Neck Pain

/Neck Pain
Neck Pain2018-04-23T16:40:06+00:00
If you experience neck pain you are not alone. Neck pain is becoming one of the most common reasons for visiting the doctor’s office. Anyone who suffers with neck pain knows that the condition can dramatically interfere with daily life, often making driving, sleeping, exercising, and even concentrating difficult. As if that isn’t enough, neck pain is often recurrent, and many common neck conditions are often slow to respond to traditional types of care, which may provide only temporary relief.

Now for the good news: a new treatment technique known as Active Release Techniques® (ART®) is proving to be a very effective method for treating many common neck problems and is helping neck-pain sufferers get back to doing their favorite activities. Before we explain why ART® works so effectively, we need to tell you how the neck becomes injured in the first place.

When we refer to the neck, we are actually talking about the upper portion of the spinal column, or the cervical spine. The cervical spine consists of seven small bones called vertebrae, which are stacked on top of each other, each connected through a series of joints. These joints allow the neck to turn and bend, which is important for all of our everyday movements. By themselves the joints of the cervical spine are not very stable, so a complex system of muscles surrounds the spinal column to control movement and protect the area from injury. These muscles are arranged in several layers. The deepest layers are very small muscles that attach to each individual vertebra and control and protect each individual joint. The middle layers span several joints, and the outer layer consists of the larger, more powerful muscles that run the entire length of the neck, all the way from the head to the shoulders.

These muscles not only need to move and protect the cervical spine, but they also must control the weight of the head. The head and neck have a unique anatomical relationship in that the larger, heavier head, which weighs about 10 pounds, sits atop the thinner neck, which means that the natural tendency would be for the heavier head to topple over. This places a high demand on the neck muscles to both support and control the weight of the head, at the same time ensuring adequate movement and stability of the joints of the cervical spine. This complex process requires each muscle to be adequately strong, flexible, and coordinated, and as long as this is the case the neck remains protected and healthy.

The health of the neck depends on a complex interaction of muscular contractions to move and stabilize each joint in the cervical spine and properly move and position the head. If any of the muscles that surround the cervical spine become tight, weak, or uncoordinated, an excessive strain is placed on the other surrounding muscles and on the spinal column. Over time, If imbalance in the muscles and the resulting abnormal head and neck motion is allowed to continue, more severe neck conditions can eventually develop.

A variety of situations can cause tightness, weakness, and abnormal function of the neck muscles. Poor or prolonged postural strain that can occur with computer use and many desk jobs, repetitive use in certain sports, muscle imbalances, lack of stretching or strengthening, and/or a car accident (even a minor accident with little or no injury) can affect the normal function of the neck and surrounding muscles, resulting in excessive strain to the area.

Over time this strain can develop into what is known as micro-trauma. Micro-trauma is very small-scale damage that occurs in the muscles, tendons, joint capsules, and ligaments in response to small levels of strain. Initially micro-trauma is not painful, but may be perceived as a mild ache or tightness in the muscles. Although small, this damage needs to be repaired. The body responds to micro-trauma by laying down small amounts of scar tissue to repair the area.

Over time this scar tissue can build up and accumulate into adhesions. As these adhesions form, they affect the normal health and function of the muscles and related joints. In fact, they often lead to pain, tightness, stiffness, restricted joint motion, and diminished blood flow. This places even further strain on the neck muscles, which in turn leads to even more micro-trauma. A repetitive strain injury cycle is set up, causing continued adhesion formation and progressive cervical spine dysfunction. At this point, pain and tightness often become noticeable.

As the repetitive-strain-injury cycle continues, the ability of the neck muscles to meet the demands placed on them diminishes. At this point it is not uncommon for the muscles to give way and more severe and debilitating pain occurs. In fact, many patients come into our office explaining that they have neck pain but no major injury occurred. These patients almost always describe some mild pain or tightness in their neck that has been building over time.

How Can Neck Injuries Be Repaired?

The most common approach to treating neck pain is medication to reduce inflammation, block pain, or relax muscles that may be causing headaches. In the case of chronic or recurrent pain, sometimes doctors prescribe stronger prescription medication to help alleviate the headache. In some cases, even more invasive measures such as joint blocks are used.

The main reason that medication fails to provide long-term resolution for neck pain is that it fails to address the underlying problems of the muscles, nerves, or joints that are causing the recurrent pain. Instead, medication addresses the symptoms of the headache and simply covers up the underlying issues in the neck, which, if not addressed, will continue to cause problems. As a result, many people become reliant on medication to accomplish the relief of their headaches. This is a temporary fix that increases the risk of side effects and dependency on the medication.

Muscle tightness and imbalance, scar-tissue adhesions, nerve entrapments, and abnormal joint movement cannot be seen on an x-ray or advanced imaging. These problems in the muscles, joints, nerves, and ligaments can, however, be felt or tested by the hands of a skilled practitioner, because scar tissue has a unique texture. A thorough history and clinical examination is usually sufficient to give the practitioner enough information to diagnose the problem.

In an attempt to treat neck pain, a variety of treatments are used, either alone or in combination. Some of the more common approaches include anti-inflammatory medication, rest, ice, ultrasound (US), muscle stimulation (E-Stim), steroid injections, stretching, exercise, and when all else fails, surgery. Most of these traditional techniques require a long period of time before they provide any significant relief, and in many cases they provide only temporary relief from symptoms instead of fixing the underlying cause.

The main reason that these approaches are often ineffective is that they fail to address the underlying scar-tissue adhesions that develop within the muscles and surrounding soft tissue. These adhesions are binding the tissues together, restricting normal movement and interfering with the normal flexibility and contraction of the muscles in and around the spine.

Passive approaches such as muscle relaxants and anti-inflammatory medication, rest, ice, and ultrasound, all focus on symptomatic relief and do nothing to address the muscle restrictions and dysfunction. More active approaches such as stretching and exercise are often needed for full rehabilitation of the condition and to restore full strength and function of the muscles; however, they do not treat the underlying adhesions. In fact, without first addressing the scar-tissue adhesions, stretches and exercise are often less effective and much slower to produce pain relief or recovery from neck pain.

artpurple-transparent  Neck Pain artpurple transparentART® stands for Active Release Technique®. It is a new and highly successful hands-on treatment method that addresses problems in the soft tissue of the body, including the muscles, ligaments, fascia, and nerves. ART® treatment is highly successful in dealing with neck injuries because it is specifically designed to locate and treat scar-tissue adhesions that accumulate in the muscles and surrounding soft tissue. Locating and treating the soft-tissue adhesions with ART® allows the practitioner to:

  1. Break up restrictive adhesions
  2. Reinstate normal tissue flexibility and movement
  3. More completely restore flexibility, balance, and stability to the injured area and to the entire kinetic chain

An ART® treatment is a type of active massage. The practitioner first shortens the muscle, tendon, or ligament, and then applies a very specific pressure with the hands as you actively stretch and lengthen the tissues. As the tissue lengthens, the practitioner is able to assess the texture and tension of the muscle to determine if the tissue is healthy or contains scar tissue that needs further treatment. When scar-tissue adhesions are felt, the amount and direction of tension can be modified to treat the problem area. In this sense, each treatment is also an assessment of the health of the area as we are able to feel specifically where the problem is occurring.

An additional benefit of ART® is that it allows us to further assess and correct problems not only at the site, but also in other areas of the kinetic chain, that are associated with movement compensations and are often contributing factors to the problem. This ensures that all the soft tissues that are dysfunctional and contributing to the specific injury are addressed, even if they have not yet all developed pain.

One of the best things about ART® is that it provides results quickly. In our experience, the majority of neck injuries respond very well to ART® treatment, especially when combined with the appropriate self-directed neck-stretching exercises. Although each case is unique and several factors determine the length of time required to fully resolve each condition, we usually find a significant improvement can be gained in four to six treatments. These results are the main reason that many elite athletes and professional sports teams have ART® practitioners on staff, and why ART® is an integral part of the Ironman triathlon series.

To book an appointment to see if ART® can help with your neck pain, call our office at (248) 477- 2100.