Neck Pain/Cervical Disc
Cervical mobilization: concurrent effects
on pain, sympathetic nervous system activity and motor activity.
Sterling M, Jull G, Wright A. Man Ther (Manual Medicine)
2001;6(2):72-81.
In this paper, 30 patients with middle or lower
neck (cervical) pain had “spinal manipulative therapy” (SMT)
and their pain reduced after care.
Spinal care was found to
have a pain fighting effect (“a
hypoalgesic effect) as pain thresholds increased. It was
also found that the sympathetic nervous system, which affects
the functions of internal organs was affected: The authors
write: “The treatment technique also produced a sympathoexcitatory
effect with an increase in skin conductance and a decrease
in skin temperature.”
Chiropractic treatment of post surgical
neck syndrome utilizing mechanical force manually assisted
short-lever spinal adjustments. Polkinghorn B and Colloca CJ
Manipulative Physiol Ther November/December 2001. Vol 24 No.
9.
This is the case of a 35-year-old female who, after having
neck surgery two separate times (a diskectomy at C3/4 and
a fusion at C5/6) suffered from chronic neck pain for over
5 years.
She had originally undergone the surgeries to resolve
neck pain. Her surgeon suggested a third surgery but she decided
on chiropractic care. Within 30 days of chiropractic care all
her chronic pain and muscle spasm resolved. A follow-up two
years later revealed no recurrences of her previous chronic
problem.
Chronic spinal pain syndromes:
a clinical pilot trial comparing acupuncture, a nonsteroidal
anti-inflammatory drug (NSAID), and spinal manipulation. Giles
LG, Muller R. J Manipulative Physiol Ther July/August 1999:22(6),
pp.376-81.
Seventy seven patients were divided into three groups.
One group received needle acupuncture, one group an NSAID and
one group chiropractic care.
They were followed up after 30
days. Spinal care was the only intervention to achieve a statistically
significant improvement. Patients receiving chiropractic care
demonstrated a 30.7% reduction in Oswestry scores and a 25%
reduction in neck disability index scores, a 50% reduction
for low back pain, 46% reduction for upper back pain and 33%
reduction for neck pain. Acupuncture and NSAIDS provided no
significant improvement.
Manipulation and mobilization of the
cervical spine. Hurwitz EL, Aker PD et al. Spine, 1996;21(15):1746-1760.
In
this review of research, the authors concluded that for those
suffering from chronic neck pain, manipulation is more effective
than any other approach.
Conservative management of mechanical
neck pain: systemic overview and meta-analysis. Asker PD, Gross
A et al. British Medical Journal 1996;313:1291-1296.
In this
review of research, the authors concluded that for those suffering
from chronic neck pain, manipulation is more effective than
any other approach.
Chiropractic treatment of cervical radiculopathy
caused by a herniated cervical disc. Brouillette DL, Gurske,
DT. Journal of Manipulative and Physiologic Therapeutics, Feb
1994; 17(2): 119-123.
This is the case study of a 60-year-old
woman with MRI documented herniated cervical disc.
Symptoms
included deep, constant, burning ache in the left arm, and
severe neck and left shoulder pain. Under chiropractic care
the patient’s pain and numbness
disappeared and her grip-strength returned to normal within
5 months.
Cervical spondylotic radiculopathy treated with the
Meric technique: a case report. Gemmell, HA. Chiropractic Technique,
Feb 1994; 6(1): 14-16.
This is the case of an annular disc protrusion
with nerve root compression at level C-5 of a 69-year-old white
male.
From the abstract:
Patient exhibited toothache-like pain over
the left upper trapezius and deltoid muscles with an absent
biceps reflex, decreased sensation to pinprick in the C5 dermatome,
and a weak deltoid muscle. The patient was successfully treated
over 26 days with eight treatments using Meric adjustments
and supportive therapy. He remained pain free, without neurological
signs, at the 4-month follow-up. Soft tissue injuries of the
cervical spine: a 15-year follow-up. Squires B, Gargan MF,
Bannister GC. J of Bone and Joint Surgery (British Edition),
1996; (70B), pp955-57.
Ten and fifteen years after the original
accident, some patients continue to complain of neck pain,
back pain, headaches and/or dizziness.
This is the study of
40 patients with a whiplash injury assessed an average of 15.5
years after the injury.
This shows us that whiplash symptoms
may remain for years without resolution. The most common complaint
was neck pain, followed by back pain, headaches and dizziness.
Psychological disturbances were seen in 52% of the patients.
Between
10 and 15 years after their initial injuries, only 18% of the
patients demonstrated significant improvement. Twenty-eight
percent showed deterioration. Brain SPECT findings in late
whiplash syndrome. Otte A, Mueller-Brand J, Fierz L. Lancet
1995; 345:1512-13.
Why do people with neck pain and whiplash
sometimes suffer vision, hearing and personality disturbances?
A study using a new technology shows that such patients have
decreased blood flow in certain brain areas and that pain irritation
from the upper neck. appears to affect the blood supply to
the brain.
Using technetium-99m hexanethylproplyrnrsminroxime
single photon emission computerized tomography (SPECT), they
found that six of seven patients with nontraumatic cervical
pain had parieto-occipital hypoperfusion. In 24 patients confirmed
by independent observers to be suffering from cognitive disturbances
after whiplash injury, all had parieto-occipital hypoperfusion
compared with 15 normal control subjects.
Manipulation and mobilization
of the cervical spine: a systematic review of the literature.
Hurwitz EL, Aker PD, Adam AH, Meeker WC, Shekelle PG. Spine
1996; 21:1746-60.
This was an analysis of the medical literature
from 1966 to 1996 regarding cervical spine manipulation and
neck pain and headache. Data was summarized and randomized
controlled clinical trials were critically appraised. Cervical
spinal manipulation was found superior to other therapies (muscle
relaxants and medical care) for neck and headache.
Chronic spinal
pain syndromes: a clinical pilot trial comparing acupuncture,
a nonsteroidal anti-inflammatory drug, and spinal manipulations.
Giles LFG, Muller R,J Manipulative Physiol Ther 1999;22(6):376-381.
Chiropractic provided chronic neck pain patients with superior
results when compared with acupuncture and drugs.
Diagnosis
and treatment of TMJ, head, neck and asthmatic symptoms in
children. Gillespie BR, Barnes JF, J of Craniomandibular Practice,
Oct. 1990, Vol 8, No. 4.
From the abstract:
Pathologic strain patterns in the soft tissues
can be a primary cause of headaches, neck aches, throat infections,
ear infections, sinus congestion, and asthma.
Reduction of a
confirmed C5-C6 disc herniation following specific chiropractic
spinal manipulation: a case study. Siciliano MA, Bernard TA,
Bentley, NJ. Chiropractic: The Journal of Chiropractic Research
and Clinical Investigation Vol. 8 No. 1 April 1992.
This is
the case of a 39-year-old male cable technician who complained
of right neck and arm pain. Twenty years earlier he had a football
injury and had some similar, temporary pain at that time. He
now had an aching, deep pain running from the base of his neck
to the right elbow and sometimes running sharply down his arm.
Magnetic
resonance imaging (MRI), thermography and Kronamaz muscle testing
apparatus documented a C5-C6 disc herniation. Under chiropractic
care the patient was symptom free. After 13 chiropractic visits,
a post-adjustment MRI revealed a reduction in the herniation.
Reabsorption
of a herniated cervical disc following chiropractic treatment
utilizing the atlas orthogonal technique: a case report. Robinson,
Kevin. Abstracts from the 14th annual upper cervical spine
conference Nov 22-23, 1997, Life University, Marietta, Ga.
Pub. in Chiropractic Research Journal, Vol. 5, No.1, Spring
1998.
This is the case of a 44 year-old man whose symptoms were
as follows: severe neck pain, constant burning, left arm
pain and left shoulder pain plus paresthesia in the index
finger of the left hand. Patient also had diminished grip
strength on left hand using dynamometer testing. Tests also
revealed hyporeflexive biceps and triceps on the left as
well as a C6 and C7 sensory deficit on the left. The MRI
scan revealed a large left lateral herniated disc at the
C6-7 level.
By the fifth week of care the patient’s symptoms of
severe neck, shoulder, and arm pain were completely resolved.
The patient’s numbness and grip strength improved consistently
during the following six months. Comparative MRI obtained
14 months following the initial exam revealed total resolution
of the herniated cervical disc.
Copyright 2004 Koren Publications,
Inc. & Tedd Koren,
D.C.
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