Neck Pain Call 02476 222002. Reg’d  Bupa Axa Hsa   All Health insurance accepted.

What is neck pain?

Neck pain is a very common medical condition, and one seen many times by Physiotherapists. Neck pain can come from many different disorders and diseases which affect the tissues in the neck, such as degenerative disc disease, neck strain, whiplash, herniated disc, or a pinched or trapped nerve or nerves. Neck pain is also referred to as cervical pain.

Symptoms

Neck pain is associated with a dull ache or aching around the afflicted area and will become worse as the neck is moved.  Other symptoms associated with neck pain include numbness, tingling, tenderness, sharp and shooting pains, headaches, difficulty swallowing, pulsations, dizziness or light headedness. It is also possible for the neck glands to swell.

Treatments for Neck Pain

Neck pain treatment options include rest, ice applications, physical therapy chiropractic manipulation, local injections of cortisone or anesthetics, muscle relaxants, analgesics, and surgical procedures. Cold Laser Therapy is also a possible form of treatment.

Neck and back pain are usually common conditions or injuries to the neck and back. The pain may come on gradually, or it may be acute and come on suddenly. Bad posture is a common cause in the onset of this pain but it is not the only cause. Physiotherapists understand the various causes of neck pain, and can offer advice.

Cervicalgia

The neck muscles are constantly placed under tension, although this tension helps to keep the head in position i.e. upright. However, the muscles in the neck are more prone to becoming stiff and painful as a result of this tension. As a result of violent movement or sudden impact (sometimes known as whiplash).
Cervicalgia is a localised pain that does not radiate through into other areas of the neck. Symptoms include:

·         A sharp pain in the neck

·         Neck ache

·         Pain resulting from head movement

·         Pain radiating to the shoulders, arms and fingers

It also may radiate pain into other areas; this is usually caused by a trapped nerve or nerves. Nerves can become trapped by tight muscles, disc damage, or the formation of bony deposits. Radiating pain in the neck which affects the shoulders and arms may also affect the fingers.

Neck dysfunction can result in dizziness, nausea or headaches but it can be successfully treated by Cold Laser Therapy, one of the treatments offered by Central Chiropractic and Physiotherapy Clinic.

Cervical Disc Injuries

Most cervical disc injuries are caused by hyperextension, which results in compression of the cervical area 

Flexion injuries in the cervical area do not result in nerve compression.

Symptoms of Cervical Disc Injuries

The Pain may cause loss of sensation or tingling/pins and needles to the arms, and weakness are the main symptoms and signs of cervical disc injury. The pain is most noticeable symptom and it is usually the only one. Cervical disc injury can complicated by compression of either a cervical nerve root or by a compression of the spinal cord, but this reported injury is very infrequent.  When compression of the nervous tissue occurs, patients may report different sensations other than pain. Weakness to the legs/leg this is called spinal cord compression. if the arms/arm are  affected this is called nerve root compression

Pain can be felt in the neck or arm. 

Pain is always in the area of the neck and upper back between the shoulder blades. This is due to inflammation of the disk and the cervical vertebra joints. Sever inflammation can flare up after a minor added injury or for other unknown reasons. Neck and shoulder pain are due to the disc bulges that herniates, and stretches the posterior longitudinal ligament.  

b. Rarely, the pain will be felt down the arm.  This pain can be lightning, caused or aggravated by movements of the neck, or can be dull and persistent. Pre-existing neck pain is also present in many individuals. After the arm pain starts, some people report feeling less pain in their neck. When arm pain is present, it is usually because of a combination of disc herniation and bony spurs compressing a nerve root. A free disc fragment can also intrude on a cervical root and cause quite a bit of pain in shoulder or down the arm.

 2. Sensory symptoms other then pain.

When felt in only one arm, they are due to compression of a cervical root and felt in the territory of the cervical root. The C4 root mainly supplies the shoulder with nerves, while the C5 root supplies primarily the arm. The C6 root supplies nerves to the radial side of the forearm, the C7 root addresses the arm and forearm, and the C8 and the T1 root handle mostly the hand. Broadly speaking, two types of sensory symptoms are felt: loss of sensation and new sensations. A loss of sensation is simply numbness. New sensations include tingling (pins and needles), heat, or cold sensations.

If the spinal cord is compressed, most patients report losing sensation in their hand and in the lower part of their body. (Numbness) They have difficulty feeling the floor when they walk and cannot feel that their bladder is full or incontance, this is an emergency and patients should be brought to the hospital right away.

3. Motor symptoms and signs.

Weakness of one arm (the other one being normal) only signals a compression of a nerve root. A compression of C4 results in a weak shoulder; C5 indicates a weak bicep muscle; C6 represents a weak wrist, thumb, and index finger; C7 is a weak tricep, extension of the fingers, and pectoralis muscles; C8 designates weak flexion of the fingers; and T1 corresponds to a weak hand.

Emergency Treatment.

If the spinal cord is compressed, patients report having difficulty walking and weak legs and hands, numbness these can be the only symptoms and should be treated as an emergency.

Although neck pain can be caused by injury, such as ‘whiplash’ injuries, it is often caused by the cumulative effect of improper sitting posture, reading in bed, poor work habits, stomach sleeping, lack of proper exercise and other lifestyle-related factors. All of these factors cause misalignments in the spine and eventually pain. In fact, the most important factor producing neck pain appears to be spinal misalignments. Even for people who complain that “stress” is causing their pain, the great majority of those have significant spinal misalignments that are contributing to their condition.

Uncorrected chronic spinal misalignments can eventually cause neck pain. As a spinal misalignment worsens, pressure can be put on delicate nerves, sending the surrounding neck muscles go into painful and movement-limiting spasm, headache, even numbness, tingling or weakness in the arms or hands

Cervicogenic headaches  

Cervicogenic headaches are defined as headaches originating from the neck. The location is typically at the back of the head, sides and top of the head as well as around the forehead and eyes affecting one or more of the above regions at once. These headaches can be located on one or both sides of the head. Cervicogenic headaches are usually associated with dysfunction of the upper neck which can present itself as neck pain or local tenderness, reduced neck range of motion and exacerbation of the headaches by neck movement. The past history of neck trauma is typical for this type of headaches.

The cervicogenic headaches are caused by irritation of nerve endings of injured joints, ligaments, muscles and discs of the neck. The nerve endings in the injured areas send pain signals up the upper nerves of the neck to the brain causing “cross wiring” with the fibres of the trigeminal nerve (one of the nerves in the head) which is responsible for perception of the head pain thus causing the headaches.

Neck pain as well as “whiplash”(WAD) injuries and both conditions can result in headaches and all three are commonly treated by Chiropractors.
The treatment is focused on the small joints in the back of the neck called facet joints that are responsible for neck pain. When these joints dysfunction but injury to the muscles he nerve fibres that innervate / act as sensors for these facet joints also serve to act as sensors to parts of the head. When these facet joints dysfunction these sensors become active, the brain cannot clearly differentiate between the facet joints and the mapping of the head and create the sensation of pain in a broader area- Headache.

Whiplash Associated Disorder (WAD).

Whiplash Associated Disorder (WAD) or commonly known as ”WHIPLASH” from the Journal of Orthopaedic Medicine 1999;   21 (1):   22–25 university Department of Orthopaedic Surgery. Bristol. UK

Khan S, Cook J, Gargan M, Bannister G 

Objective:   To determine which patients with chronic “whiplash”(WAD) will benefit from chiropractic treatment.

Design:   Retrospective review by structured telephone interviews of 93 consecutive patients seen in chiropractic clinic.

Setting:   Independent chiropractic clinic in a large city.

Subjects:   93 patients, 68 female.

Main outcome measure:   Gargan and Bannister grading pre and post treatment.

Results:   Three groups of patients were recognised. Group 1 consisted of patients with isolated neck pain associated with a restricted range of neck movement. Group 2 consisted of patients with neurological symptoms or signs associated with a restricted range of movement. Group 3 comprised patients who described severe neck pain but all of whom had a full range of neck movement. Patients in this group often described an unusual group of symptoms, with a bizarre, non-dermatomal pain distribution. There was a significant difference in outcome between the three groups (p<0.001) with only groups 1 and 2 improving following chiropractic manipulation.

Conclusion: Whiplash Associated Disorder (WAD) or “Whiplash’ and neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.

Neck Anatomy

The head  weight of 12lbs or more not only does the neck fully support all that weight, it enables the  head to turn or move up or down No other part of the spine has the ability to move so much: in forward motion, and in backward motion, this also includes the  side-to-side motion, and from  shoulder to shoulder. 

The neck is called the cervical spine, and it begins at the base of your skull. It contains 7 small bones (vertebrae), which doctors label C1 to C7 (the ‘C’ means cervical). The numbers 1 to 7 indicate the level of the vertebrae. C1 is nearest to the skull, while C7 is nearest to the chest.

In between each vertebra are tough fibrous shock-absorbing discs called the intervertebral discs. Each disc is made up of a gel-like outer band (annulus fibrosus) and a gel-like inner substance (nucleus pulposus).

Besides the bones and the discs, the neck consists of joints, muscles, and ligaments these stabilize and give the neck its full range of movement.

The neck is the upper part of the spinal cord, and consists of nerve roots, and an elaborate system of arteries and veins. The nerves in the neck help the brain communicate with the shoulders, arms, and chest. The arteries and veins circulate blood to both the brain and the heart.

For Further in depth Information on Neck pain or Headaches, please go to top left corner under “Pain” or “Conditions.” For Cold Laser Therapy, please go to top left corner under “Treatments”

Call 02476 222002 . Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simpleyhealth. Standard life. Pru health. Mercia health.Medicash Medisure. All health insurance accepted

Stiff Neck. Inflammatory Diseases, Severe Injuries, Cervical Disc Degeneration, When Should You Seek Medical Care? What is Whiplash Associated Disorder (WAD )or commonly known as ”Whiplash” (WAD) Diagnosis.

Non specific term for limited neck mobility often due to muscle cramps and accompanied by pain.

The neck (cervical spine) is composed of vertebrae that begin at the base of the skull and end in the upper torso. The vertebrae along with the ligaments provide stability to the spine. The muscles allow for support and movement of the neck. The neck supports the weight of the head which is 12lbs amounting to a significant load for the neck to cope with during motion thus increasing stress onto the neck (cervical spine). Compare to the rest of the spine, the neck is less protected and is more susceptible to injury and various disorders that can result in pain and restricted motion. Sometimes neck pain is a temporary condition going away on its own accord. Other cases require medical diagnosis and treatment to relieve the symptoms.

Cause

Neck pain may result from injury to the soft tissues including muscles, ligaments, nerves, bones and joints of the spine. Soft tissue injuries or prolonged wear and tear are amongst the most common causes of neck pain. Infection or tumours may cause neck pain in rare instances. Sometimes neck problems may be the source of pain in the upper back, shoulders, or arms.

Inflammatory Diseases

The vertebral column. Rheumatoid arthritis involves joints in the neck and may cause severe stiffness and pain. Rheumatoid arthritis usually occurs in the upper neck area.

Cervical Disc Degeneration

Cervical disc degeneration usually occurs in people aged 40 and older. Disc’s act as shock absorbers between the bones. During cervical disc degeneration the normal gelatin like centre of the disc dries out and the gap between the vertebrae narrows. As the disc space narrows, added stress is imposed onto the joints of the spine exacerbating further wear and degenerative changes. When occurs when cervical disc protrudes due to the weakening of its rim, putting pressure on the spinal cord or nerve roots.

Injury

Due to its flexibility and the weight of the head it supports the neck is extremely vulnerable to injury. Road traffic or diving accidents, contact sports, and falls are the main causes of neck injury. A “rear end” shunt during car accident may result in hyperextension, a backward motion of the neck beyond normal limits, or hyper flexion, a forward motion of the neck beyond normal limits. The use of seat belts and head restrains in cars can help to prevent or minimize neck injury. The soft tissues such as muscles and ligaments are most commonly involved. Severe injuries including fracture or dislocation of the neck may lead to the damage the spinal cord and cause paralysis.

What is Whiplash Associated Disorder (WAD) or’whiplash”?

“Whiplash” (WAD) injury occurs when the body reacts to sudden deceleration or acceleration force causing hyper flexion or hyperextension of the neck.

“Whiplash” (WAD) injuries are associated with car accidents. The “Whiplash”(WAD) injury is sustained when the muscles of the neck and shoulders do not have enough time to brace and hold the head during sudden acceleration or deceleration force application leading to injuries of the muscles, ligaments, capsule of the facet joints and discs of cervical spine.

Uncomplicated cases

“Whiplash” (WAD) cases that are uncomplicated are the result of sprained ligaments in the neck. The muscles spasm naturally to form a protective mechanism for the neck. The “whiplas”(WAD) injury may cause a stiff neck and pain may be present down one or both arms if the nerve roots of cervical part of spinal cord get compressed. Relief for “whiplash” (WAD) can be found with chiropractic treatment, physiotherapy or pain medication.

Severe cases

In severe cases of “whiplash”(WAD) may last for a month or more with persistent and in some cases constant pain. This may indicate that the” whiplash”(WAD) injury has extensive damage and resulting in disc’s rupturing and trapped nerves in the neck. This may also predispose to a “slipped”, ruptured or herniated disc in the back. (See our Cold Laser Therapy Section under Inflammatory conditions.)

Other Causes of neck pain

Tumors, infections, or congenital abnormalities of the vertebrae are less common causes of neck pain.

When Should You Seek Medical Care?

Cases of severe neck pain occur following an injury such as motor vehicle accident, blow to the head or fall related accident. Only a trained professional, such as a paramedic, should immobilize the patient to avoid the risk of further injury and possible paralysis. Medical care should be sought immediately.

Immediate medical care should also be sought when an injury causes pain in the neck that radiates down the arms and legs. Radiating pain or numbness in your arms or legs causing weakness in the arms or legs without significant neck pain should also be evaluated. If there has not been an injury, you should seek medical care when neck pain is:

·         Continuous and persistent

·         Severe

·         Accompanied by pain that radiates down the arms or legs

·         Accompanied by headaches, numbness, tingling, or weakness

Diagnosis

Determining the source of the pain is essential to recommend the appropriate treatment and rehabilitation. Therefore, a comprehensive examination is required to determine the cause of neck pain.

Your Physiotherapist or Chiropractor will take a complete history of the symptoms you are having with your neck. The Physiotherapist or Chiropractor may ask you about other illnesses, any injury that occurred to your neck, and any complaints you have associated with neck pain. Previous treatment for your neck condition will also be noted.

Physiotherapist or Chiropractor will also perform a physical examination. This examination may include evaluation of neck motion, tenderness of the neck and the function of the nerves and muscles in your arms and legs.

Digital X-rays often will be obtained to allow your Physiotherapist or Chiropractor to look at the bones in your neck. This entails simple diagnostic imaging study (radiography) and aids your Physiotherapist or Chiropractor to determine the cause of neck pain and to prescribe effective treatment.

Further evaluation may involve the following:

·         MRI (magnetic resonance imaging). This non x-ray study allows an evaluation of the spinal cord and nerve roots.

·         CT (computed tomography). This specialized x-ray study allows careful evaluation of the bone and spinal canal.

·         EMG (electromyography). This test evaluates nerve and muscle function.

Treatment

The treatment of neck pain depends on the diagnosis. Most patients are treated successfully with Physiotherapy or Chiropractic Treatment. Also rest, medication, immobilization, exercise, activity modifications, or a combination of these methods can be very useful.

Inflammation is a result of stretching muscles and ligaments beyond their limits, (See also Cold Laser Therapy under conditions treated; this therapy is extremely affective in the treatment of inflammation). Surgery is required in very few cases to relieve neck pain. For most patients, a combination of Physiothrapy or Chiropractic treatment, rest, medication, and physical therapy will relieve neck pain. Surgery may be necessary to reduce pressure on the spinal cord or a nerve root when pain is caused by a herniated disc or bony narrowing of the spinal canal. Surgery may also be required following an injury to stabilize the neck and minimize the possibility of paralysis, such as when a fracture results in instability of the neck.

Non specific term for limited neck mobility, often due to muscle cramps and accompanied by pain.

For further in depth information on neck pain, go to top left corner under pain and conditions.

Call 02476 222002.Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simpleyhealth. Standard life. Pru health. Mercia health.Medicash Medisure. All health insurance accepted.

Neck Pain. Cervical Disc Injuries. Cervicalgia Cervicogenic headaches.

WHIPLASH – ASSOCIATED DISORDER (WAD).

From the Journal of Orthopaedic Medicine 1999;   21 (1):   22–25 university Department of Orthopaedic Surgery, Bristol, UK 

Conclusion: “Whiplash”(WAD) and Neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment. 

Cervicalgia.

The neck muscles are constantly placed under tension, although this tension helps to keep the head in position i.e. upright. However, the muscles in the neck are more prone to becoming stiff and painful as a result of this tension. As a result of violent movement or sudden impact (known sometimes as “whiplash” (WAD)).

Cervicalgia is a localised pain that does not radiate through into other areas of the neck.

Symptoms include:

·         A sharp pain in the neck

·         Neck ache

·         Pain resulting from head movement

·         Pain radiating to the shoulders, arms and fingers

It also may radiate pain into other areas; this is usually caused by a trapped nerve or nerves. Nerves can become trapped by tight muscles, disc damage, or the formation of bony deposits. Radiating pain in the neck which affects the shoulders and arms may also affect the fingers.

Neck dysfunction can result in dizziness, nausea or headaches but it can be successfully treated by Cold Laser Therapy, one of the treatments offered by Central Chiropractic Clinic

Cervicogenic headaches  

Cervicogenic headaches   are defined as headaches originating from the neck. The location is typically at the back of the head, sides and top of the head as well as around the forehead and eyes affecting one or more of the above regions at once. These headaches can be located on one or both sides of the head. Cervicogenic headaches are usually associated with dysfunction of the upper neck which can present itself as neck pain or local tenderness, reduced neck range of motion and exacerbation of the headaches by neck movement. The past history of neck trauma is typical for this type of headaches.

The cervicogenic headaches are caused by irritation of nerve endings of injured joints, ligaments, muscles and discs of the neck. The nerve endings in the injured areas send pain signals up the upper nerves of the neck to the brain causing “cross wiring” with the fibres of the trigeminal nerve (one of the nerves in the head) which is responsible for perception of the head pain thus causing the headaches.

Cervical Disc Injuries

Most cervical disc injuries are caused by hyperextension, which results in compression of the cervical area 

Flexion injuries in the cervical area do not result in nerve compression.

Symptoms of Cervical Disc Injuries

The Pain may cause loss of sensation or tingling/pins and needles to the arms and weakness are the main symptoms and signs of cervical disc injury. The pain is most noticeable symptom and it is usually the only one. Cervical disc injury can complicated by compression of either a cervical nerve root or by a compression of the spinal cord, but this reported injury is very infrequent.  When compression of the nervous tissue occurs, patients may report different sensations other than pain. Weakness to the legs/leg this is called spinal cord compression. if the arms/arm are  affected this is called nerve root compression

Pain can be felt in the neck or arm. 

Pain is always in the area of the neck and upper back between the shoulder blades. This is due to inflammation of the disk and the cervical vertebra joints. Sever inflammation can flare up after a minor added injury or for other unknown reasons. Neck and shoulder pain are due to the disc bulges that herniates, and stretches the posterior longitudinal ligament.  

b. Rarely, the pain will be felt down the arm.  This pain can be lightning, caused or aggravated by movements of the neck, or can be dull and persistent. Pre-existing neck pain is also present in many individuals. After the arm pain starts, some people report feeling less pain in their neck. When arm pain is present, it is usually because of a combination of disc herniation and bony spurs compressing a nerve root. A free disc fragment can also intrude on a cervical root and cause quite a bit of pain in shoulder or down the arm.

 2. Sensory symptoms other then pain.

When felt in only one arm, they are due to compression of a cervical root and felt in the territory of the cervical root. The C4 root mainly supplies the shoulder with nerves, while the C5 root supplies primarily the arm. The C6 root supplies nerves to the radial side of the forearm, the C7 root addresses the arm and forearm, and the C8 and the T1 root handle mostly the hand. Broadly speaking, two types of sensory symptoms are felt: loss of sensation and new sensations. A loss of sensation is simply numbness. New sensations include tingling (pins and needles), heat, or cold sensations.

If the spinal cord is compressed, most patients report losing sensation in their hand and in the lower part of their body. (Numbness) They have difficulty feeling the floor when they walk and cannot feel that their bladder is full or inconstancy this is an emergency and patients should be brought to the hospital right away.

3. Motor symptoms and signs.

Weakness of one arm (the other one being normal) only signals a compression of a nerve root. A compression of C4 results in a weak shoulder; C5 indicates a weak bicep muscle; C6 represents a weak wrist, thumb, and index finger; C7 is a weak tricep, extension of the fingers, and pectoralis muscles; C8 designates weak flexion of the fingers; and T1 corresponds to a weak hand.

 Emergency treatment.

If the spinal cord is compressed, patients report having difficulty walking and weak legs and hands, numbness these can be the only symptoms and should be treated as an emergency.

Although neck pain can be caused by injury, such as ‘whiplash’ injuries, it is often caused by the cumulative effect of improper sitting posture, reading in bed, poor work habits, stomach sleeping, lack of proper exercise and other lifestyle-related factors. All of these factors cause misalignments in the spine and eventually pain. In fact, the most important factor producing neck pain appears to be spinal misalignments. Even for people who complain that “stress” is causing their pain, the great majority of those have significant spinal misalignments that are contributing to their condition.

Uncorrected chronic spinal misalignments can eventually cause neck pain. As a spinal misalignment worsens, pressure can be put on delicate nerves, sending the surrounding neck muscles go into painful and movement-limiting spasm, headache, even numbness, tingling or weakness in the arms or hands

Neck pain as well as “whiplash”(WAD) injuries and both conditions can result in headaches and all three are commonly treated by Chiropractors.
The treatment is focused on the small joints in the back of the neck called facet joints that are responsible for neck pain. When these joints dysfunction but injury to the muscles he nerve fibres that innervate / act as sensors for these facet joints also serve to act as sensors to parts of the head. When this facet joints dysfunction these sensors become active, the brain cannot clearly differentiate between the facet joints and the mapping of the head and create the sensation of pain in a broader area- Headache.

FROM:   Journal of Orthopaedic Medicine 1999;   21 (1):   22–25uinversity Department of Orthopaedic Surgery, Bristol, UK

Khan S, Cook J, Gargan M, Bannister G 

Objective:   To determine which patients with chronic “whiplash” (WAD) will benefit from chiropractic treatment.

Design:   Retrospective review by structured telephone interviews of 93 consecutive patients seen in chiropractic clinic.

Setting:   Independent chiropractic clinic in a large city.

Subjects:   93 patients, 68 female.

Main outcome measure:   Gargan and Bannister grading pre and post treatment.

Results:   Three groups of patients were recognised. Group 1 consisted of patients with isolated neck pain associated with a restricted range of neck movement. Group 2 consisted of patients with neurological symptoms or signs associated with a restricted range of movement. Group 3 comprised patients who described severe neck pain but all of whom had a full range of neck movement. Patients in this group often described an unusual group of symptoms, with a bizarre, non-dermatomal pain distribution. There was a significant difference in outcome between the three groups (p<0.001) with only groups 1 and 2 improving following chiropractic manipulation.

Conclusion: “Whiplash”(WAD) and Neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.

Journal of Orthopaedic Medicine 1999;   21 (1):   22–25 university Department of Orthopaedic Surgery

Call 02476 222002.Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simpleyhealth. Standard life. Pru health. Mercia health.Medicash Medisure. All health insurance accepted.

“Whiplash” (WAD) or Neck Pain. Inflammatory Diseases, Severe Injuries, Cervical Disc Degeneration, When Should You Seek Medical Care? What is Whiplash Associated Disorder (WAD) commonly known as ”Whiplash’ Neck injury Diagnosis”,

Non specific term, Stiff neck for limited neck mobility, often due to muscle cramps and accompanied by pain.

The neck (cervical spine) is composed of vertebrae that begin at the base of the skull and end in the upper torso. The vertebrae along with the ligaments provide stability to the spine. The muscles allow for support and movement of the neck. The neck supports the weight of the head which is 12 lbs amounting to a significant load for the neck to cope with during motion thus increasing stress onto the neck (cervical spine). Compare to the rest of the spine, the neck is less protected and is more susceptible to injury and various disorders that can result in pain and restricted motion. Sometimes neck pain is a temporary condition going away on its own accord. Other cases require medical diagnosis and treatment to relieve the symptoms.

Cause

Neck pain may result from injury to the soft tissues including muscles, ligaments, nerves, bones and joints of the spine. Soft tissue injuries or prolonged wear and tear are amongst the most common causes of neck pain. Infection or tumours may cause neck pain in rare instances. Sometimes neck problems may be the source of pain in the upper back, shoulders, or arms.

Inflammatory Diseases

The vertebral  column. Rheumatoid arthritis involves joints in the neck and may cause severe stiffness and pain. Rheumatoid arthritis usually occurs in the upper neck area.

Cervical Disc Degeneration

Cervical disc degeneration usually occurs in people aged 40 and older. Disc’s act as shock absorbers between the bones. During cervical disc degeneration the normal gelatine like centre of the disc dries out and the gap between the vertebrae narrows. As the disc space narrows, added stress is imposed onto the joints of the spine exacerbating further wear and degenerative changes. When occurs when cervical disc protrudes due to the weakening of its rim, putting pressure on the spinal cord or nerve roots.

Injury

Due to its flexibility and the weight of the head it supports the neck is extremely vulnerable to injury. Road traffic or diving accidents, contact sports, and falls are the main causes of neck injury. A “rear end” shunt during car accident may result in hyperextension, a backward motion of the neck beyond normal limits, or hyper flexion, a forward motion of the neck beyond normal limits. The use of seat belts and head restrains in cars can help to prevent or minimize neck injury. The soft tissues such as muscles and ligaments are most commonly involved. Severe injuries including fracture or dislocation of the neck may lead to the damage the spinal cord and cause paralysis.

What is Whiplash Associated Disorder (WAD) commenly Known as ”Whiplash”?

“Whiplash”(WAD) injury occurs when the body reacts to sudden deceleration or acceleration force causing hyper flexion or hyperextension of the neck.

“Whiplash” (WAD) injuries are associated with car accidents. The whiplash injury is sustained when the muscles of the neck and shoulders do not have enough time to brace and hold the head during sudden acceleration or deceleration force application, leading to injuries of the muscles, ligaments, capsule of the facet joints and discs of cervical spine.

Uncomplicated cases

“Whiplash” (WAD) cases that are uncomplicated are the result of sprained ligaments in the neck. The muscles spasm naturally to form a protective mechanism for the neck. The “whiplash” injury may cause a stiff neck and pain may be present down one or both arms if the nerve roots of cervical part of spinal cord get compressed. Relief for “whiplash” can be found with  physiotherpy therapy or pain medication.

  

Severe cases

In severe cases of whiplash may last for a month or more with persistent and in some cases constant pain. This may indicate that the whiplash injury has extensive damage and resulting in disc’s rupturing and trapped nerves in the neck. This may also predispose to a “slipped”, ruptured or herniated disc in the back. (See our Cold Laser Therapy Section under Inflammatory conditions.)

Other Causes of neck pain

Tumours, infections, or congenital abnormalities of the vertebrae are less common causes of neck pain.

When Should You Seek Medical Care?

Cases of severe neck pain occur following an injury such as motor vehicle accident, blow to the head or fall related accident. Only a trained professional, such as a paramedic, should immobilize the patient to avoid the risk of further injury and possible paralysis. Medical care should be sought immediately.

Immediate medical care should also be sought when an injury causes pain in the neck that radiates down the arms and legs. Radiating pain or numbness in your arms or legs causing weakness in the arms or legs without significant neck pain should also be evaluated. If there has not been an injury, you should seek medical care when neck pain is:

·         Continuous and persistent

·         Severe

·         Accompanied by pain that radiates down the arms or legs

·         Accompanied by headaches, numbness, tingling, or weakness

Diagnosis

Determining the source of the pain is essential to recommend the appropriate treatment and rehabilitation. Therefore, a comprehensive examination is required to determine the cause of neck pain.

Further evaluation may involve the following:

·         MRI (magnetic resonance imaging). This non x-ray study allows an evaluation of the spinal cord and nerve roots.

·         CT (computed tomography). This specialized x-ray study allows careful evaluation of the bone and spinal canal.

·         EMG (electromyography). This test evaluates nerve and muscle function.

Treatment

The treatment of neck pain depends on the diagnosis. Most patients are treated successfully with Physiotherapy Treatment. Also rest, medication, immobilization, exercise, activity modifications, or a combination of these methods can be very useful.

Inflammation is a result of stretching muscles and ligaments beyond their limits, (See also Cold Laser Therapy under conditions treated; this therapy is extremely affective in the treatment of inflammation). Surgery is required in very few cases to relieve neck pain. For most patients, a combination of Physiotherapy treatment, rest, medication, and physical therapy will relieve neck pain. Surgery may be necessary to reduce pressure on the spinal cord or a nerve root when pain is caused by a herniated disc or bony narrowing of the spinal canal. Surgery may also be required following an injury to stabilize the neck and minimize the possibility of paralysis, such as when a fracture results in instability of the neck.

For further in depth information on  “neck pain”, please go to top left corner under “Pain’ or ‘Conditions”.

Call 02476 222002.Neck Pain Chiropractic Treatment

The neck (cervical spine) is composed of vertebrae that begin at the base of the skull and end in the upper torso. The vertebrae along with the ligaments provide stability to the spine. The muscles allow for support and movement of the neck. The neck supports the weight of the head which is 12lbs  amounting to a significant load for the neck to cope with during motion thus increasing stress onto the neck (cervical spine). Compare to the rest of the spine, the neck is less protected and is more susceptible to injury and various disorders that can result in pain and restricted motion. Sometimes neck pain is a temporary condition going away on its own accord. Other cases require medical diagnosis and treatment to relieve the symptoms.

Cause

Neck pain may result from injury to the soft tissues including muscles, ligaments, nerves, bones and joints of the spine. Soft tissue injuries or prolonged wear and tear are amongst the most common causes of neck pain. Infection or tumors may cause neck pain in rare instances. Sometimes neck problems may be the source of pain in the upper back, shoulders, or arms.

Inflammatory Diseases.  The vertebral column.

Rheumatoid arthritis involves joints in the neck and may cause severe stiffness and pain. Rheumatoid arthritis usually occurs in the upper neck area.

Cervical Disc Degeneration

Cervical disc degeneration usually occurs in people aged 40 and older. Discs act as shock absorbers between the bones. During cervical disc degeneration the normal gelatine like centre of the disc dries out and the gap between the vertebrae narrows. As the disc space narrows, added stress is imposed onto the joints of the spine exacerbating further wear and degenerative changes. When occurs when cervical disc protrudes due to the weakening of its rim, putting pressure on the spinal cord or nerve roots.

Injuries.

Due to its flexibility and the weight of the head it supports the neck is extremely vulnerable to injury. Road traffic or diving accidents, contact sports, and falls are the main causes of neck injury. A “rear end” shunt during car accident may result in hyperextension, a backward motion of the neck beyond normal limits, or hyperflexion, a forward motion of the neck beyond normal limits. The use of seat belts and head restrains in cars can help to prevent or minimize neck injury. The soft tissues such as muscles and ligaments are most commonly involved. Severe injuries including fracture or dislocation of the neck may lead to the damage the spinal cord and cause paralysis.

What is “Whiplash -Associated Disorder (WAD)? Neck pain

‘Whiplash’(WAD) injury occurs when the body reacts to sudden deceleration or acceleration force causing hyperflexion or hyperextension of the neck.

“Whiplash”(WAD) injuries are associated with car accidents. The ’whiplash’ injury is sustained when the muscles of the neck and shoulders do not have enough time to brace and hold the head during sudden acceleration or deceleration force application, leading to injuries of the muscles, ligaments, capsule of the facet joints and discs of cervical spine.

Uncomplicated cases

‘Whiplash’ (WAD) cases that are uncomplicated are the result of sprained ligaments in the neck. The muscles spasm naturally to form a protective mechanism for the neck. The ‘whiplash’ injury may cause a stiff neck and pain may be present down one or both arms if the nerve roots of cervical part of spinal cord get compressed. Relief for ‘whiplash’ can be found with chiropractic treatment, physical therapy or pain medication.

Studies have shown that 35 of 39 patients, or 91%, of patients with chronic Whiplash Associated Disorder (WAD) common term “whiplash” benefited from chiropractic treatment

Severe cases

In severe cases of ‘whiplash’ (WAD) may last for a month or more with persistent and in some cases constant pain. This may indicate that the ‘whiplash’ injury has extensive damage and resulting in discs rupturing and trapped nerves in the neck. This may also predispose to a “slipped”, ruptured or herniated disc in the back.

(See our Cold Laser Therapy Section under Inflammatory conditions.)

Other Causes of neck pain

Tumors, infections, or congenital abnormalities of the vertebrae are less common causes of neck pain.

When Should You Seek Medical Care?

Cases of severe neck pain occur following an injury such as motor vehicle accident, blow to the head or fall related accident. Only a trained professional, such as a paramedic, should immobilize the patient to avoid the risk of further injury and possible paralysis. Medical care should be sought immediately.

Immediate medical care should also be sought when an injury causes pain in the neck that radiates down the arms and legs. Radiating pain or numbness in your arms or legs causing weakness in the arms or legs without significant neck pain should also be evaluated. If there has not been an injury you should seek medical care when neck pain is:

o    continuous and persistent severe pain

o    accompanied by headaches, numbness, tingling or weakness

Diagnosis

Determining the source of the pain is essential to recommend the appropriate treatment and rehabilitation. Therefore, a comprehensive examination is required to determine the cause of neck pain.

A  Chiropractor will take a complete history of the symptoms you are having with your neck. The Chiropractor may ask you about other illnesses, any injury that occurred to your neck, and any complaints you have associated with neck pain. Previous treatment for your neck condition will also be noted.

Chiropractor will also perform a physical examination. This examination may include evaluation of neck motion, tenderness of the neck and the function of the nerves and muscles in your arms and legs.

Digital -X-rays often will be obtained to allow your Chiropractor to look at the bones in your neck. This entails simple diagnostic imaging study (radiography) and aids your Chiropractor to determine the cause of neck pain and to prescribe effective treatment.

Further evaluation may involve the following:

o    MRI (magnetic resonance imaging). This non x-ray study allows an evaluation of the spinal cord and nerve roots.

o    CT (computed tomography). This specialized x-ray study allows careful evaluation of the bone and spinal canal.

o    EMG (electromyography). This test evaluates nerve and muscle function.

Treatment

The treatment of neck pain depends on the diagnosis. Most patients are treated successfully with Chiropractic Treatment. Also rest medication, immobilization, exercise, activity modifications, or a combination of these methods can be very useful.

Inflammation is a result of stretching muscles and ligaments beyond their limits,

(See also Cold Laser Therapy under conditions treated; this therapy is extremely affective in the treatment of inflammation).

Surgery is required in very few cases to relieve neck pain. For most patients, a combination of Chiropractic treatment, rest, medication, and physical therapy will relieve neck pain. Surgery may be necessary to reduce pressure on the spinal cord or a nerve root when pain is caused by a herniated disc or bony narrowing of the spinal canal. Surgery may also be required following an injury to stabilize the neck and minimize the possibility of paralysis, such as when a fracture results in instability of the neck.

Cold Laser Therapy/Treatment

Cold laser therapy is now used in treating this condition and is employed by us at Central Chiropractic Clinic. Chiropractic treatment combined with Cold Laser Therapy is extremely effective in reducing both shoulder pain and restricted movement. At present this type of treatment is not available within N.H.S.

Treatment usually combines   use of anti-inflammatory drugs to relieve pain and inflammation with intermittent applications of heat and ice packs. Exercises are prescribed to build strength and improve movement and it is important to persist at these because recovery is gradual but slow. In some cases steroid injections into the joint may be needed. In severe cases the affected shoulder may need to be manipulated under anaesthesia before an aggressive rehabilitation program can be commenced.

Probable Outcomes

The residual symptoms of pain or stiffness are often present even after completion of course of conservative therapy. However, functional disability is rare.

Low Level Cold Laser Therapy (LLLT) is a Handheld, non invasive, light-emitting medical device which is used over different areas of the body. It provides an unmatched advantage in the treatment of conditions such as Athletic Injuries;

Chronic Neck Pain. Whiplash associated Disorder (WAD) common term “Whiplash”

Lower Back Pain
Knee and Foot Pain
Shoulder Injuries and conditions including frozen shoulder
Carpal Tunnel Syndrome
Arthritic Pain Relief

Muscle Spasm
Relief of Muscle and Joint Pain
Skin infections.

Cold Laser Therapy is used at our clinic for pain relief and treatment of ligament and tendon injuries, muscle sprains by reducing pain and accelerating the healing process.

For further in depth information on “Pain” or “Conditions” and “Treatments” for cold Laser Therapy. Please go to top left corner

Neck Pain. and Whiplash -Associated Disorders (WAD). Commonly known as “Whiplash” (WAD). Reg’d BUPA AXA HSA AVIA all health insurers

Cervicalgia

The neck muscles are constantly placed under tension, although this tension helps to keep the head in position i.e. upright. However the muscles in the neck are more prone to becoming stiff and painful as a result of this tension. As a result of violent movement or sudden impact (known sometimes as “whiplash” (WAD)).

Cervicalgia is a localised pain that does not radiate through into other areas of the neck.

Symptoms include:

·         A sharp pain in the neck

·         Neck ache

·         Pain resulting from head movement

·         Pain radiating to the shoulders, arms and fingers

It also may radiate pain into other areas; this is usually caused by a trapped nerve or nerves. Nerves can become trapped by tight muscles, disc damage, or the formation of bony deposits. Radiating pain in the neck which affects the shoulders and arms may also affect the fingers.

Neck dysfunction can result in dizziness, nausea or headaches but it can be successfully treated by Cold Laser Therapy, one of the treatments offered by Central Chiropractic Clinic

Cervicogenic headaches  

Cervicogenic headaches   are defined as headaches originating from the neck. The location is typically at the back of the head, sides and top of the head as well as around the forehead and eyes affecting one or more of the above regions at once. These headaches can be located on one or both sides of the head. Cervicogenic headaches are usually associated with dysfunction of the upper neck which can present itself as neck pain or local tenderness, reduced neck range of motion and exacerbation of the headaches by neck movement. The past history of neck trauma is typical for this type of headaches.

The cervicogenic headaches are caused by irritation of nerve endings of injured joints, ligaments, muscles and discs of the neck. The nerve endings in the injured areas send pain signals up the upper nerves of the neck to the brain causing “cross wiring” with the fibres of the trigeminal nerve (one of the nerves in the head) which is responsible for perception of the head pain thus causing the headaches.

Cervical Disc Injuries

Most cervical disc injuries are caused by hyperextension, which results in compression of the cervical area 

Flexion injuries in the cervical area do not result in nerve compression.

Symptoms of Cervical Disc Injuries

The Pain may cause loss of sensation or tingling/pins and needles to the arms, and weakness are the main symptoms and signs of cervical disc injury. The pain is most noticeable symptom and it is usually the only one. Cervical disc injury can complicated by compression of either a cervical nerve root or by a compression of the spinal cord, but this reported injury is very infrequent.  When compression of the nervous tissue occurs, patients may report different sensations other than pain. Weakness to the legs/leg this is called spinal cord compression. if the arms/arm are  affected this is called nerve root compression

Pain can be felt in the neck or arm. 

Pain is always in the area of the neck and upper back between the shoulder blades. This is due to inflammation of the disc and the cervical vertebra joints. Sever inflammation can flare up after a minor added injury or for other unknown reasons. Neck and shoulder pain are due to the disc bulges that herniates, and stretches the posterior longitudinal ligament.  

b. Rarely, the pain will be felt down the arm.  This pain can be lightning, caused or aggravated by movements of the neck, or can be dull and persistent. Pre-existing neck pain is also present in many individuals. After the arm pain starts, some people report feeling less pain in their neck. When arm pain is present, it is usually because of a combination of disc herniation and bony spurs compressing a nerve root. A free disc fragment can also intrude on a cervical root and cause quite a bit of pain in shoulder or down the arm.

 2. Sensory symptoms other then pain.

When felt in only one arm, they are due to compression of a cervical root and felt in the territory of the cervical root. The C4 root mainly supplies the shoulder with nerves, while the C5 root supplies primarily the arm. The C6 root supplies nerves to the radial side of the forearm, the C7 root addresses the arm and forearm, and the C8 and the T1 root handle mostly the hand. Broadly speaking, two types of sensory symptoms are felt: loss of sensation and new sensations. A loss of sensation is simply numbness. New sensations include tingling (pins and needles), heat, or cold sensations.

If the spinal cord is compressed, most patients report losing sensation in their hand and in the lower part of their body. (Numbness) They have difficulty feeling the floor when they walk and cannot feel that their bladder is full or inconstancy this is an emergency and patients should be brought to the hospital right away.

3. Motor symptoms and signs.

Weakness of one arm (the other one being normal) only signals a compression of a nerve root. A compression of C4 results in a weak shoulder; C5 indicates a weak bicep muscle; C6 represents a weak wrist, thumb, and index finger; C7 is a weak tricep extension of the fingers, and pectoralis muscles; C8 designates weak flexion of the fingers; and T1 corresponds to a weak hand.

 Emergency treatment.

If the spinal cord is compressed, patients report having difficulty walking and weak legs and hands, numbness these can be the only symptoms and should be treated as an emergency.

Although neck pain can be caused by injury, such as ‘whiplash’(WAD) injuries, it is often caused by the cumulative effect of improper sitting posture, reading in bed, poor work habits, stomach sleeping, lack of proper exercise and other lifestyle-related factors. All of these factors cause misalignments in the spine and eventually pain. In fact, the most important factor producing neck pain appears to be spinal misalignments. Even for people who complain that “stress” is causing their pain, the great majority of those have significant spinal misalignments that are contributing to their condition.

Uncorrected chronic spinal misalignments can eventually cause neck pain. As a spinal misalignment worsens, pressure can be put on delicate nerves, sending the surrounding neck muscles go into painful and movement-limiting spasm, headache, even numbness, tingling or weakness in the arms or hands

Neck pain as well as “whiplash” (WAD) injuries and both conditions can result in headaches and all three are commonly treated by Chiropractors.
The treatment is focused on the small joints in the back of the neck called facet joints that are responsible for neck pain. When these joints dysfunction but injury to the muscles he nerve fibres that innervate / act as sensors for these facet joints also serve to act as sensors to parts of the head. When these facet joints dysfunction these sensors become active, the brain cannot clearly differentiate between the facet joints and the mapping of the head and create the sensation of pain in a broader area- Headache.

Whiplash associated Disorder (WAD) common term “Whiplash’ (WAD)

 FROM:   Journal of Orthopaedic Medicine 1999;   21 (1):   22–25 university Department of Orthopaedic Surgery Bristol UK

Khan S, Cook J, Gargan M, Bannister G 

Objective:   To determine which patients with chronic Whiplash Associated Disorder (WAD) will benefit from chiropractic treatment.

Design:   Retrospective review by structured telephone interviews of 93 consecutive patients seen in chiropractic clinic.

Setting:   Independent chiropractic clinic in a large city.

Subjects:   93 patients, 68 female.

Main outcome measure:   Gargan and Bannister grading pre and post treatment.

Results:   Three groups of patients were recognised. Group 1 consisted of patients with isolated neck pain associated with a restricted range of neck movement. Group 2 consisted of patients with neurological symptoms or signs associated with a restricted range of movement. Group 3 comprised patients who described severe neck pain but all of whom had a full range of neck movement. Patients in this group often described an unusual group of symptoms, with a bizarre, non-dermatomal pain distribution. There was a significant difference in outcome between the three groups (p<0.001) with only groups 1 and 2 improving following chiropractic manipulation.

Conclusion: “Whiplash” (WAD) and Neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.

Journal of Orthopaedic Medicine 1999;   21 (1):   22–2 university Department of Orthopaedic Surgery

Call 02476 222002.Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simpleyhealth. Standard life. Pru health. Mercia health.Medicash Medisure. All health insurance accepted.

The 4 Stages of Whiplash – Associated Disorders (WAD). commonly known as “Whiplash”(WAD).

Stage 1

During stage 1 a person travelling in a car is suddenly jolted forward, then the seat begins to be pushed out from under the car occupant; this causes the middle of the back to be pushed against the back of the car seat. This results in an upward thrust in the cervical spine, compressing the discs and joints in the neck, as the back of the seat starts to thrusts the body forward, while the head is thrust backwards. These movements cause severe jolt to the neck.  Properly adjusted head restraints will limit the distance the head travels backwards. The damage to the spine will take place before the head reaches the head rest.

Stage 2

The body has reached an acceleration of one to two times that of the car, however the head has not started to accelerate forward and continues to move backward.  This produces abnormal S-curve in the cervical spine as the seat back recoils forward, the seat acts like a spring thrusting the body forward. This forward seat back spring action happens while the head is still moving backwards.

The result is a severe jolt to the neck resulting in the most damaging aspects of a “whiplash” (WAD) injury.

Stage 3

The body is now falling back down into the seat while the head and neck are in forward acceleration as the car is slowing down. By decreasing the pressure on your brakes while in the first stages of the collision, the brakes will be reapplied during this stage. This reapplication of the brake causes the car to slow down much quicker and makes it much more probable the increase in severity of the flexing injury to the neck. As the forward movement takes place, the seat belt tightens and takes up the sack, as you move forward in your seat, any slack in your seat belt and shoulder harness is taken up.

Stage 4

The most damage is caused during the phase 4 of the “whiplash” (WAD) phenomenon. The seat belt stops the bodies inside the car from moving while the heads are moving freely forward thus creating violent forward motion and causing strain to the muscles and ligaments of the neck. This also causes tears to fibres in the spinal discs and jolts vertebrae out of their usual position. The spinal cord and nerves may get overstretched and irritated. The brain may hit the inside of the skull causing brain injury. By not wearing a seat belt and hitting the inside of the car, windscreen or steering wheel there is a greater chance of suffering  concussion or more severe brain injury.

Typical Symptoms Include;

• Pain and stiffness of the neck, extending up to the head and down to the shoulders
• Headache
• Numbness or tingling in the arms going down into the hands
• Low back pain
• Dizziness
• Mental problems, such as poor concentration, memory or mental performance
• Tiredness
• Ringing in the ears or tinnitus
• Blurred vision

“Whiplash”(WAD) Injury for further in depth information on “Whiplash”,(WAD) Neck pain treatment, symptoms, or neck pain please go to top left corner under “pain” or “conditions” and for Cold laser treatment under “Treatments”  

Call 02476 222002.Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simpleyhealth. Standard life. Pru health. Mercia health.Medicash Medisure. All health insurance accepted.

Whiplash - Associated Disorder (WAD). Commonly known as ”Whiplash”,

The importance of medical advice.

Many people involved in rear-end car shunts will suffer “whiplash” (WAD) injury as a result. Sometimes they will be unaware that they have suffered whiplash injury and would fail to seek medical advice.  Many people do recover from the condition with time. However many do not, and the condition becomes chronic and may affect them for the rest of their life.

It is imperative therefore, for anybody to seek medical advice immediately if the ate suffering any of the following symptoms after a car crash:

·        Neck pain and stiffness.

·        Headaches

·        Numbness or pain in the arm or hand

·        Dizziness 

·        Blurred vision

·        Shoulder pain

·        Concentration difficulties

·        Ringing in the ears

·        Irritability

“Whiplash”(WAD) injury occurs when the body reacts to sudden deceleration or acceleration force causing hyperflexion or hyperextension of the neck.

“Whiplash”(WAD) injuries are associated with car accidents. The “whiplash”(WAD) injury is sustained when the muscles of the neck and shoulders do not have enough time to brace and hold the head during sudden acceleration or deceleration force application, leading to injuries of the muscles, ligaments, capsule of the facet joints and discs of cervical spine.

Uncomplicated cases

“Whiplash”(WAD) cases that are uncomplicated are the result of sprained ligaments in the neck. The muscles spasm naturally to form a protective mechanism for the neck. The “whiplash”(WAD) injury may cause a stiff neck and pain may be present down one or both arms if the nerve roots of cervical part of spinal cord get compressed.

Relief for “whiplash”(WAD) can be found with chiropractic treatment or physical therapy or pain medication.

****** Studies have shown that 35 of 39 patients, or 91%, of patients with chronic Whiplash Associated Disorder (WAD). Common term ”whiplash” benefited from chiropractic treatment ********

 Severe cases

In severe cases of “whiplash” (WAD) may last for a month or more with persistent and in some cases constant pain. This may indicate that the “whiplash”(WAD) injury has extensive damage and resulting in discs rupturing and trapped nerves in the neck. This may also predispose to a “slipped”, ruptured or herniated disc in the back. (See our Cold Laser Therapy Section under Inflammatory conditions.)

What are the symptoms?

·         pain or stiffness in the neck, jaw, shoulders, back, or arms

·         headaches

·         dizziness

·         blurred vision or ringing in the ears

·         tingling or numbness in the arms, hands or shoulders

·         memory loss or difficulty concentrating

·         nervousness or irritability

·         difficulty sleeping

·         fatigue

·         burning or prickling or tingling, particularly around your neck

·         depression

·         vertigo

What if I don’t feel anything at first, but start to have symptoms later?

This is typical of “whiplash” (WAD): Symptoms may occur right away but often do not begin to develop for several hours after the incident and then worsen over the next 36 to 72 hours.

How long do the symptoms last?

Most neck and head pain symptoms clear up within a few days or weeks,. For others, the recovery can take up to three or four months. But about 35 percent of people with whiplash report symptoms for up to a year, and about 15 percent of patients report permanent symptoms as a result of their injuries.

Diagnosis

Determining the source of the pain is essential to recommend the appropriate treatment and rehabilitation. Therefore, a comprehensive examination is required to determine the cause of neck pain.

“Whiplash”(WAD) is difficult to diagnose since most injuries are to soft tissues like muscles and ligaments and will not show up on an x-ray. If an x-ray fails to reveal a problem, doctors will sometimes order specialized tests such as magnetic resonance imaging (MRI). But more often they will make a diagnosis based on your symptoms.

Your Chiropractor will take a complete history of the symptoms you are having with your neck. The Chiropractor may ask you about other illnesses, any injury that occurred to your neck, and any complaints you have associated with neck pain. Previous treatment for your neck condition will also be noted.

X-rays often will be obtained to allow your Chiropractor to look at the bones in your neck. This entails simple diagnostic imaging study (radiography) and aids your Chiropractor to determine the cause of neck pain and to prescribe effective treatment.

Further evaluation may involve the following:

·         MRI (magnetic resonance imaging). This non x-ray study allows an evaluation of the spinal cord and nerve roots.

·         CT (computed tomography). This specialized x-ray study allows careful evaluation of the bone and spinal canal.

·         EMG (electromyography). This test evaluates nerve and muscle function.

Treatment

The treatment of neck pain depends on the diagnosis. Most patients are treated successfully with Chiropractic Treatment. Also rest, medication, immobilization, exercise, activity modifications, or a combination of these methods can be very useful.

Inflammation is a result of stretching muscles and ligaments beyond their limits, (See also Cold Laser Therapy under conditions treated; this therapy is extremely affective in the treatment of inflammation). Surgery is required in very few cases to relieve neck pain. For most patients, a combination of Chiropractic treatment, rest, medication, and physical therapy will relieve neck pain. Surgery may be necessary to reduce pressure on the spinal cord or a nerve root when pain is caused by a herniated disc or bony narrowing of the spinal canal. Surgery may also be required following an injury to stabilize the neck and minimize the possibility of paralysis such as when a fracture results in instability of the neck.

If you’ve seen your doctor about your injury and the symptoms persist for more than four weeks, it may be time for you to see a specialist. Such as a neurologist or chiropractor who can help diagnose your condition.

What is the treatment for Whiplash  Associated Disorder (WAD)”whiplash”

Doctors often prescribe anti-inflammatory painkillers or muscle relaxants. You can apply ice to the injured area to reduce pain and swelling for up to 15 minutes every hour. Chiropractic treatment is very effective in the management of “whiplash”(WAD).( see also Cold Laser Therapy under Conditions Treated).

What can I do to help prevent Whiplash Associated Disorder (WAD)”whiplash”

Since the most common cause of the injury is car crashes, experts say safe driving, seatbelts, and properly adjusted headrests are your best protection against “whiplash” (WAD). Seatbelts help keep you from being thrown forward; a low headrest in your car allows your head to pivot backwards over the top during an accident: Always raise or lower your car’s headrest until the centre of the rest meets the centre of the back of your head.

Call 02476 222002.Registered with BUPA. AXA PPP. HSA. AVIVA. CIGNA. Simpleyhealth. Standard life. Pru health. Mercia health. All health insurance accepted.

Whiplash – Associated Disorder (WAD). From the Journal of Orthopaedic Medicine and University Department of Orthopaedic Surgery Bristol UK.

Whiplash – Associated Disorder (WAD). Conclusion: “Whiplash”(WAD) and neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.

 

 Cervicalgia,       Cervical disc injuries,       Cervicogenic headaches 

Neck and back pain are usually caused common conditions or injuries to the neck and back. The pain may come on gradually, or it may be acute and come on suddenly. Bad posture is a common cause in the onset of this pain but it is not the only cause. Chiropractors Coventry understand the various causes of neck pain, and can offer advice.

Cervicalgia

The neck muscles are constantly placed under tension, although this tension helps to keep the head in position i.e. upright. However, the muscles in the neck are more prone to becoming stiff and painful as a result of this tension. As a result of violent movement or sudden impact (known sometimes as whiplash).

Cervicalgia is a localised pain that does not radiate through into other areas of the neck.

Symptoms include:

·         A sharp pain in the neck

·         Neck ache

·         Pain resulting from head movement

·         Pain radiating to the shoulders, arms and fingers

It also may radiate pain into other areas; this is usually caused by a trapped nerve or nerves. Nerves can become trapped by tight muscles, disc damage, or the formation of bony deposits. Radiating pain in the neck which affects the shoulders and arms may also affect the fingers.

Neck dysfunction can result in dizziness, nausea or headaches but it can be successfully treated by Cold Laser Therapy, one of the treatments offered by Central Chiropractic Clinic

Cervicogenic headaches  

Cervicogenic headaches   are defined as headaches originating from the neck. The location is typically at the back of the head, sides and top of the head as well as around the forehead and eyes affecting one or more of the above regions at once. These headaches can be located on one or both sides of the head. Cervicogenic headaches are usually associated with dysfunction of the upper neck which can present itself as neck pain or local tenderness, reduced neck range of motion and exacerbation of the headaches by neck movement. The past history of neck trauma is typical for this type of headaches.

 

The cervicogenic headaches are caused by irritation of nerve endings of injured joints, ligaments, muscles and discs of the neck. The nerve endings in the injured areas send pain signals up the upper nerves of the neck to the brain causing “cross wiring” with the fibres of the trigeminal nerve (one of the nerves in the head) which is responsible for perception of the head pain thus causing the headaches.

Cervical Disc Injuries

Most cervical disc injuries are caused by hyperextension, which results in compression of the cervical area 

Flexion injuries in the cervical area do not result in nerve compression.

Symptoms of Cervical Disc Injuries

The Pain may cause loss of sensation or tingling/pins and needles to the arms, and weakness are the main symptoms and signs of cervical disc injury. The pain is most noticeable symptom and it is usually the only one. Cervical disc injury can complicated by compression of either a cervical nerve root or by a compression of the spinal cord, but this reported injury is very infrequent.  When compression of the nervous tissue occurs, patients may report different sensations other than pain. Weakness to the legs/leg this is called spinal cord compression. if the arms/arm are  affected this is called nerve root compression

Pain can be felt in the neck or arm. 

Pain is always in the area of the neck and upper back between the shoulder blades. This is due to inflammation of the disc and the cervical vertebra joints. Sever inflammation can flare up after a minor added injury or for other unknown reasons. Neck and shoulder pain are due to the disc bulges that herniates, and stretches the posterior longitudinal ligament.  

b. Rarely, the pain will be felt down the arm.  This pain can be lightning, caused or aggravated by movements of the neck, or can be dull and persistent. Pre-existing neck pain is also present in many individuals. After the arm pain starts, some people report feeling less pain in their neck. When arm pain is present, it is usually because of a combination of disc herniation and bony spurs compressing a nerve root. A free disc fragment can also intrude on a cervical root and cause quite a bit of pain in shoulder or down the arm.

 2. Sensory symptoms other then pain.

When felt in only one arm, they are due to compression of a cervical root and felt in the territory of the cervical root. The C4 root mainly supplies the shoulder with nerves, while the C5 root supplies primarily the arm. The C6 root supplies nerves to the radial side of the forearm, the C7 root addresses the arm and forearm, and the C8 and the T1 root handle mostly the hand. Broadly speaking, two types of sensory symptoms are felt: loss of sensation and new sensations. A loss of sensation is simply numbness. New sensations include tingling (pins and needles), heat, or cold sensations.

If the spinal cord is compressed, most patients report losing sensation in their hand and in the lower part of their body. (Numbness) They have difficulty feeling the floor when they walk and cannot feel that their bladder is full or inconstancy this is an emergency and patients should be brought to the hospital right away.

3. Motor symptoms and signs.

Weakness of one arm (the other one being normal) only signals a compression of a nerve root. A compression of C4 results in a weak shoulder; C5 indicates a weak bicep muscle; C6 represents a weak wrist, thumb, and index finger; C7 is a weak tricep, extension of the fingers, and pectoralis muscles; C8 designates weak flexion of the fingers; and T1 corresponds to a weak hand.

 Emergency  treatment.

If the spinal cord is compressed, patients report having difficulty walking and weak legs and hands, numbness these can be the only symptoms and should be treated as an emergency.

Although neck pain can be caused by injury, such as ‘whiplash’(WAD) injuries, it is often caused by the cumulative effect of improper sitting posture, reading in bed, poor work habits, stomach sleeping, lack of proper exercise and other lifestyle-related factors. All of these factors cause misalignments in the spine and eventually pain. In fact, the most important factor producing neck pain appears to be spinal misalignments. Even for people who complain that “stress” is causing their pain, the great majority of those have significant spinal misalignments that are contributing to their condition.

Uncorrected chronic spinal misalignments can eventually cause neck pain. As a spinal misalignment worsens, pressure can be put on delicate nerves, sending the surrounding neck muscles go into painful and movement-limiting spasm, headache, even numbness, tingling or weakness in the arms or hands

Neck pain as well as whiplash injuries and both conditions can result in headaches and all three are commonly treated by Chiropractors.
The treatment is focused on the small joints in the back of the neck called facet joints that are responsible for neck pain. When these joints dysfunction but injury to the muscles he nerve fibres that innervate / act as sensors for these facet joints also serve to act as sensors to parts of the head. When these facet joints dysfunction these sensors become active, the brain cannot clearly differentiate between the facet joints and the mapping of the head and create the sensation of pain in a broader area- Headache.

Whiplash – Associated Disorder (WAD)

Whiplash – Associated Disorder (WAD). From the Journal of Orthopaedic Medicine.

 1999;   21 (1):   22–25 university Department of Orthopaedic Surgery. Bristol. UK

Khan S, Cook J, Gargan M, Bannister G 

Objective:   To determine which patients with chronic “Whiplash” (WAD) will benefit from chiropractic treatment.

Design:   Retrospective review by structured telephone interviews of 93 consecutive patients seen in chiropractic clinic.

Setting:   Independent chiropractic clinic in a large city.

Subjects:   93 patients, 68 female.

Main outcome measure:   Gargan and Bannister grading pre and post treatment.

Results:   Three groups of patients were recognised. Group 1 consisted of patients with isolated neck pain associated with a restricted range of neck movement. Group 2 consisted of patients with neurological symptoms or signs associated with a restricted range of movement. Group 3 comprised patients who described severe neck pain but all of whom had a full range of neck movement. Patients in this group often described an unusual group of symptoms, with a bizarre, non-dermatomal pain distribution. There was a significant difference in outcome between the three groups (p<0.001) with only groups 1 and 2 improving following chiropractic manipulation.

Conclusion: “Whiplash” Associated Disorder (WAD) / Neck injuries are common. Chiropractic is the only proven effective treatment in chronic cases. Our study enables patients to be classified at initial assessment in order to target those patients who will benefit from such treatment.

Journal of Orthopaedic Medicine 1999;   21 (1):   22–25 university Department of Orthopaedic Surgery

Neck Anatomy

The head  weight of 12 lbs or more not only does the neck fully support all that weight, it enables the  head to turn or move up or down No other part of the spine has the ability to move so much: in forward motion, and in backward motion, this also includes the  side-to-side motion, and from  shoulder to shoulder. 

The neck is called the cervical spine, and it begins at the base of your skull. It contains 7 small bones (vertebrae), which doctors label C1 to C7 (the ‘C’ means cervical). The numbers 1 to 7 indicate the level of the vertebrae. C1 is nearest to the skull, while C7 is nearest to the chest.

In between each vertebra are tough fibrous shock-absorbing discs called the intervertebral discs. Each disc is made up of a gel-like outer band (annulus fibrosus) and a gel-like inner substance (nucleus pulposus).

Besides the bones and the discs, the neck consists of joints, muscles, and ligaments these stabilize and give the neck its full range of movement.

The neck is the upper part of the spinal cord, and consists of nerve roots, and an elaborate system of arteries and veins. The nerves in the neck help the brain communicate with the shoulders, arms, and chest. The arteries and veins circulate blood to both the brain and the heart.

For Further in depth Information on Neck pain or Headaches, please go to top left corner under “Pain” or “Conditions.” For Cold Laser Therapy, please go to top left corner under “Treatments 

 

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Neck Pain Nuneaton Neck Pain Injury Nuneaton Neck Pain Cold laser Treatment Nuneaton Warwickshire.

The symptoms of neck problems and injuries can vary significantly depending of the cause. 

For example the pain radiating into the shoulder blade and arm and increasing on coughing or sneezing could be a symptom of a disc injury.

A common disorder referred to as “cervical spondylosis” or degenerative joint disease would affect the bones and the discs of the neck. In this case the pain is usually worse in the morning and is associated with the stiffness and loss of neck mobility to a certain extend.

A neck spasm with the head tilting to one side is called “torticollis” and is a result of severe nerves irritation of the neck. 

Chiropractic treatment involving manipulation would help to restore movement in the segments of the neck and take the pressure off the nerves thus easing the pain and discomfort. Treatment modalities such as Cold Laser Therapy would aid in reducing inflammation associated with degenerative joint disease and disc damage.

Neck Pain Nuneaton for further in depth information on neck pain Nuneaton or whiplash, please go to top left corner under “Pain” or “Conditions” and “Treatments” for Cold laser Therapy.