on Jan 16 in Chiropractic Blog posted Back pain, chiropractic works, ergonomics, Neck pain by Dr. Camp
People often ask me: Dr. Camp, what is the most common thing you treat in your office? I’d have to say it’s a combo pack of pain in the neck and pain between the shoulder blades. These are the people who tell me “Doc, I store all my stress in my shoulders.”
These people often present with the “I don’t know what I did…. maybe I just slept funny and woke up with pain.” They are often the ones who say, “One day I woke up and had this odd pain which got worse and worse for a while, and now it doesn’t seem to get worse, but it also doesn’t seem to be going away.”
As far as I’m concerned, these patients appear to be the most difficult for people in the industry to diagnose. They are referred to as “Insidious Onset” patients. Much easier for the practitioner are the patients who say, “I did (insert activity here) and knew right then that I had done something wrong. When this happens we talk about knowing “the mechanism of injury” which really makes our jobs easier. Too bad these are not the most common patients to enter our offices.
There was an orthopedist named Alf Brieg who did an enormous amount of study on people with chronic pain and he made the statement “Eighty percent of the patients I see with Chronic Pain have a postural component to it.” This just ties in SO well with the concept of “I don’t know what I did but suddenly I have pain.” Yes, it takes such a long time for these postural changes to cause the pain, that there often isn’t a specific event that one can attribute to the chronic pain syndrome.
These are also often the people who have some innocuous incident that leads to major symptoms. The folks who say “I bent over to pick up a piece of paper and couldn’t stand up again.” Clearly, it’s not the sudden weight of the paper that did it, more the “straw that broke the camel’s back” situation with a long term problem finally manifesting itself in what feels like a “rude awakening”.
What I find most often with these patients are either a straight neck, and/or one that has a reverse of the normal curve (see the photo on the left) that we’d expect to find in the cervical spine. Sometimes, these reverse cervical curve (Cervical Kyphosis) patients present with low back pain. I know… it doesn’t seem to make sense, but believe me, people, it’s physics that I CAN but won’t explain now, in this particular article.
How do these necks change into the straight or reverse curves ? One of two ways: “Plastic Deformation of Tissue,” which is commonly slip and fall, car accident, or any other type of trauma that damages the ligaments such that the neck can change from its normal orientation to the ones I have been describing here.
The other way is “Visco-Elastic Deformation of Tissue”, which refers to the body’s being essentially a VERY thick fluid, and the nature of fluid things being to flow into the path of least resistance. I find this often in people who work on a computer for a living. How do you find out if you are one of these types of people? The only way is with a lateral X-ray to determine the alignment of your cervical spine. I sometimes tease people calling it “computer geek syndrome” and yes, it can strike at any age from people in their teens who play a lot of video games, to adult computer programmers, or the more usual suspects: people who just do a lot of data entry in their jobs and often work on laptop computers.
Is there and answer for people like this ? Only if you find a Chiropractor who takes pride in postural correction and while MANY say they do… there are few who actually do this type of work. Let me be frank, no amount of adjustments alone will correct this type of condition. It requires cervical traction in extension to effect these types of change. You may get symptomatic relief from the typical type of practice, but you won’t have the changes that are depicted in the photo on the right (which incidentally is an “after” X-ray of one of my patients who indeed had a reverse cervical curve when we started working together. )
Why don’t more doctors of Chiropractic do this type of care? There are many reasons, some of which I won’t go into here, but the main thing is that Cervical Traction in Extension is not fun for the patient so the doctor has to overcome the natural objections of the patient in order to help. It’s often easier for the doctors just not to talk about it. Also… insurance companies don’t care to fix many of the underlying problems their insureds have, hence the patients may have to be willing to pay for whatever portion of the care that is not covered by their medical insurance. I find that if you have suffered enough, it’s totally worth it to fix the underlying condition as opposed to patch the pain temporarily.
Whatever direction you decide to go fix or patch, Chiropractic is the discipline that CAN help you. You just need to find a practitioner who will take the time to explain the options, and who has the willingness to do the type of work that truly effects change as opposed to just providing symptomatic relief.
The answers are out there !