most common causes of neck/cervical spine pain:

Cervical sprain injuries
Degenerative joint syndrome of the neck (eg, facet joints)
Facet joint sprain
Whiplash
Check out WYLDs top 15 reasons for neck pain here

Every day stress from sitting at a desk, having poor posture, chemical/emotional/physical stress can alter the biomechanics of your neck and leave you feeling fatigued and achy. This stress can also cause misalignments within your neck which can compromise the integrity of your joints and lead to ongoing degeneration due to lack of proper movement. As well as functional abnormalities and lack of function.

Common neck/cervical spine conditions

Common disc disorders include degenerative disc disease and disc herniation that can cause spinal nerve impingement—sometimes called a “pinched nerve.” This can happen when a disc flattens (loss of disc height) or changes shape—the space for a spinal nerve passing through the neuroforamen is restricted. Nerve compression may cause pain that radiates (travels) from the neck into the upper back and arm(s). This conditions is called a cervical radiculopathy.

Cervical spinal stenosis is a narrowing of the middle portion of the spinal canal and can lead to compression of the spinal cord.

Cervical trauma represents the most serious of the neck conditions a person may experience. Injury anywhere affecting the cervical spinal column can disrupt nerve communication further down the spinal cord, sometimes resulting in paralysis or even death. Damage (even a bruise) to the C4 nerve, which helps power the diaphragm to make breathing possible, can result in losing the ability to breathe unassisted.

Any of these ‘common’ neck disorders can cause compression of the spinal cord resulting in cervical myelopathy. The neck is the most common spinal level to develop a myelopathy. Neck pain is a common symptom, although not all patients experience pain.

The connection between your cervical spine and function of your body

Cervical spinal nerves, also called cervical nerves, provide functional control and sensation to different parts of the body based on the spinal level where they branch out from the spinal cord. While innervation can vary from person to person, some common patterns include:

C1, C2, and C3 (the first three cervical nerves) help control the head and neck, including movements forward, backward, and to the sides.1 The C2 dermatome handles sensation for the upper part of the head, and the C3 dermatome covers the side of the face and back of the head.2 (C1 does not have a dermatome.)
C4 helps control upward shoulder movements.1 C4 (along with C3 and C5) also helps power the diaphragm—the sheet of muscle that stretches to the bottom of the rib cage for breathing.1 The C4 dermatome covers parts of the neck, shoulders, and upper part of arms.2
C5 helps control the deltoids (which form the rounded contours of the shoulders) and the biceps (which allow bending of the elbow and rotation of the forearm).1 The C5 dermatome covers the outer part of the upper arm down to about the elbow.2
C6 helps control the wrist extensors (muscles that control wrist extension) and also provides some innervation to the biceps.1,3 The C6 dermatome covers the thumb side of the hand and forearm.2
C7 helps control the triceps (the large muscle on the back of the arm that straightens the elbow) and wrist extensor muscles.1,3 The C7 dermatome goes down the back of the arm and into the middle finger.2
C8 helps control the hands, such as finger flexion (handgrip).1,3 The C8 dermatome covers the pinky side of the hand and forearm.2

If a cervical nerve becomes irritated or compressed, it may cause pain and/or dysfunction that correlates to its dermatome for sensations and/or myotome for motor control.

The nerves that come from your cervical spine/neck most importantly control crucial functions such as

Brain to Body connection

Messages (nerve impulses) from the brain travel along the spinal cord and control the activities of the body, such as the movement of the arms and legs, sensory functions like touch and temperature, and things we don't think about that go on in the background, like the function of the organs.

At the top of the spine, nerves branching off from the cervical section of the spinal cord supply the arms, hands, neck, shoulders and diaphragm, and enable us to breathe. The functions of your cervical spine are crucial and the nerve impulses should be as stress free as possible.

How can Chiropractic help with neck pain?

A neck adjustment (also known as cervical manipulation) is a precise procedure applied to the joints of the neck, usually by hand. A neck adjustment works to improve the mobility of the spine and to restore range of motion; it can also increase movement of the adjoining muscles. Patients typically notice an improved ability to turn and tilt the head, and a reduction of pain, soreness, and stiffness.

Of course, your Chiropractor will develop a program of care that may combine more than one type of treatment, depending on your personal needs. In addition to manipulation, the treatment plan may include mobilisation, massage or rehabilitative exercises, or something else.

What Research Shows

A review of scientific literature found evidence that patients with chronic neck pain enrolled in clinical trials reported significant improvement following chiropractic spinal manipulation. As part of the literature review, published in the March/April 2007 issue of the Journal of Manipulative and Physiological Therapeutics, the researchers reviewed nine previously published trials and found “high-quality evidence” that patients with chronic neck pain showed significant pain-level improvements following spinal manipulation. No trial group was reported as having remained unchanged, and all groups showed positive changes up to 12 weeks post-treatment.

Another study, funded by the National Institutes of Health and published in the Annals of Internal Medicine in 2012, tested the effectiveness of different approaches for treating mechanical neck pain: 272 participants were divided into three groups that received either spinal manipulative therapy (SMT) from a doctor of chiropractic, pain medication (over-the-counter pain relievers, narcotics and muscle relaxants) or exercise recommendations. After 12 weeks, about 57 percent of those who met with chiropractors and 48 percent who exercised reported at least a 75 percent reduction in pain, compared to 33 percent of the people in the medication group. After one year, approximately 53 percent of the drug-free groups continued to report at least a 75 percent reduction in pain, compared to just 38 percent pain reduction among those who took medication.

Also in 2012, research published in the Spine journal analyzed the prevalence, patterns and predictors of chiropractic utilization in the U.S. general population. The researchers found that, "Back pain and neck pain were the most prevalent health problems for chiropractic consultations and the majority of users reported chiropractic helping a great deal with their health problem and improving overall health or well-being."

When you see one of our Chiropractors at WYLD Chiropractic, they will spend time helping you understand what will happen at each visit and why. Sometimes we forget that healing takes time. We all want to be at our ideal health destination, but how we get there is just as important as why.

As Chiropractors, we focus on improving the relationship between your brain and your body and, like any good relationship, solid foundations are built over time. If we want those connections to stay strong, they also need to be well maintained. The thing is, at WYLD Chiropractic we are not just aligning your spine, we are retraining the brain, helping it to form new connections and pathways. This is called neural plasticity.

When you come to see us, commonly your spine has been under stress for many years. As a result, your nervous system, including your brain, has learnt some not so helpful patterns.

Back Pain — At WYLD Chiropractic we provide you with a personalised care plan which is your own road map to your ideal health destination. What if reaching “pain free” is only the first stop along the route to ideal health. What we know as chiropractors, is pain is a symptom of often a much greater picture.
Pain is incredibly motivating and is often what takes us to the Chiropractor in the first place, but if our final destination is only “pain free palm springs”, we often miss out on “optimal health oasis.” We want you to experience all chiropractic has to offer, beyond pain relief. So remember, your brain is changing one adjustment at a time. “Life is not a single event; it is an ongoing dynamic process” 4 . Getting your spine and nervous system checked consistently by a chiropractor helps you adapt to an ever changing life. Your body is full of potential, let’s see how far you can go!

What To Expect At Your First Chiropractic Visit

An initial Chiropractic exam for back pain will typically have three parts: a consultation, case history, and physical examination. Laboratory analysis and X-ray examination may be performed.
1. Consultation. The patient meets with the chiropractor and provides a brief synopsis of his or her lower back pain, such as:
  - Duration and frequency of symptoms
  - Description of the symptoms (e.g. burning, throbbing)
  - Areas of pain
  - What makes the pain feel better (e.g. sitting, stretching)
  - What makes the pain feel worse (e.g. standing, lifting).
2. Case history. The chiropractor identifies the area(s) of complaint and the nature of the back pain by asking questions and learning more about different areas of the patient's history, including:
  - Family history
  - Dietary habits
  - Past history of other treatments (chiropractic, osteopathic, medical and other)
  - Occupational history
  - Psychosocial history
  - Other areas to probe, often based on responses to above questions
  - Physical examination. A chiropractor may utilize a variety of methods to determine the spinal segments that require chiropractic treatments, including but not limited to static and motion palpation techniques determining spinal segments that are hypo mobile (restricted in their movement) or fixated. Depending on the results of the above examination, a chiropractor may use additional diagnostic tests, such as:
    1. X-ray to locate subluxations (the altered position of the vertebra)
    2. A device that detects the temperature of the skin in the paraspinal region to identify spinal areas with a significant temperature variance that requires manipulation.
      Chiropractors are trained in a variety of methods to assess the underlying cause of the problem, including:
      1. Evaluation and management services. Chiropractors are trained in examining the joints, bones, muscles and tendons of the spine, head, extremities and other areas of the body with the purpose of noting any misalignment, tenderness, asymmetry, defects or other problems.
        Neurologic and other common physical examination procedures. Chiropractors are trained to perform a variety of neurologic tests (nerve root compression/tension, motor strength, coordination, deep tendon and pathological reflexes, etc.) and are skilled in performing orthopedic, cardiovascular and many other common examinations.
        Specialised assessment. Chiropractors are trained to assess range of motion, stability, muscle strength, muscle tone and other assessments with the lower back.
        Common diagnostic studies. Chiropractors are trained in use of diagnostic studies and tools such as radiography (X-rays), laboratory diagnostics and neurodiagnostics.