What are the Treatment Options for Neck Pain?

If you are suffering from neck pain, the first step is to get an accurate and definitive diagnosis from a qualified doctor.  Most cases of neck pain involve tight muscles and inflammation in the joints or around the nerve root.  Some cases of neck pain are from arthritic bone spurs or a herniated disc.  Depending on the cause of the pain and other factors, a specific treatment plan can be assembled by your doctor.

The remaining article lists out natural and drug free treatment options.  It is the belief of the doctors at Frisco Spinal Rehab that your first choice in treatment should be a conservative approach that focuses on treating the true cause of your pain as opposed to only masking the symptoms.

Ergonomics and Posture

Improving your ergonomics and posture are good starting points.  Look at the activities you perform the most and evaluate your posture during these activities and how you can reduce stress on your body.  There are several great websites for improving your ergonomic setup at work.  Just Google “Ergonomic Setup” and you can find what you need.  Sit and stand with good posture – shoulders back and head centered over the shoulders.

General Exercise

Emotional stress is a big factor in many cases of neck pain.  The single best way to counter emotional stress is cardiovascular exercise.  Any activity that increases your heart rate to an appropriate level for your age for an extended period will help force blood flow through the small capillaries in the tight muscles.  A good example for a 35 year old healthy female would be to walk fast enough to get the heart rate up to 130 beats/minute for 20-30 minutes.  This will help relax the mind and drive oxygen into the tight muscles.  It is important to perform cardiovascular exercise at a minimum of 3/week.

Chiropractic Adjustments

Most of the time neck pain tied in with tight and restricted joints.  Restoring motion into these joints is an important step to allowing your body to heal itself.  The joints in the body are dependent upon motion to keep them healthy and any restriction can lead to inflammation and pain.  Lost motion for an extended period can lead to degenerative joint disease.  The chiropractors at Frisco Spinal Rehabilitation use all sorts of different methods to restore proper joint motion.  Joint mobilization, manual chiropractic adjustments as well as instrument chiropractic adjustments are all used with great success.

Rehabilitative Exercises

Recent studies have shown the importance of a particular exercise known as chin retraction exercises or chin tucks.  The concept is to keep the chin tucked down while pushing the head back as far as comfortable possible.  Performing this exercise with resistance may be even better.  This exercise strengthens the deep neck flexors which are very important to the stability of the cervical spine.  Other exercises include isometric neck exercises forward, backwards and side to side.  This involves pushing and activating the muscles but not actually moving the head.  It can be done with an exercise ball as resistance or with your own hand as resistance.

Traditional stretching of the trapezius, levator scapulae, SCM, scalene and pectoralis muscles is not as important as the above exercises but has some benefit as well.  A different type of stretching known as proprioceptive neuromuscular facilitation or PNF can be helpful but requires a partner.

Various Types of Massage

Many types of neck pain involve tight or spastic muscles as well as the formation of scar tissue or fibrotic tissue from some sort of injury.  Depending on the type of muscular problem, different techniques are used.  Trigger point massage focuses on finding tight and painful knots and applying pressure right over them.  The pressure is called ischmic compression and initially reduces blood flow and forces metabolic waste out of the area.  When the pressure is taken away, blood flow rushing into the tissue and cleans up residual metabolic waste.

Myofascial release focuses on breaking up adhesions in the fascial layer or scar tissue.  The treatment involves putting pressure on a muscle as you take it from a short to long position.  Active release technique follows this same line of thinking.  Gua Sha is a technique that involves applying repetitive strokes that lead to some slight bruising to evoke an immune response.  The concept is to create some petechia or superficial bruising which causes big white blood cells called macrophages to come in and gobble up inflammatory chemicals and promote healing.  The Graston technique follows a similar line of thinking.

Various Types of Traction

Over the years we have heard some interesting stories from our patients.  One lady described how her dad would tell the family every night after dinner that he was going to the basement to hang himself.  Well it sounded disturbing, what he was actually doing was called over the door traction.  It involved a harness, rope, pulley and weight to pull on the neck.  This can be purchased for less than $20 in most drug stores.

Other types of traction include foam devices that you rest your head over called fulcrum traction.  A device called a posture pump helps to stretch and elongate the neck as well as re-establishing the cervical curve in the neck.  A fancy form a traction known as spinal decompression involves a computer pulling a various weights on the head to open up the neck and reduce pain.  All types of traction are offered at Frisco Spinal Rehab depending on the underlying problem.

Acupuncture

Acupuncture has a good history of resolving many types of neck pain.  The use of acupuncture is not limited to needles.  Acupressure, cupping, herbs and mind/body exercises are part of the history of this method.  Acupuncture can help break the neurological pain cycle as well as causing an increase in endorphins and encephalin in the blood stream which are the body’s natural pain killers.

Physiotherapy

A common adjust to other treatments is the use of cold laser therapy, ultrasound and various types of electrical stimulation.  Electrical therapies come in many types such as micro current, low voltage, high voltage, interferential, Russian stimulation and TENS with each serving a specific function.

Kinesiotaping may help promote circulation and reduce congestion in the lymphatic flow in the neck.  Diathermy and infrared heat can be used for the same purpose as well as hot and cold packs.

Other Options

Other options include supportive pillows and topical creams such as Biofreeze and Relief.  Most of these creams contain varying levels of menthol and camphor.  They can provide short term relief.  Supplement such as Omega 3 fish oils and magnesium can help with neck pain.  Herbs such as Valerian root and turmeric may help as well.

Frisco Spinal Rehabilitation

The chiropractors in our clinic are here to help you however they can.  If you are in need of a definitive diagnosis for your neck pain or need help deciding what your best treatment options are, call today.  Our clinic is in Frisco, TX and has chiropractors and massage therapists ready to serve your needs.

Can I benefit from a Lumbar Support Brace?

Over the past few years, more and more patients at Frisco Spinal Rehab have experienced quicker relief and better outcomes using a lumbar support brace.  I have to admit, my acceptance and our other doctor’s acceptance of using a lumbar support belt or brace has been a slow process.  It has taken multiple studies and results to change our mindset and gain our confidence.

My initial concern over the use of a lumbar support belt was that by limiting motion, the muscles in the lower back would atrophy or become weaker and ultimately the person’s condition would end up worse.  Most of the treatment in our office is designed to restore motion thereby reducing pain and increasing function.  Anything that limited motion was viewed with skepticism.  For example, 40 years ago patients with severe low back pain were told to stay in bed for days or weeks at a time.  Studies since then have shown that bed rest prolongs recovery and increases a person’s risk of future episodes of low back pain.

Studies regarding the use of a lumbosacral support brace have shown the short term use of a brace or symptomatic use of a brace does not cause any atrophy at all.  In fact one recent study showed a significant increase in paraspinal muscle strength following the use of a brace.  Another study showed a 40% decrease in pain immediately with the use of a brace!  And a 40% increase in function following 6 weeks of use as well as a 20% reduction in medications over a 90 day period.  What do the people who have used the brace really think of it?  Statistics show a 95% satisfaction rate and recommendation rate by prior patients.

When we prescribe a lumbar support brace at Frisco Spinal Rehabilitation, our first goal is to decrease pain by increasing the intra-abdominal pressure to provide more stability to the spine as you move.  The second goal is to reduce motion in inflamed facet joints.  The facet joints are the little joints in the back of the spine that help control and direct motion.  The third goal is to provide a static stretch to the erector spinae muscles with the mechanical pressure from the brace.  The erector spinae muscles run an inch or two lateral and parallel to the spine.  By doing the above, the final goal is to get people with moderate or severe back pain up and moving right away.  By restoring normal activity levels, the healing process can be accelerated.

Fifteen to forty five percent of the population experiences low back pain in a given year.  Not every one of these people need a lumbar support brace.  The conditions we are most likely to prescribe a lumbar support brace for are lumbar disc herniations and bulges, stenosis, sciatica, lumbar instability and cases of low back pain that are unresponsive to chiropractic, medication and physical therapy treatment approaches.

I recently had a patient who wanted to hug me the treatment following fitting her for a brace.  She suffers from bulging lumbar discs and is the primary caregiver for her teenage son who is wheelchair bond.  She states the difference was “immediate and dramatic” and that her back is final responding to the treatment since she isn’t aggravating it transferring her son all the time.  Many of our patients have experienced similar results.

At Frisco Spinal Rehab we use a couple of different brands and styles of braces depending on your particular condition.  The braces are always fitted and many health insurances pay for some or most of the cost.  Our front office can help you determine what portion your insurance will cover if the brace is deemed medically necessary for your condition.

If you are suffering with a back condition and would like to consult with one of our chiropractors about use of a lumbar support brace feel free to contact us.  Even if you’re not a current patient at Frisco Spinal Rehab but you live in the Frisco, TX area we can still advise you regarding the potential benefit of a brace.

Written by David Kaff, DC

Do I Need Foot Orthotics?

Do your feet ache at the end of a long day?  If so, it may benefit you to look into custom made foot orthotics.  As a chiropractor, I am often amazed at the condition of many of our patient’s feet and the general lack of concern regarding proper foot care.  Many of our patients have spent years wearing high heels and improper fitting shoes that were “stylish” or “professional”.

Most of our patients at Frisco Spinal Rehab are unaware that we offer customized orthotics because so many other types of treatment are utilized.  Many of the patients that have discovered this service are extremely appreciative of the cost and the results of this product.  At the time of this writing, the cost for a pair of customized orthotics is $150.  It is not uncommon to see charges in the $300-500.00 range at other offices.   This service is one of our hidden gems.

Are Foot Orthotics for everyone?

Not everyone needs or can benefit from orthotics.  Only people with certain foot conditions such as bone spurs, plantar fasciitis, neuromas and heel pain are ideal candidates.  Plantar fasciitis is a condition that results from straining the fibrous band of tissue that runs from the heel bone to the ball of the foot.  This tissue is normally strained when the arch drops excessively and the fascia is pulled or elongated.  This aberrant motion is called hyper pronation.  Customized orthotics are designed to support the arch and prevent hyper pronation.

A large percentage of the patients we treat in Frisco suffer from lower back pain.  In some of these cases, the low back pain is chronic and testing the feet for hyper pronation and the possible need for orthotics can prove invaluable.  In our office the first test is to observe the feet throughout the gait cycle.  If a problem is observed, the next text is called the Navicular Drop test.  This is a simple test to determine how much each arch is dropping and whether orthotics are likely to provide stability to the kinetic chain.

In addition to helping foot conditions and back pain, customized orthotics can also play an important role in reducing biomechanical stress in the ankles, knees, hips and sacroiliac joints.  Professional golfers commonly use custom orthotics to provide balance from the feet all the way through the body and to the club head.

The orthotics in our office are made from a casting kit not a computer scanner.  No measurement is more true than the traditional casting method.  After a cast has been made then the orthotics can be further customized with depressions to accommodate for bone spurs or other imbalances.  Softer more flexible materials are then selected for sports use or harder materials such as graphite composite for dress shoes. The whole process takes about 15 minutes.  The orthotics last from 1-5 years.

Anyone in the Frisco, TX area is welcome to come is for a free consultation regarding customized orthotics including our current patients.  In addition to this service, we also have success using ultrasound for soft tissue conditions in the feet.  Just like the spinal joints can be adjusted, the joints in the feet can be reset as well.  Many patients have reported remarkable success with foot, knee and ankle adjustments.  Other treatment options we use are massage, Graston (a type of massage with stainless steel instruments), cold laser therapy and rehab exercises such as the marble drop and towel scrunch.  Feel free to contact us is you have any questions about your particular condition.

Written by David Kaff, D.C.

Ice or Heat?

Many people ask the question whether to use ice or heat to help reduce their pain and speed the recovery process. Our opinion is that ice is usually the answer. Most of the conditions we treat in our office present with some degree of inflammation and swelling. Ice should be applied immediately after an injury to slow down the inflammation and swelling. Ice works like a local anesthetic to numb the injured tissue by slowing down the nerve impulses and interrupting the pain/muscle spasm reaction. When the tissue becomes cold, the veins and arteries contract and reduce circulation. Once the ice has been removed and the body temperature returns to normal, the constriction is released and nutrients return to the affected area and help speed up the recovery process.

Ice can be applied for 20-30 minutes at a time. We recommend that you ice continuously 20 min on, 20 min off, 20 min on, 20 min off and so forth. Being consistent with icing may allow the body to heal itself faster.

Ice Burn!!!

An Ice burn can occur if the ice has been left on area for too long or placed directly on the skin. Always place a towel or any other material between the ice pack and your skin.

**NEVER PUT ICE DIRECTLY ON THE SKIN. **

Do not ice if you have any of the following conditions or circumstances
Raynauds Phenomenon – A condition affecting small blood vessels in the extremities. Exposure to cold may cause a return in symptoms.
Cold Hypersensitivity – There are many forms of cold hypersensitivity, which includes:

  • Cold Urticaria – Also known as hives. A release of histamine during re-warming after a period of cooling, causing red, itchy welts on the skin.
  • Cold Erythema – A rash characterized by redness and itching, caused by exposure to cold. This condition can cause severe pain and muscular spasms.
  • Cold Hemoglobinuria – When red blood cells break down so quickly that some hemoglobin cannot combine with blood proteins.

Anesthesia – When there is an area of numbness or altered sensitivity, cold therapy should not be used because the pain and the degree of cooling cannot be felt by the patient.

Written by Courtney Trautman, LMT  Edited by Dr. Kaff, D.C.