Chronic neck pain is a severe condition that we often treat in the office. Not everybody with chronic neck pain has a history of trauma. Many people slowly develop neck pain over the course of years without any one specific traumatic incident, such as a car accident or falling. Many people slowly start to develop neck pain overtime. It begins as very mild and occasional pain, occurring once or twice a year. The intensity, frequency, and duration of symptoms increases throughout the years.
People eventuallydevelop more severe chronic neck pain symptoms that requires significant treatment. More advanced conditions require a significant amount of treatment just to maintain their pain levels, range of motion, and functional activities of daily living at reasonable levels. This neck pain may limit recreational activities and hobbies.
Different studies have looked at treatment ofboth acute and chronic neck pain. The study looked at chronic neck pain in patients without a history of trauma. Equivalent groups were established. One was control group with no treatment. The second group had a combination of chiropractic and physical therapy activities incorporated into their treatment plan. Treatment included massage or soft tissue therapies in addition to stretching, strengthening, and neuromuscular reeducation activities.
The chiropractic and physical therapy group showed a significant improvement in pain and functional abilities. The control group did not get any better. If you suffer with chronic neck pain I don’t think this comes as a surprise. If you don’t do anything it doesn’t improve on its own. It has continued to get worse throughout the years, and would seem reasonable that you are going to have to do some type of intervention for improvement. This study showed that chiropractic in combination with other physical therapy treatments can help decrease pain and functional abilities in chronic neck pain without trauma.
The abstract does not get into details regarding neuromuscular reeducation, which basically can be described as retraining patterns andmovements within the neck muscles. Commonly with chronic neck pain the bigger muscles go into spasm and restrict how joints move. In addition the smaller muscles that should control how a cervical joint moves are not able to do their job. Treatment that helps loosen up spasm muscles, strengthen, and teach the little muscles how to work again. Re-educational movement pattern activities are simple and provide benefits.
We find it is veryimportant with chronic neck pain to get those little muscles engaged and functioning again. It is always in treatment to get the big trapezius muscle to loosen up, but it needs to be done to relieve pain intensity, frequency, and duration. Below is the research study for your reading pleasure.
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Journal of Manipulative and Physiological Therapeutics
Volume 29, Issue 2 , Pages 100-106, February 200612
Improvement After Chiropractic Care in CervicocephalicKinesthetic Sensibility and Subjective Pain Intensity in Patients with NontraumaticChronic Neck Pain
Per J. Palmgren, DC, Peter J. Sandström,DC, Fredrik J. Lundqvist, DC, HannuHeikkilä, MD, PhD
The objective of this study was to examine alteration in head repositioning accuracy (HRA), range of motion, and pain intensity in patients with chronic cervical pain syndrome without a history of cervical trauma.
The study was a prospective, randomized, controlled trial. Forty-one patients with chronic cervical pain were randomly assigned to either a control group or a chiropractic treatment group. All patients were clinically examined, given general information on cervical pain, and provided with training instructions based on the clinical evaluation. The treatment included sessions with high-velocity and low-amplitude manipulation, proprioceptive neuromuscular facilitation, ischemic compression ofmyofascialtrigger points, and spinal rehabilitation exercises aiming to normalize cervical range of motion (CROM) and HRA. Subjective pain intensity, cervical kinesthetic sensibility, and CROM were recorded before and after the study period.
There was no difference between the treatment patients and the control subjects at the beginning with regard to age,sex, subjective pain intensity, range of motion, and HRA. At the 5-week follow-up, the treatment patients showed significant reductions in pain and improvement of all HRA aspects measured whereas the control subjects did not show any reduction in pain andimprovement in only one HRA aspect. No significant difference was detected in CROM.
The results of this study suggest that chiropractic care can be effective in influencing the complex process of proprioceptive sensibility and pain of cervical origin. Short, specific chiropractic treatment programs with proper patient information may alter the course ofchronic cervical pain.
© 2006 National University of Health Sciences. Published by Elsevier Inc. All rights reserved. PubMed