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The Neck Cervical Spine Anatomy.

The cervical spine begins at the base of the skull. Seven vertebrae make up the cervical spine with eight pairs of cervical nerves. The individual cervical vertebrae are abbreviated C1, C2, C3, C4, C5, C6 and C7. The cervical nerves are also abbreviated; C1 through C8.

Cervical Vertebrae and Supporting Structures

The cervical bones, the vertebrae are smaller in size when compared to other spinal vertebrae. The purpose of the cervical spine is to contain and protect the spinal cord, support the skull, and enable diverse head movement ( rotate side to side, bend forward and backward).

A complex system of ligaments, tendons, and muscles help to support and stabilize the cervical spine. Ligaments work to prevent excessive movement that could result in serious injury. Muscles also help to provide spinal balance and stability, and enable movement. Muscles contract and relax in response to nerve impulses originating in the brain. Some muscles work in pairs or as antagonists. This means when a muscle contracts, the opposing muscle relaxes. There are different types of muscle: forward flexors, lateral flexors, rotators, and extensors.

Spinal Cord and Cervical Nerve Roots

Nerve impulses travel to and from the brain through the spinal cord to a specific location by way of the peripheral nervous system (PNS). The PNS is the complex system of nerves that branch off from the spinal nerve roots. These nerves travel outside of the spinal canal or spinal cord into the organs, arms, legs, fingers – throughout the entire body.

Injury or mild trauma to the cervical spine can cause a serious or life-threatening medical emergency (spinal cord injury or SCI, fracture). Pain, numbness, weakness, and tingling are symptoms that may develop when one or more spinal nerves are injured, irritated, or stretched. The cervical nerves control many bodily functions and sensory activities.

C1: Head and neck
C2: Head and neck
C3: Diaphragm
C4: Upper body muscles ( Deltoids, Biceps)
C5: Wrist extensors
C6: Wrist extensors
C7: Triceps
C8: Hands

Neck 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 5 kg 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.

Causes

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.

Neck pain may result from abnormalities in the soft tissues, muscles, ligaments, and nerves as well as in bones and joints of the spine. The most common causes of neck pain are soft-tissue abnormalities due to injury or prolonged wear and tear. In rare instances, infection or tumors may cause neck pain. In some people, neck problems may be the source of pain in the upper back, shoulders, or arms. Cold Laser Therapy section this therapy has a five star rating for treating neck injuries and conditions.

Neck 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 a car accident may result in hyper-extension, 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.

Arthritis of the Neck

The neck is a common site for arthritis to develop.

The most common type of arthritis that affects the neck is osteoarthritis. This condition is also known as cervical spondylosis, cervical osteoarthritis, or degenerative joint disease of the neck.

Other forms of arthritis that can affect the neck are rheumatoid arthritis, psoriatic, ankylosing spondylitis, Reiter’s disease, gout, pseudogout, and diffuse idiopathic skeletal hyperostosis (DISH).

Rheumatoid arthritis can destroy joints in the neck and cause severe stiffness and pain. Rheumatoid arthritis typically affects upper neck area. View our Cold Laser Therapy section this therapy has a five star rating for treating  this condition

Cervical spondylosis is a condition that mainly affects older people, usually over the age of 45. Men are affected more often than women. This condition results from degenerative changes that occur in the cervical spine (the spine of the neck). Changes in cartilage metabolism lead to slow wear and tear of discs and joints in the neck. Over time, the degenerative changes can lead to a bulging or herniated disc, calcium build-up within the disc, or bony growths on the spine. The end result is nerve compression or inflammation.

Also, depending on which way the disc herniates or the direction of the bony growths, there is a possibility that the spinal cord or nerve roots leading from the spinal cord could be compressed.

There is also the possibility that the blood flow to certain nerves may be affected.

Symptoms depend on the location of the nerve compression, but can include pain, numbness, weakness, headaches, urinary problems, etc.

Initially the person may not have any symptoms.

Others will have neck or shoulder pain, headaches in the back of the head, or stiffness of the neck. They may have difficulty turning or bending the neck from side-to-side.

Some will have pain that shoots down a certain part of the arm. They may also notice numbness, weakness, or pain in the arm. One or both sides may be affected. Often it causes the hands to become clumsy.

Some individuals will have numbness or weakness in their legs. This indicates that there may be pressure on the spinal cord. This is considered a surgical emergency. Many with this condition will have decreased vibration-sense in their legs. They may be unsteady while walking. In fact, spondylosis with myelopathy is a fairly common cause of unsteadiness in the elderly.

Others will have a specific level on the chest or abdomen where there is a noticeable change in sensation.

Problems with urination may occur. Some will have to urinate more often, while others will have to urinate urgently. A few will develop urinary incontinence.

The symptoms may get worse with turning, extending, or bending the neck. In others, coughing or straining may temporarily cause shooting pain in the arms or shoulders or it may worsen weakness in the legs.

Physical exam may reveal numbness or pain along a certain nerve distribution. Certain muscles may be weak and the reflexes not as brisk as normal. The affected individual may have difficulty with turning the neck or bending it from side to side. The arms or legs may be stiff. The hands may be weak and the muscles of the hands atrophied.

X-rays can be helpful in making the diagnosis. However, though X-ray findings of degenerative changes are often found in many older people, only a few will truly evidence the neurological changes caused by this condition. Alone, finding degenerative changes on X-rays is not conclusive but part of an overall determination of this condition that must take into consideration other factors. X-rays done with flexion and extension may show instability.

CT scan can be used to look at the spinal column and see if there is any narrowing or other abnormality.

MRI can also be used to look at the spinal column and see if there is any narrowing or other abnormality.

Nerve conduction studies and electromyography can be done to test the nerves and muscles.

The primary treatment for this condition is first to determine what type of arthritis is causing the problem. The second is making sure the neck is not unstable. Then, it is important to restrict neck movements. This is usually done with a cervical collar.

Medical treatment is usually with anti-inflammatory medicines, analgesics, and muscle relaxants. However, if this fails, then surgery may be necessary.

Physical therapy modalities such as Cold/Low level laser therapy, including stretching and strengthening exercises.

Patients may respond to steroid injections placed in the epidural space.

If that does not work, then surgery to decompress the nerve and stabilize the neck may be necessary.

Surgery is usually done if:

Conservative measures such as a cervical collar do not work.
There is severe pain.
There are significant neurological deficits, such as difficulty walking, severe hand weakness, or bladder problems.
There is compression of the spinal cord.

With any nerve condition, if it is not treated early, there is a danger that the loss of nerve function may be permanent. Nerves are very delicate. Once they are injured beyond a certain point, they do not recover. Therefore, the symptoms that can be caused by this condition could become permanent if not treated appropriately (i.e., numbness, weakness, and urinary problems).

There is no specific way to prevent this condition. However, good posture should be maintained.

Also, avoid repetitive injuries to the neck and cervical spine.

Neck Disc Injury, “Slipped Disc”, also known as Prolapsed, Bulging, Herniated or Extruded Disc

Disc Problems

What Causes Disc Problems?

Discs are the soft but strong cushions that separate the bones (vertebrae) in your spine and absorb shock as you move. Repeated strain over time, an injury, or sudden, forceful movements can damage discs and irritate nerves, causing pain, numbness, or tingling in your back and legs, neck,Shoulders and arms.

Common Slipped Disc, Neck Disc Injury

A Slipped Disc or (Disc Prolapsed) in the neck is a common cause of neck pain. Slipped disc treatment during the early stages involves limited mobilisation. Later, more active physical therapy rehabilitation is useful. During the later stages neck pain treatment can be enhanced if a pillow is used to support the neck.

Other Causes

Less common causes of neck pain include tumors, infections, or congenital abnormalities of the vertebrae.

Whiplash Associated Disorder (WAD) and Cervical Spine Injury

What is whiplash? 

An acute “whiplash” injury follows sudden or excessive hyper-extension, hyper-flexion, or rotation of the neck and causes neck pain and other symptoms. “Whiplash” injury is common in road traffic accidents, and may also be caused by sports injuries, falls or assaults. Most cases of “whiplash” injury occur as the result of rear-end vehicle collisions at speeds of less than 10 miles per hour. Patients present with neck pain and stiffness, occipital headache, thoracic back pain and/or lumber back pain, and upper-limb pain and paraesthesia.

There are two types of injury:

• Typical cervical hyper-extension injuries occur in passengers an drivers of a stationary or slow-moving vehicle that is struck from behind. Body is thrown forward but the head lags, resulting in hyper-extension of the neck. When the head and neck have reached maximum extension, the neck then snaps into flexion.
• A rapid deceleration injury throws the head forwards and flexes the neck. When the chin hits the chest it limits forward flexion but the forward movement may be sufficient to cause longitudinal distraction and neurological damage. Hyper-extension may occur in the subsequent recoil.

“Whiplash” injuries may occur at relatively low vehicle velocity impacts. One study showed the cervical muscle injury threshold to be about 10 km/hour. Whiplash-associated disorders (WAD) can be classified by the severity of signs and symptoms:

• Grade 1: no complaints or physical signs.
• Grade 2: indicates neck complaints but no physical signs.
• Grade 3: indicates neck complaints and musculoskeletal signs.
• Grade 4: neck complaints and neurological signs.
• Grade 5: neck complaints dislocation and fracture. Most cervical spine fractures occur predominantly at two levels:

1. One third of injuries occur at the level of C2, and one half of injuries occur at the level of C6 or C7.

2. Most fatal cervical spine injuries occur in upper cervical levels, either at cranio-cervical junction C1, or at C2

 Uncomplicated cases of Whiplash Associated Disorder (WAD)

“Whiplash”(WAD) cases that are uncomplicated are the result of sprained ligaments in the neck. The muscles of the neck spasm naturally, as a protective reaction. The “Whiplash”(WAD) injury may cause stiff neck and pain that may be present down one or both arms if the nerves of neck part of spinal cord get compressed. Pain Relief for “Whiplash”(WAD) can be found with Chiropractic  or Physiotherapy including pain medication and Cold/ low level laser therapy,

Patient’s with chronic whiplash benefited from Chiropractic  or Physiotherapy

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 discs rupturing and trapped nerves in the neck. This may also predispose to a “slipped”disc, also known as a prolapsed, bulging, ruptured or herniated disc in the back. (View our Cold/low level laser therapy Section, a five star rating has been given to cold/low level laser therapy for soft tissue neck injuries)

Cold/Low level Laser Therapy (LILT). treatment research  for Neck Pain

Neck pain  is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser – is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders. (View our Cold/Low Level Laser Therapy section)

1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5;374(9705):1897-908.

Cold or Low Laser Therapy(LLLT) has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force (published in the journal Spine).

(View our Cold/Low Level Laser Therapy section)

Whiplash Associated Disorder (WAD Research)

“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” (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.

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 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.

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 care or Physiotherapy. 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, this therapy is extremely affective in the treatment of inflammation. Cold/Low level laser therapy a five star rating for soft tissue neck injuries (“Whiplash”). Surgery is required in very few cases to relieve neck pain. For most patients, a combination of Chiropractic care, rest, medication, and Physiotherapy 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.

Cervical Disc Injury.

Causes and Risk Factors of Cervical disc injuries

Most cervical disc syndromes are caused by injuries that involve hyperextension, which results in compression of the anatomic structures.

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

Symptoms of Cervical disc injuries

Pain, loss of sensation or new sensations, and weakness are the main symptoms and signs of cervical disc injury. The most common symptom is pain and it is usually the only one. Rarely, cervical disc injury is complicated by compression of either a cervical nerve root or even more rarely by a compression of the spinal cord. When compression of the nervous tissue occurs, patients will report abnormal sensations other than pain and will report loosing strength in one arm (nerve root compression) or in both arms and legs (spinal cord compression).

1. Pain is the most common complaint and can be felt in the neck or arm.

a. Pain is usually limited to the neck and upper back between the shoulder blades. It occurs because of low-grade inflammation of the disc and the cervical vertebra joints. While the disease is chronic, inflammation can flare up after a minor added injury or for other reasons that are not yet well understood. Less commonly, neck and shoulder pain occur because the disc bulges acutely (herniates) and stretches the posterior longitudinal ligament. With conservative treatment, this pain usually goes away in a few weeks, but it is likely to happen again, especially if the affected individual does not change his/her lifestyle.

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 usual.

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 fibers 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.

Temporomandibular Jaw Disorders (TMD, TMJ Syndrome)

“TMD” temporomandibular (jaw) disorders, also called “TMJ syndrome.” If you felt pain sometimes in your jaw area, or maybe your dentist or Chiropractor has told you that you have TMD.

If you have questions about TMD, you are not alone. Researchers, too, are looking for answers to what causes TMD, what are the best treatments, and how can we prevent these disorders. The National Institute of Dental and Craniofacial Research has written this pamphlet to share with you what we have learned about TMD.

TMD is not just one disorder, but a group of conditions, often painful, that affect the jaw joint (temporomandibular joint, or TMJ) and the muscles that control chewing. Although we don’t know how many people actually have TMD, the disorders appear to affect about twice as many women as men.

The good news is that for most people, pain in the area of the jaw joint or a muscle is not a signal that a serious problem is developing. Generally, discomfort from TMD is occasional and temporary, often occurring in cycles. The pain eventually goes away with little or no treatment. Only a small percentage of people with TMD pain develop significant, long-term symptoms.

What is the Temporomandibular Joint?

The temporomandibular joint connects the lower jaw, called the mandible, to the temporal bone at the side of the head or neck. If you place your fingers just in front of your ears and open your mouth, you can feel the joint on each side of your head. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew and yawn. Muscles attached to and surrounding the jaw joint controls its position and movement.

When we open our mouths, the rounded ends of the lower jaw, called condyles, glide along the joint socket of the temporal bone. The condyles slide back to their original position when we close our mouths. To keep this motion smooth, a soft disc lies between the condyle and the temporal bone. This disc absorbs shocks to the TMJ from chewing and other movements.

What Are Temporomandibular Disorders?

Researchers generally agree that temporomandibular disorders fall into three main categories:

• Myofascial pain, the most common form of TMD, which is discomfort or pain in the muscles that control jaw function and the neck and shoulder muscles;
• Neck Pain/Ache.
• Internal derangement of the joint, meaning a dislocated jaw or displaced disc, or injury to the condyle;
• Degenerative joint disease, such as osteoarthritis or rheumatoid arthritis in the jaw joint.

A person may have one or more of these conditions at the same time.

T M J Treatment

If you place your fingers in front of each ear and open your jaw, you’ll feel lots of clicking, or a grinding movement. This is the temporomandibular joint (TMJ), a place where your skull’s temporal bone attaches to your mandible (Jaw).

Because this joint comprises of a large number of ligaments, cartilage, fascia, discs, muscles, nerves and blood vessels that run around and through it, you can have all kinds of problems: trouble opening the mouth wide; a locked jaw; headache; clicking or popping sounds, tinnitus (ringing in the ears); throat fullness; shoulder, cheek or jaw pain; neck ache; facial nerve pain; ear or eye pain; dental pain; nausea; blurred vision and dizziness when the TMJ joint is misaligned.

An unhealthy skull/jaw alignment can put great stress upon the spinal column. By relieving pressure on the upper neck and bones of the skull, chiropractic treatment may relieve or correct TMJ problems. There are also documented cases of dental problems that, once corrected, help patients to hold their spinal adjustments for longer periods between chiropractic treatments.

All TMJ sufferers need chiropractic treatment; anyone who has been to the dentist should follow up with a check up from their chiropractor.

Trapped Nerve or “Pinched” Nerve.

Having a Trapped nerve hurts often feeling like severe, sharp, excruciating and intense pain. Trapped nerves could happen nearly anywhere affecting nerves that go to the arms, fingers, wrists, neck, head, back, shoulders, legs, muscles and internal organs. “Pinched” or trapped nerves can affect your health, posture, vitality, resistance to disease, even your emotional health. “Pinched”/trapped nerves can make life a misery.

Trapped?

Do nerves really  get  trapped? Actually directly trapping the nerve is quite rare. Much more common is what chiropractors call the vertebral subluxation complex or subluxations. Other terms for this are: nerve impingement, nerve irritation, nerve lesion, spinal stress and meningeal tension.

Even though there may be no actual trapping, people like the word because it’s so descriptive. It can really feel like something is being trapped in there. Some health professionals even use it. People at times seeing a chiropractor’s saying their GP, osteopath, massage therapist referred them because they had a trapped nerve and should visit a chiropractor to get the trapped nerve freed.

What Can Cause Subluxations?

Nearly any kind of stress can cause a subluxation: a fall or an accident, even a very small one that happened years ago; a poor sleeping position; poor posture; fatigue; emotional stress; poor nutrition or a combination of stresses. A subluxation need not happen all at once. It could set in the body over time. 

 Trapped Nerves Don’t Normally Hurt

Chiropractors sometimes say that people with painful Trapped nerves might be considered lucky they know they have a problem and they (hopefully) will go to a chiropractor.

 If You Don’t Experience The Pain From a Trapped Nerve?  What Would Be The Outcome?

Some patients may watch their body suffer and their health deteriorate for years without the faintest idea that the problem may be coming from their spine. These people desperately need to see a chiropractor but because they don’t have spine or nerve pain they may never receive the care they need. This is the big job facing chiropractors today educating people about vertebral subluxations and the need for periodic spinal checkups.

Treatment of Trapped Nerves

Trapped nerves do not get untrapped by themselves. No amount of painkillers or muscle relaxants can fix them. Only doctors of chiropractic are able to analyze your spinal column for trapped nerves or vertebral subluxations and use spinal adjustment techniques to gently realign the spine, release the internal stress and free the body from the trapped nerves.

Chiropractors are health care practitioners who are most experienced in freeing body of vertebral subluxations.

Nerves Travel Through the Body?

Individual nerve fibers are tiny. Although they may be many inches long they are so thin you need a powerful microscope to see them. Nerve fibers are also found in large bundles called nerves. Billions of nerve fibers are bundled inside your spinal cord – an extension of your brain, which passes through the spinal column. Nerves branch off from spinal cord and exit spine through openings between the vertebrae to connect to every cell in the body.

Life without Nerves

Without nerves you couldn’t see, hear, touch, taste or smell or feel hot, cold, pleasure or pain, and no messages could come in and no messages could go out; without nerves no muscles could move.

Nerves Keep the Body Alive and Healthy

Nerve messages also help regulate the body’s activities such as breathing, heartbeat, digestion, excretion, blood pressure and immune system so that the body can respond to germs, changes in temperature and all kinds of stress. In addition to nerve impulses, nutrients flow over your nerves to nourish the muscles and tissues. If this flow is blocked it may cause your muscles to waste away.

If the nerves are trapped, “impinged” or otherwise interfered with, the flow of messages and nutrients over them can be disrupted and the body can become “diseased” or weakened. When you are diseased you have less energy and vitality and are less able to deal with physical and emotional stress.

Lowered resistance to disease, infection, colds, flu, allergies, ulcers, constipation, diarrhoea, asthma, fevers, headaches, seizures, bedwetting, hearing, balance or visual disturbances and many other health problems have been related to an unhealthy nervous system.

How Do Nerves Get Impinged or Trapped

The skeletal system, especially the spinal column, protects the spinal cord and other nerves. If the spinal bones (vertebrae) are misaligned even slightly they may “pinch,” impinge, irritate, compress or stretch the nerves they are supposed to protect.

This in turn can affect other structures in the area including blood vessels, discs, ligaments, joints, muscles, fascia, tendons and meninges. As mentioned earlier, this is referred to as a subluxation.

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The Neck Cervical Spine Anatomy.

The cervical spine begins at the base of the skull. Seven vertebrae make up the cervical spine with eight pairs of cervical nerves. The individual cervical vertebrae are abbreviated C1, C2, C3, C4, C5, C6 and C7. The cervical nerves are also abbreviated; C1 through C8.

Cervical Vertebrae and Supporting Structures

The cervical bones, the vertebrae are smaller in size when compared to other spinal vertebrae. The purpose of the cervical spine is to contain and protect the spinal cord, support the skull, and enable diverse head movement ( rotate side to side, bend forward and backward).

A complex system of ligaments, tendons, and muscles help to support and stabilize the cervical spine. Ligaments work to prevent excessive movement that could result in serious injury. Muscles also help to provide spinal balance and stability, and enable movement. Muscles contract and relax in response to nerve impulses originating in the brain. Some muscles work in pairs or as antagonists. This means when a muscle contracts, the opposing muscle relaxes. There are different types of muscle: forward flexors, lateral flexors, rotators, and extensors.

Spinal Cord and Cervical Nerve Roots

Nerve impulses travel to and from the brain through the spinal cord to a specific location by way of the peripheral nervous system (PNS). The PNS is the complex system of nerves that branch off from the spinal nerve roots. These nerves travel outside of the spinal canal or spinal cord into the organs, arms, legs, fingers – throughout the entire body.

Injury or mild trauma to the cervical spine can cause a serious or life-threatening medical emergency (spinal cord injury or SCI, fracture). Pain, numbness, weakness, and tingling are symptoms that may develop when one or more spinal nerves are injured, irritated, or stretched. The cervical nerves control many bodily functions and sensory activities.

C1: Head and neck
C2: Head and neck
C3: Diaphragm
C4: Upper body muscles ( Deltoids, Biceps)
C5: Wrist extensors
C6: Wrist extensors
C7: Triceps
C8: Hands

Neck 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 5 kg 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.

Causes

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.

Neck pain may result from abnormalities in the soft tissues, muscles, ligaments, and nerves as well as in bones and joints of the spine. The most common causes of neck pain are soft-tissue abnormalities due to injury or prolonged wear and tear. In rare instances, infection or tumors may cause neck pain. In some people, neck problems may be the source of pain in the upper back, shoulders, or arms. Cold Laser Therapy section this therapy has a five star rating for treating neck injuries and conditions.

Neck 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 a car accident may result in hyper-extension, 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.

Arthritis of the Neck

The neck is a common site for arthritis to develop.

The most common type of arthritis that affects the neck is osteoarthritis. This condition is also known as cervical spondylosis, cervical osteoarthritis, or degenerative joint disease of the neck.

Other forms of arthritis that can affect the neck are rheumatoid arthritis, psoriatic, ankylosing spondylitis, Reiter’s disease, gout, pseudogout, and diffuse idiopathic skeletal hyperostosis (DISH).

Rheumatoid arthritis can destroy joints in the neck and cause severe stiffness and pain. Rheumatoid arthritis typically affects upper neck area. View our Cold Laser Therapy section this therapy has a five star rating for treating  this condition

Cervical spondylosis is a condition that mainly affects older people, usually over the age of 45. Men are affected more often than women. This condition results from degenerative changes that occur in the cervical spine (the spine of the neck). Changes in cartilage metabolism lead to slow wear and tear of discs and joints in the neck. Over time, the degenerative changes can lead to a bulging or herniated disc, calcium build-up within the disc, or bony growths on the spine. The end result is nerve compression or inflammation.

Also, depending on which way the disc herniates or the direction of the bony growths, there is a possibility that the spinal cord or nerve roots leading from the spinal cord could be compressed.

There is also the possibility that the blood flow to certain nerves may be affected.

Symptoms depend on the location of the nerve compression, but can include pain, numbness, weakness, headaches, urinary problems, etc.

Initially the person may not have any symptoms.

Others will have neck or shoulder pain, headaches in the back of the head, or stiffness of the neck. They may have difficulty turning or bending the neck from side-to-side.

Some will have pain that shoots down a certain part of the arm. They may also notice numbness, weakness, or pain in the arm. One or both sides may be affected. Often it causes the hands to become clumsy.

Some individuals will have numbness or weakness in their legs. This indicates that there may be pressure on the spinal cord. This is considered a surgical emergency. Many with this condition will have decreased vibration-sense in their legs. They may be unsteady while walking. In fact, spondylosis with myelopathy is a fairly common cause of unsteadiness in the elderly.

Others will have a specific level on the chest or abdomen where there is a noticeable change in sensation.

Problems with urination may occur. Some will have to urinate more often, while others will have to urinate urgently. A few will develop urinary incontinence.

The symptoms may get worse with turning, extending, or bending the neck. In others, coughing or straining may temporarily cause shooting pain in the arms or shoulders or it may worsen weakness in the legs.

Physical exam may reveal numbness or pain along a certain nerve distribution. Certain muscles may be weak and the reflexes not as brisk as normal. The affected individual may have difficulty with turning the neck or bending it from side to side. The arms or legs may be stiff. The hands may be weak and the muscles of the hands atrophied.

X-rays can be helpful in making the diagnosis. However, though X-ray findings of degenerative changes are often found in many older people, only a few will truly evidence the neurological changes caused by this condition. Alone, finding degenerative changes on X-rays is not conclusive but part of an overall determination of this condition that must take into consideration other factors. X-rays done with flexion and extension may show instability.

CT scan can be used to look at the spinal column and see if there is any narrowing or other abnormality.

MRI can also be used to look at the spinal column and see if there is any narrowing or other abnormality.

Nerve conduction studies and electromyography can be done to test the nerves and muscles.

The primary treatment for this condition is first to determine what type of arthritis is causing the problem. The second is making sure the neck is not unstable. Then, it is important to restrict neck movements. This is usually done with a cervical collar.

Medical treatment is usually with anti-inflammatory medicines, analgesics, and muscle relaxants. However, if this fails, then surgery may be necessary.

Physical therapy modalities such as Cold/Low level laser therapy, including stretching and strengthening exercises.

Patients may respond to steroid injections placed in the epidural space.

If that does not work, then surgery to decompress the nerve and stabilize the neck may be necessary.

Surgery is usually done if:

Conservative measures such as a cervical collar do not work.
There is severe pain.
There are significant neurological deficits, such as difficulty walking, severe hand weakness, or bladder problems.
There is compression of the spinal cord.

With any nerve condition, if it is not treated early, there is a danger that the loss of nerve function may be permanent. Nerves are very delicate. Once they are injured beyond a certain point, they do not recover. Therefore, the symptoms that can be caused by this condition could become permanent if not treated appropriately (i.e., numbness, weakness, and urinary problems).

There is no specific way to prevent this condition. However, good posture should be maintained.

Also, avoid repetitive injuries to the neck and cervical spine.

Neck Disc Injury, “Slipped Disc”, also known as Prolapsed, Bulging, Herniated or Extruded Disc

Disc Problems

What Causes Disc Problems?

Discs are the soft but strong cushions that separate the bones (vertebrae) in your spine and absorb shock as you move. Repeated strain over time, an injury, or sudden, forceful movements can damage discs and irritate nerves, causing pain, numbness, or tingling in your back and legs, neck,Shoulders and arms.

Common Slipped Disc, Neck Disc Injury

A Slipped Disc or (Disc Prolapsed) in the neck is a common cause of neck pain. Slipped disc treatment during the early stages involves limited mobilisation. Later, more active physical therapy rehabilitation is useful. During the later stages neck pain treatment can be enhanced if a pillow is used to support the neck.

Other Causes

Less common causes of neck pain include tumors, infections, or congenital abnormalities of the vertebrae.

Whiplash Associated Disorder (WAD) and Cervical Spine Injury

What is whiplash? 

An acute “whiplash” injury follows sudden or excessive hyper-extension, hyper-flexion, or rotation of the neck and causes neck pain and other symptoms. “Whiplash” injury is common in road traffic accidents, and may also be caused by sports injuries, falls or assaults. Most cases of “whiplash” injury occur as the result of rear-end vehicle collisions at speeds of less than 10 miles per hour. Patients present with neck pain and stiffness, occipital headache, thoracic back pain and/or lumber back pain, and upper-limb pain and paraesthesia.

There are two types of injury:

• Typical cervical hyper-extension injuries occur in passengers an drivers of a stationary or slow-moving vehicle that is struck from behind. Body is thrown forward but the head lags, resulting in hyper-extension of the neck. When the head and neck have reached maximum extension, the neck then snaps into flexion.
• A rapid deceleration injury throws the head forwards and flexes the neck. When the chin hits the chest it limits forward flexion but the forward movement may be sufficient to cause longitudinal distraction and neurological damage. Hyper-extension may occur in the subsequent recoil.

“Whiplash” injuries may occur at relatively low vehicle velocity impacts. One study showed the cervical muscle injury threshold to be about 10 km/hour. Whiplash-associated disorders (WAD) can be classified by the severity of signs and symptoms:

• Grade 1: no complaints or physical signs.
• Grade 2: indicates neck complaints but no physical signs.
• Grade 3: indicates neck complaints and musculoskeletal signs.
• Grade 4: neck complaints and neurological signs.
• Grade 5: neck complaints dislocation and fracture. Most cervical spine fractures occur predominantly at two levels:

1. One third of injuries occur at the level of C2, and one half of injuries occur at the level of C6 or C7.

2. Most fatal cervical spine injuries occur in upper cervical levels, either at cranio-cervical junction C1, or at C2

 Uncomplicated cases of Whiplash Associated Disorder (WAD)

“Whiplash”(WAD) cases that are uncomplicated are the result of sprained ligaments in the neck. The muscles of the neck spasm naturally, as a protective reaction. The “Whiplash”(WAD) injury may cause stiff neck and pain that may be present down one or both arms if the nerves of neck part of spinal cord get compressed. Pain Relief for “Whiplash”(WAD) can be found with Chiropractic  or Physiotherapy including pain medication and Cold/ low level laser therapy,

Patient’s with chronic whiplash benefited from Chiropractic  or Physiotherapy

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 discs rupturing and trapped nerves in the neck. This may also predispose to a “slipped”disc, also known as a prolapsed, bulging, ruptured or herniated disc in the back. (View our Cold/low level laser therapy Section, a five star rating has been given to cold/low level laser therapy for soft tissue neck injuries)

Cold/Low level Laser Therapy (LLLT). treatment research  for Neck Pain

Neck pain  is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser – is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders. (View our Cold/Low Level Laser Therapy section)

1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5;374(9705):1897-908.

Cold/Low Laser Therapy(LLLT) has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force (published in the journal Spine).

(View our Cold/Low Level Laser Therapy section)

Whiplash Associated Disorder (WAD Research)

“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” (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.

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 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.

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 care or Physiotherapy. 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, this therapy is extremely affective in the treatment of inflammation. Cold/Low level laser therapy a five star rating for soft tissue neck injuries (“Whiplash”). Surgery is required in very few cases to relieve neck pain. For most patients, a combination of Chiropractic care, rest, medication, and Physiotherapy 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.

Cervical Disc Injury.

Causes and Risk Factors of Cervical disc injuries

Most cervical disc syndromes are caused by injuries that involve hyperextension, which results in compression of the anatomic structures.

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

Symptoms of Cervical disc injuries

Pain, loss of sensation or new sensations, and weakness are the main symptoms and signs of cervical disc injury. The most common symptom is pain and it is usually the only one. Rarely, cervical disc injury is complicated by compression of either a cervical nerve root or even more rarely by a compression of the spinal cord. When compression of the nervous tissue occurs, patients will report abnormal sensations other than pain and will report loosing strength in one arm (nerve root compression) or in both arms and legs (spinal cord compression).

1. Pain is the most common complaint and can be felt in the neck or arm.

a. Pain is usually limited to the neck and upper back between the shoulder blades. It occurs because of low-grade inflammation of the disc and the cervical vertebra joints. While the disease is chronic, inflammation can flare up after a minor added injury or for other reasons that are not yet well understood. Less commonly, neck and shoulder pain occur because the disc bulges acutely (herniates) and stretches the posterior longitudinal ligament. With conservative treatment, this pain usually goes away in a few weeks, but it is likely to happen again, especially if the affected individual does not change his/her lifestyle.

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 usual.

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 fibers 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.

Temporomandibular Jaw Disorders (TMD, TMJ Syndrome)

“TMD” temporomandibular (jaw) disorders, also called “TMJ syndrome.” If you felt pain sometimes in your jaw area, or maybe your dentist or Chiropractor has told you that you have TMD.

If you have questions about TMD, you are not alone. Researchers, too, are looking for answers to what causes TMD, what are the best treatments, and how can we prevent these disorders. The National Institute of Dental and Craniofacial Research has written this pamphlet to share with you what we have learned about TMD.

TMD is not just one disorder, but a group of conditions, often painful, that affect the jaw joint (temporomandibular joint, or TMJ) and the muscles that control chewing. Although we don’t know how many people actually have TMD, the disorders appear to affect about twice as many women as men.

The good news is that for most people, pain in the area of the jaw joint or a muscle is not a signal that a serious problem is developing. Generally, discomfort from TMD is occasional and temporary, often occurring in cycles. The pain eventually goes away with little or no treatment. Only a small percentage of people with TMD pain develop significant, long-term symptoms.

What is the Temporomandibular Joint?

The temporomandibular joint connects the lower jaw, called the mandible, to the temporal bone at the side of the head or neck. If you place your fingers just in front of your ears and open your mouth, you can feel the joint on each side of your head. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew and yawn. Muscles attached to and surrounding the jaw joint controls its position and movement.

When we open our mouths, the rounded ends of the lower jaw, called condyles, glide along the joint socket of the temporal bone. The condyles slide back to their original position when we close our mouths. To keep this motion smooth, a soft disc lies between the  condyle and the temporal bone. This disc absorbs shocks to the TMJ from chewing and other movements.

What Are Temporomandibular Disorders?

Researchers generally agree that temporomandibular disorders fall into three main categories:

• Myofascial pain, the most common form of TMD, which is discomfort or pain in the muscles that control jaw function and the neck and shoulder muscles;
• Neck Pain/Ache.
• Internal derangement of the joint, meaning a dislocated jaw or displaced disc, or injury to the condyle;
• Degenerative joint disease, such as osteoarthritis or rheumatoid arthritis in the jaw joint.

A person may have one or more of these conditions at the same time.

T M J Treatment

If you place your fingers in front of each ear and open your jaw, you’ll feel lots of clicking, or a grinding movement. This is the temporomandibular joint (TMJ), a place where your skull’s temporal bone attaches to your mandible (Jaw).

Because this joint comprises of a large number of ligaments, cartilage, fascia, discs, muscles, nerves and blood vessels that run around and through it, you can have all kinds of problems: trouble opening the mouth wide; a locked jaw; headache; clicking or popping sounds, tinnitus (ringing in the ears); throat fullness; shoulder, cheek or jaw pain; neck ache; facial nerve pain; ear or eye pain; dental pain; nausea; blurred vision and dizziness when the TMJ joint is misaligned.

An unhealthy skull/jaw alignment can put great stress upon the spinal column. By relieving pressure on the upper neck and bones of the skull, chiropractic treatment may relieve or correct TMJ problems. There are also documented cases of dental problems that, once corrected, help patients to hold their spinal adjustments for longer periods between chiropractic treatments.

All TMJ sufferers need chiropractic treatment; anyone who has been to the dentist should follow up with a check up from their chiropractor.

Trapped Nerve or “Pinched” Nerve.

Having a Trapped nerve hurts often feeling like  severe, sharp, excruciating and intense pain. Trapped nerves could happen nearly anywhere affecting nerves that go to the arms, fingers, wrists, neck, head, back, shoulders, legs, muscles and internal organs. “Pinched” or Trapped nerves can affect your health, posture, vitality, resistance to disease, even your emotional health. “Pinched”/trapped nerves can make life a misery.

Trapped ?

Do nerves really get trapped? Actually directly trapping the nerve  is quite rare. Much more common is what chiropractors call the vertebral subluxation complex or subluxations. Other terms for this are: nerve impingement, nerve irritation, nerve lesion, spinal stress and meningeal tension.

Even though there may be no actual trapping, people like the word because it’s so descriptive. It can really feel like something is being trapped in there. Some health professionals even use it. People at times seeing a chiropractor’s  saying their GP, osteopath, massage therapist referred them because they had a trapped nerve and should visit a chiropractor to get  the trapped nerve freed.

What Can Cause Subluxations?

Nearly any kind of stress can cause a subluxation: a fall or an accident, even a very small one that happened years ago; a poor sleeping position; poor posture; fatigue; emotional stress; poor nutrition or a combination of stresses. A subluxation need not happen all at once. It could  set in the body over time. 

 Trapped Nerves Don’t Normally Hurt

Chiropractors sometimes say that people with painful  Trapped nerves might be considered lucky-they know they have a problem and they (hopefully) will  go to a chiropractor.

 If  You  don’t Experience The pain From a  Trapped Nerve?  What Would Be The Outcome?

Some patients  may watch their body suffer and their health deteriorate for years without the faintest idea that the problem may be coming from their spine. These people desperately need to see a chiropractor but because they don’t have spine or nerve pain they may never receive the care they need. This is the big job facing chiropractors today – educating people about vertebral subluxations and the need for periodic spinal checkups.

Treatment Of Trapped Nerves

Trapped nerves do not get untrapped by themselves. No amount of painkillers or muscle relaxants can fix them. Only doctors of chiropractic are able to analyze your spinal column for trapped nerves or vertebral subluxations and use spinal adjustment techniques to gently realign the spine, release the internal stress and free the body from the trapped nerves.

Chiropractors are heakth care practitioners who are most experienced in freeing body of vertebral subluxations.

Nerves  Travel Through the Body?

Individual nerve fibers are tiny. Although they may be many inches long they are so thin you need a powerful microscope to see them. Nerve fibers are also found in large bundles called nerves. Billions of nerve fibers are bundled inside your spinal cord – an extension of your brain, which passes through the spinal column. Nerves branch off from spinal cord and exit spine through openings between the vertebrae to connect to every cell in the body.

Life without Nerves

Without nerves you couldn’t see, hear, touch, taste or smell or feel hot, cold, pleasure or pain,and no messages could come in and no messages could go out; without nerves no muscles could move.

Nerves Keep the Body Alive and Healthy

Nerve messages also help regulate the body’s activities such as breathing, heartbeat, digestion, excretion,  blood pressure and immune system so that the body can respond to germs, changes in temperature and all kinds of stress. In addition to nerve impulses, nutrients flow over your nerves to nourish the muscles and tissues. If this flow is blocked it may cause your muscles to waste away.

If the nerves are trapped, “impinged” or otherwise interfered with, the flow of messages and nutrients over them can be disrupted and the body can become “diseased” or weakened. When you are diseased you have less energy and vitality and are less able to deal with physical and emotional stress.

Lowered resistance to disease, infection, colds, flu, allergies, ulcers, constipation, diarrhea, asthma, fevers, headaches, seizures, bedwetting, hearing, balance or visual disturbances and many other health problems have been related to an unhealthy nervous system.

How Do Nerves Get Impinged or Trapped

The skeletal system, especially the spinal column, protects the spinal cord and other nerves. If  the spinal bones (vertebrae) are misaligned even slightly they may “pinch,” impinge, irritate, compress or stretch the nerves they are supposed to protect.

This in turn can affect other structures in the area including blood vessels, discs, ligaments, joints, muscles, fascia, tendons and meninges. As mentioned earlier, this is referred to as a subluxation.

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The Neck Cervical Spine Anatomy.

The cervical spine begins at the base of the skull. Seven vertebrae make up the cervical spine with eight pairs of cervical nerves. The individual cervical vertebrae are abbreviated C1, C2, C3, C4, C5, C6 and C7. The cervical nerves are also abbreviated; C1 through C8.

Cervical Vertebrae and Supporting Structures

The cervical bones, the vertebrae are smaller in size when compared to other spinal vertebrae. The purpose of the cervical spine is to contain and protect the spinal cord, support the skull, and enable diverse head movement ( rotate side to side, bend forward and backward).

A complex system of ligaments, tendons, and muscles help to support and stabilize the cervical spine. Ligaments work to prevent excessive movement that could result in serious injury. Muscles also help to provide spinal balance and stability, and enable movement. Muscles contract and relax in response to nerve impulses originating in the brain. Some muscles work in pairs or as antagonists. This means when a muscle contracts, the opposing muscle relaxes. There are different types of muscle: forward flexors, lateral flexors, rotators, and extensors.

Spinal Cord and Cervical Nerve Roots

Nerve impulses travel to and from the brain through the spinal cord to a specific location by way of the peripheral nervous system (PNS). The PNS is the complex system of nerves that branch off from the spinal nerve roots. These nerves travel outside of the spinal canal or spinal cord into the organs, arms, legs, fingers – throughout the entire body.

Injury or mild trauma to the cervical spine can cause a serious or life-threatening medical emergency (spinal cord injury or SCI, fracture). Pain, numbness, weakness, and tingling are symptoms that may develop when one or more spinal nerves are injured, irritated, or stretched. The cervical nerves control many bodily functions and sensory activities.

C1: Head and neck
C2: Head and neck
C3: Diaphragm
C4: Upper body muscles ( Deltoids, Biceps)
C5: Wrist extensors
C6: Wrist extensors
C7: Triceps
C8: Hands

Neck 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 5 kg 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.

Causes

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.

Neck pain may result from abnormalities in the soft tissues, muscles, ligaments, and nerves as well as in bones and joints of the spine. The most common causes of neck pain are soft-tissue abnormalities due to injury or prolonged wear and tear. In rare instances, infection or tumors may cause neck pain. In some people, neck problems may be the source of pain in the upper back, shoulders, or arms. Cold Laser Therapy section this therapy has a five star rating for treating neck injuries and conditions.

Neck 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 a car accident may result in hyper-extension, 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.

Arthritis of the Neck

The neck is a common site for arthritis to develop.

The most common type of arthritis that affects the neck is osteoarthritis. This condition is also known as cervical spondylosis, cervical osteoarthritis, or degenerative joint disease of the neck.

Other forms of arthritis that can affect the neck are rheumatoid arthritis, psoriatic, ankylosing spondylitis, Reiter’s disease, gout, pseudogout, and diffuse idiopathic skeletal hyperostosis (DISH).

Rheumatoid arthritis can destroy joints in the neck and cause severe stiffness and pain. Rheumatoid arthritis typically affects upper neck area. View our Cold Laser Therapy section this therapy has a five star rating for treating  this condition

Cervical spondylosis is a condition that mainly affects older people, usually over the age of 45. Men are affected more often than women. This condition results from degenerative changes that occur in the cervical spine (the spine of the neck). Changes in cartilage metabolism lead to slow wear and tear of discs and joints in the neck. Over time, the degenerative changes can lead to a bulging or herniated disc, calcium build-up within the disc, or bony growths on the spine. The end result is nerve compression or inflammation.

Also, depending on which way the disc herniates or the direction of the bony growths, there is a possibility that the spinal cord or nerve roots leading from the spinal cord could be compressed.

There is also the possibility that the blood flow to certain nerves may be affected.

Symptoms depend on the location of the nerve compression, but can include pain, numbness, weakness, headaches, urinary problems, etc.

Initially the person may not have any symptoms.

Others will have neck or shoulder pain, headaches in the back of the head, or stiffness of the neck. They may have difficulty turning or bending the neck from side-to-side.

Some will have pain that shoots down a certain part of the arm. They may also notice numbness, weakness, or pain in the arm. One or both sides may be affected. Often it causes the hands to become clumsy.

Some individuals will have numbness or weakness in their legs. This indicates that there may be pressure on the spinal cord. This is considered a surgical emergency. Many with this condition will have decreased vibration-sense in their legs. They may be unsteady while walking. In fact, spondylosis with myelopathy is a fairly common cause of unsteadiness in the elderly.

Others will have a specific level on the chest or abdomen where there is a noticeable change in sensation.

Problems with urination may occur. Some will have to urinate more often, while others will have to urinate urgently. A few will develop urinary incontinence.

The symptoms may get worse with turning, extending, or bending the neck. In others, coughing or straining may temporarily cause shooting pain in the arms or shoulders or it may worsen weakness in the legs.

Physical exam may reveal numbness or pain along a certain nerve distribution. Certain muscles may be weak and the reflexes not as brisk as normal. The affected individual may have difficulty with turning the neck or bending it from side to side. The arms or legs may be stiff. The hands may be weak and the muscles of the hands atrophied.

X-rays can be helpful in making the diagnosis. However, though X-ray findings of degenerative changes are often found in many older people, only a few will truly evidence the neurological changes caused by this condition. Alone, finding degenerative changes on X-rays is not conclusive but part of an overall determination of this condition that must take into consideration other factors. X-rays done with flexion and extension may show instability.

CT scan can be used to look at the spinal column and see if there is any narrowing or other abnormality.

MRI can also be used to look at the spinal column and see if there is any narrowing or other abnormality.

Nerve conduction studies and electromyography can be done to test the nerves and muscles.

The primary treatment for this condition is first to determine what type of arthritis is causing the problem. The second is making sure the neck is not unstable. Then, it is important to restrict neck movements. This is usually done with a cervical collar.

Medical treatment is usually with anti-inflammatory medicines, analgesics, and muscle relaxants. However, if this fails, then surgery may be necessary.

Physical therapy modalities such as Cold/Low level laser therapy, including stretching and strengthening exercises.

Patients may respond to steroid injections placed in the epidural space.

If that does not work, then surgery to decompress the nerve and stabilize the neck may be necessary.

Surgery is usually done if:

Conservative measures such as a cervical collar do not work.
There is severe pain.
There are significant neurological deficits, such as difficulty walking, severe hand weakness, or bladder problems.
There is compression of the spinal cord.

With any nerve condition, if it is not treated early, there is a danger that the loss of nerve function may be permanent. Nerves are very delicate. Once they are injured beyond a certain point, they do not recover. Therefore, the symptoms that can be caused by this condition could become permanent if not treated appropriately (i.e., numbness, weakness, and urinary problems).

There is no specific way to prevent this condition. However, good posture should be maintained.

Also, avoid repetitive injuries to the neck and cervical spine.

Neck Disc Injury, “Slipped Disc”, also known as Prolapsed, Bulging, Herniated or Extruded Disc

Disc Problems

What Causes Disc Problems?

Discs are the soft but strong cushions that separate the bones (vertebrae) in your spine and absorb shock as you move. Repeated strain over time, an injury, or sudden, forceful movements can damage discs and irritate nerves, causing pain, numbness, or tingling in your back and legs, neck,Shoulders and arms.

Common Slipped Disc, Neck Disc Injury

A Slipped Disc or (Disc Prolapsed) in the neck is a common cause of neck pain. Slipped disc treatment during the early stages involves limited mobilisation. Later, more active physical therapy rehabilitation is useful. During the later stages neck pain treatment can be enhanced if a pillow is used to support the neck.

Other Causes

Less common causes of neck pain include tumors, infections, or congenital abnormalities of the vertebrae.

Whiplash Associated Disorder (WAD) and Cervical Spine Injury

What is whiplash? 

An acute “whiplash” injury follows sudden or excessive hyper-extension, hyper-flexion, or rotation of the neck and causes neck pain and other symptoms. “Whiplash” injury is common in road traffic accidents, and may also be caused by sports injuries, falls or assaults. Most cases of “whiplash” injury occur as the result of rear-end vehicle collisions at speeds of less than 10 miles per hour. Patients present with neck pain and stiffness, occipital headache, thoracic back pain and/or lumber back pain, and upper-limb pain and paraesthesia.

There are two types of injury:

• Typical cervical hyper-extension injuries occur in passengers an drivers of a stationary or slow-moving vehicle that is struck from behind. Body is thrown forward but the head lags, resulting in hyper-extension of the neck. When the head and neck have reached maximum extension, the neck then snaps into flexion.
• A rapid deceleration injury throws the head forwards and flexes the neck. When the chin hits the chest it limits forward flexion but the forward movement may be sufficient to cause longitudinal distraction and neurological damage. Hyper-extension may occur in the subsequent recoil.

“Whiplash” injuries may occur at relatively low vehicle velocity impacts. One study showed the cervical muscle injury threshold to be about 10 km/hour. Whiplash-associated disorders (WAD) can be classified by the severity of signs and symptoms:

• Grade 1: no complaints or physical signs.
• Grade 2: indicates neck complaints but no physical signs.
• Grade 3: indicates neck complaints and musculoskeletal signs.
• Grade 4: neck complaints and neurological signs.
• Grade 5: neck complaints dislocation and fracture. Most cervical spine fractures occur predominantly at two levels:

1. One third of injuries occur at the level of C2, and one half of injuries occur at the level of C6 or C7.

2. Most fatal cervical spine injuries occur in upper cervical levels, either at cranio-cervical junction C1, or at C2

 Uncomplicated cases of Whiplash Associated Disorder (WAD)

“Whiplash”(WAD) cases that are uncomplicated are the result of sprained ligaments in the neck. The muscles of the neck spasm naturally, as a protective reaction. The “Whiplash”(WAD) injury may cause stiff neck and pain that may be present down one or both arms if the nerves of neck part of spinal cord get compressed. Pain Relief for “Whiplash”(WAD) can be found with Chiropractic  or Physiotherapy including pain medication and Cold/ low level laser therapy,

Patient’s with chronic whiplash benefited from Chiropractic  or Physiotherapy

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 discs rupturing and trapped nerves in the neck. This may also predispose to a “slipped”disc, also known as a prolapsed, bulging, ruptured or herniated disc in the back. (View our Cold/low level laser therapy Section, a five star rating has been given to cold/low level laser therapy for soft tissue neck injuries)

Cold/Low level Laser Therapy (LLLT). treatment research  for Neck Pain

Neck pain  is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser – is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders. (View our Cold/Low Level Laser Therapy section)

1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5;374(9705):1897-908.

Cold/Low Laser Therapy(LLLT) has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force (published in the journal Spine).

(View our Cold/Low Level Laser Therapy section)

Whiplash Associated Disorder (WAD Research)

“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” (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.

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 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.

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 care or Physiotherapy. 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, this therapy is extremely affective in the treatment of inflammation. Cold/Low level laser therapy a five star rating for soft tissue neck injuries (“Whiplash”). Surgery is required in very few cases to relieve neck pain. For most patients, a combination of Chiropractic care, rest, medication, and Physiotherapy 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.

Cervical Disc Injury.

Causes and Risk Factors of Cervical disc injuries

Most cervical disc syndromes are caused by injuries that involve hyperextension, which results in compression of the anatomic structures.

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

Symptoms of Cervical disc injuries

Pain, loss of sensation or new sensations, and weakness are the main symptoms and signs of cervical disc injury. The most common symptom is pain and it is usually the only one. Rarely, cervical disc injury is complicated by compression of either a cervical nerve root or even more rarely by a compression of the spinal cord. When compression of the nervous tissue occurs, patients will report abnormal sensations other than pain and will report loosing strength in one arm (nerve root compression) or in both arms and legs (spinal cord compression).

1. Pain is the most common complaint and can be felt in the neck or arm.

a. Pain is usually limited to the neck and upper back between the shoulder blades. It occurs because of low-grade inflammation of the disc and the cervical vertebra joints. While the disease is chronic, inflammation can flare up after a minor added injury or for other reasons that are not yet well understood. Less commonly, neck and shoulder pain occur because the disc bulges acutely (herniates) and stretches the posterior longitudinal ligament. With conservative treatment, this pain usually goes away in a few weeks, but it is likely to happen again, especially if the affected individual does not change his/her lifestyle.

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 usual.

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 fibers 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.

Temporomandibular Jaw Disorders (TMD, TMJ Syndrome)

“TMD” temporomandibular (jaw) disorders, also called “TMJ syndrome.” If you felt pain sometimes in your jaw area, or maybe your dentist or Chiropractor has told you that you have TMD.

If you have questions about TMD, you are not alone. Researchers, too, are looking for answers to what causes TMD, what are the best treatments, and how can we prevent these disorders. The National Institute of Dental and Craniofacial Research has written this pamphlet to share with you what we have learned about TMD.

TMD is not just one disorder, but a group of conditions, often painful, that affect the jaw joint (temporomandibular joint, or TMJ) and the muscles that control chewing. Although we don’t know how many people actually have TMD, the disorders appear to affect about twice as many women as men.

The good news is that for most people, pain in the area of the jaw joint or a muscle is not a signal that a serious problem is developing. Generally, discomfort from TMD is occasional and temporary, often occurring in cycles. The pain eventually goes away with little or no treatment. Only a small percentage of people with TMD pain develop significant, long-term symptoms.

What is the Temporomandibular Joint?

The temporomandibular joint connects the lower jaw, called the mandible, to the temporal bone at the side of the head or neck. If you place your fingers just in front of your ears and open your mouth, you can feel the joint on each side of your head. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew and yawn. Muscles attached to and surrounding the jaw joint controls its position and movement.

When we open our mouths, the rounded ends of the lower jaw, called condyles, glide along the joint socket of the temporal bone. The condyles slide back to their original position when we close our mouths. To keep this motion smooth, a soft disc lies between the  condyle and the temporal bone. This disc absorbs shocks to the TMJ from chewing and other movements.

What Are Temporomandibular Disorders?

Researchers generally agree that temporomandibular disorders fall into three main categories:

• Myofascial pain, the most common form of TMD, which is discomfort or pain in the muscles that control jaw function and the neck and shoulder muscles;
• Neck Pain/Ache.
• Internal derangement of the joint, meaning a dislocated jaw or displaced disc, or injury to the condyle;
• Degenerative joint disease, such as osteoarthritis or rheumatoid arthritis in the jaw joint.

A person may have one or more of these conditions at the same time.

T M J Treatment

If you place your fingers in front of each ear and open your jaw, you’ll feel lots of clicking, or a grinding movement. This is the temporomandibular joint (TMJ), a place where your skull’s temporal bone attaches to your mandible (Jaw).

Because this joint comprises of a large number of ligaments, cartilage, fascia, discs, muscles, nerves and blood vessels that run around and through it, you can have all kinds of problems: trouble opening the mouth wide; a locked jaw; headache; clicking or popping sounds, tinnitus (ringing in the ears); throat fullness; shoulder, cheek or jaw pain; neck ache; facial nerve pain; ear or eye pain; dental pain; nausea; blurred vision and dizziness when the TMJ joint is misaligned.

An unhealthy skull/jaw alignment can put great stress upon the spinal column. By relieving pressure on the upper neck and bones of the skull, chiropractic treatment may relieve or correct TMJ problems. There are also documented cases of dental problems that, once corrected, help patients to hold their spinal adjustments for longer periods between chiropractic treatments.

All TMJ sufferers need chiropractic treatment; anyone who has been to the dentist should follow up with a check up from their chiropractor.

Trapped Nerve or “Pinched” Nerve.

Having a Trapped nerve hurts often feeling like  severe, sharp, excruciating and intense pain. Trapped nerves could happen nearly anywhere affecting nerves that go to the arms, fingers, wrists, neck, head, back, shoulders, legs, muscles and internal organs. “Pinched” or Trapped nerves can affect your health, posture, vitality, resistance to disease, even your emotional health. “Pinched”/trapped nerves can make life a misery.

Trapped ?

Do nerves really get trapped? Actually directly trapping the nerve  is quite rare. Much more common is what chiropractors call the vertebral subluxation complex or subluxations. Other terms for this are: nerve impingement, nerve irritation, nerve lesion, spinal stress and meningeal tension.

Even though there may be no actual trapping, people like the word because it’s so descriptive. It can really feel like something is being trapped in there. Some health professionals even use it. People at times seeing a chiropractor’s  saying their GP, osteopath, massage therapist referred them because they had a trapped nerve and should visit a chiropractor to get  the trapped nerve freed.

What Can Cause Subluxations?

Nearly any kind of stress can cause a subluxation: a fall or an accident, even a very small one that happened years ago; a poor sleeping position; poor posture; fatigue; emotional stress; poor nutrition or a combination of stresses. A subluxation need not happen all at once. It could  set in the body over time. 

 Trapped Nerves Don’t Normally Hurt

Chiropractors sometimes say that people with painful  Trapped nerves might be considered lucky-they know they have a problem and they (hopefully) will  go to a chiropractor.

 If  You  don’t Experience The pain From a  Trapped Nerve?  What Would Be The Outcome?

Some patients  may watch their body suffer and their health deteriorate for years without the faintest idea that the problem may be coming from their spine. These people desperately need to see a chiropractor but because they don’t have spine or nerve pain they may never receive the care they need. This is the big job facing chiropractors today – educating people about vertebral subluxations and the need for periodic spinal checkups.

Treatment Of Trapped Nerves

Trapped nerves do not get untrapped by themselves. No amount of painkillers or muscle relaxants can fix them. Only doctors of chiropractic are able to analyze your spinal column for trapped nerves or vertebral subluxations and use spinal adjustment techniques to gently realign the spine, release the internal stress and free the body from the trapped nerves.

Chiropractors are heakth care practitioners who are most experienced in freeing body of vertebral subluxations.

Nerves  Travel Through the Body?

Individual nerve fibers are tiny. Although they may be many inches long they are so thin you need a powerful microscope to see them. Nerve fibers are also found in large bundles called nerves. Billions of nerve fibers are bundled inside your spinal cord – an extension of your brain, which passes through the spinal column. Nerves branch off from spinal cord and exit spine through openings between the vertebrae to connect to every cell in the body.

Life without Nerves

Without nerves you couldn’t see, hear, touch, taste or smell or feel hot, cold, pleasure or pain,and no messages could come in and no messages could go out; without nerves no muscles could move.

Nerves Keep the Body Alive and Healthy

Nerve messages also help regulate the body’s activities such as breathing, heartbeat, digestion, excretion,  blood pressure and immune system so that the body can respond to germs, changes in temperature and all kinds of stress. In addition to nerve impulses, nutrients flow over your nerves to nourish the muscles and tissues. If this flow is blocked it may cause your muscles to waste away.

If the nerves are trapped, “impinged” or otherwise interfered with, the flow of messages and nutrients over them can be disrupted and the body can become “diseased” or weakened. When you are diseased you have less energy and vitality and are less able to deal with physical and emotional stress.

Lowered resistance to disease, infection, colds, flu, allergies, ulcers, constipation, diarrhea, asthma, fevers, headaches, seizures, bedwetting, hearing, balance or visual disturbances and many other health problems have been related to an unhealthy nervous system.

How Do Nerves Get Impinged or Trapped

The skeletal system, especially the spinal column, protects the spinal cord and other nerves. If  the spinal bones (vertebrae) are misaligned even slightly they may “pinch,” impinge, irritate, compress or stretch the nerves they are supposed to protect.

This in turn can affect other structures in the area including blood vessels, discs, ligaments, joints, muscles, fascia, tendons and meninges. As mentioned earlier, this is referred to as a subluxation.

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An acute “whiplash” injury follows sudden or excessive hyper-extension, hyper-flexion, or rotation of the neck and causes neck pain and other symptoms. “Whiplash” injury is common in road traffic accidents, and may also be caused by sports injuries, falls or assaults. Most cases of “whiplash” injury occur as the result of rear-end vehicle collisions at speeds of less than 10 miles per hour. Patients present with neck pain and stiffness, headache at the back of the head, thoracic back pain and/or lower back pain. Some pins and needles and pain can also be present in the arms. 

Call 02476 222002.Registered with BUPA, AXA  PPP, HSA, AVIVA, Simplyhealth, Standard Life, Mercia health, BHSF, Pru health,.Cigna,Groupma, Police health scheme, Medicare,  Medisure, Medicash and all other healthcare insurers .

Whiplash Associated Disorder (WAD) and Cervical Spine Injury

An acute “whiplash” injury follows sudden or excessive hyper-extension, hyper-flexion, or rotation of the neck and causes neck pain and other symptoms. “Whiplash” injury is common in road traffic accidents, and may also be caused by sports injuries, falls or assaults. Most cases of “whiplash” injury occur as the result of rear-end vehicle collisions at speeds of less than 10 miles per hour. Patients present with neck pain and stiffness, headache at the back of the head, thoracic back pain and/or lower back pain. Some pins and needles and pain can also be present in the arms. 

Typical cervical over-extension injuries occur in passengers an drivers of a stationary or slow-moving vehicle that is struck from behind. Body is thrown forward but the head lags, resulting in hyper-extension of the neck. When the head and neck have reached maximum extension, the neck then snaps into flexion.

• A rapid deceleration injury throws the head forwards and flexes the neck. When the chin hits the chest it limits forward flexion but the forward movement may be sufficient to cause longitudinal distraction and neurological damage. Hyperextension may occur in the subsequent recoil.

“Whiplash” injuries may occur at relatively low vehicle velocity impacts. One study showed the cervical muscle injury threshold to be about 10 km/hour. Whiplash-associated disorders (WAD) can be classified by the severity of signs and symptoms:

• Grade 1: no complaints or physical signs.
• Grade 2: indicates neck complaints but no physical signs.
• Grade 3: indicates neck complaints and musculoskeletal signs.
• Grade 4: neck complaints and neurological signs.
• Grade 5: neck complaints dislocation and fracture. Most cervical spine fractures occur predominantly at two levels:

1. One third of injuries occur at the level of C2, and one half of injuries occur at the level of C6 or C7.

2. Most fatal cervical spine injuries occur in upper cervical levels, either at cranio-cervical junction C1, or at C2

 Uncomplicated cases of Whiplash Associated Disorder (WAD)

“Whiplash”(WAD) cases that are uncomplicated are the result of sprained ligaments in the neck. The muscles of the neck spasm naturally, as a protective reaction. The “Whiplash”(WAD) injury may cause stiff neck and pain that may be present down one or both arms if the nerves of neck part of spinal cord get compressed. Pain Relief for “Whiplash”(WAD) can be found with Chiropractic care or Physiotherapy including pain medication.

****** Studies have shown that 35 of 39 patients, or 91%, of patients with chronic Whiplash associated disorder (WAD) “Whiplash” benefited from chiropractic care and Physiotherapy ********

Severe cases of Whiplash Associated Disorder (WAD).

In severe cases of “Whiplash”(WAD) the symptoms 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” disc, also known as a prolapsed, bulging, ruptured or herniated disc in the back.

(View  our Cold Low Level  Laser Therapy section,a five star rating has been given to Cold/Low Level Laser Therapy, for healing & pain relief ).

( Cold/Low Level Laser Therapy Section.)

The symptoms of Whiplash Associated Disorder (WAD)

• 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?

It is common for “Whiplash”(WAD) symptoms to occur right away but often there is a delay 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. About 35 percent of people with “Whiplash”(WAD) report symptoms for up to a year. Around 15 percent of patients report permanent symptoms as a result of their injuries.

Diagnosis of Whiplash Associated Disorder

Determining the source of the pain is essential in establishing 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, Chiropractor or Physiotherapists 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 or Physiotherapist will take a complete medical history. The Chiropractor or Physiotherapists  may ask you about other illnesses, any injuries 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 or Physiotherapy to look at the Vertebrae (bones) in your neck. This entails simple diagnostic imaging study (radiography) and aids your Chiropractor and Physiotherapist 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 for Whiplash Associated Disorder (WAD).

The treatment of neck pain depends on the diagnosis. Most patients are treated successfully with Chiropractic care. 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. Cold/Low Level Laser Therapy is extremely effective in the treatment of inflammation. Surgery is required in very few cases to relieve neck pain. For most patients, a combination of Chiropractic care or Physiotherapy, rest, medication, 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.

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).

Cold/low level Laser Therapy (LLLT). Research,for neck pain and injuries, published by The Lancet.

Neck pain is a pain in the neck. It is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser – is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders.

1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5; 374(9705):1897-908.

Cold/ Low Laser Therapy(LLLT) has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force (published in the journal Spine).

(View our Cold / Low Level Laser Therapy(LLLT) section. Cold/low level Laser Therapy has a five star rating for  healing & pain relief  for Whiplash  soft tissue injuries ).

What can I do to help prevent Whiplash associated disorder (WAD)

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.

Causes and Risk Factors of Cervical disc injuries

Most cervical disc syndromes are caused by injuries that involve hyperextension, which results in compression of the anatomic structures.

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

Symptoms of Cervical disc injuries

Pain, loss of sensation or new sensations, and weakness are the main symptoms and signs of cervical disc injury. The most common symptom is pain and it is usually the only one. Rarely, cervical disc injury is complicated by compression of either a cervical nerve root or even more rarely by a compression of the spinal cord. When compression of the nervous tissue occurs, patients will report abnormal sensations other than pain and will report loosing strength in one arm (nerve root compression) or in both arms and legs (spinal cord compression).

1. Pain is the most common complaint and can be felt in the neck or arm.

a. Pain is usually limited to the neck and upper back between the shoulder blades. It occurs because of low-grade inflammation of the disc and the cervical vertebra joints. While the disease is chronic, inflammation can flare up after a minor added injury or for other reasons that are not yet well understood. Less commonly, neck and shoulder pain occur because the disc bulges acutely (herniates) and stretches the posterior longitudinal ligament. With conservative treatment, this pain usually goes away in a few weeks, but it is likely to happen again, especially if the affected individual does not change his/her lifestyle.

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 usual.

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An acute “whiplash” injury follows sudden or excessive hyper-extension, hyper-flexion, or rotation of the neck and causes neck pain and other symptoms. “Whiplash” injury is common in road traffic accidents, and may also be caused by sports injuries, falls or assaults. Most cases of “whiplash” injury occur as the result of rear-end vehicle collisions at speeds of less than 10 miles per hour. Patients present with neck pain and stiffness, headache at the back of the head, thoracic back pain and/or lower back pain. Some pins and needles and pain can also be present in the arms. 

Call 02476 222002.Registered with BUPA, AXA  PPP, HSA, AVIVA, Simplyhealth, Standard Life, Mercia health, BHSF, Pru health,.Cigna,Groupma, Police health scheme, Medicare,  Medisure, Medicash and all other healthcare insurers .

Whiplash Associated Disorder (WAD) and Cervical Spine Injury

An acute “whiplash” injury follows sudden or excessive hyper-extension, hyper-flexion, or rotation of the neck and causes neck pain and other symptoms. “Whiplash” injury is common in road traffic accidents, and may also be caused by sports injuries, falls or assaults. Most cases of “whiplash” injury occur as the result of rear-end vehicle collisions at speeds of less than 10 miles per hour. Patients present with neck pain and stiffness, headache at the back of the head, thoracic back pain and/or lower back pain. Some pins and needles and pain can also be present in the arms. 

Typical cervical over-extension injuries occur in passengers an drivers of a stationary or slow-moving vehicle that is struck from behind. Body is thrown forward but the head lags, resulting in hyper-extension of the neck. When the head and neck have reached maximum extension, the neck then snaps into flexion.

• A rapid deceleration injury throws the head forwards and flexes the neck. When the chin hits the chest it limits forward flexion but the forward movement may be sufficient to cause longitudinal distraction and neurological damage. Hyperextension may occur in the subsequent recoil.

“Whiplash” injuries may occur at relatively low vehicle velocity impacts. One study showed the cervical muscle injury threshold to be about 10 km/hour. Whiplash-associated disorders (WAD) can be classified by the severity of signs and symptoms:

• Grade 1: no complaints or physical signs.
• Grade 2: indicates neck complaints but no physical signs.
• Grade 3: indicates neck complaints and musculoskeletal signs.
• Grade 4: neck complaints and neurological signs.
• Grade 5: neck complaints dislocation and fracture. Most cervical spine fractures occur predominantly at two levels:

1. One third of injuries occur at the level of C2, and one half of injuries occur at the level of C6 or C7.

2. Most fatal cervical spine injuries occur in upper cervical levels, either at cranio-cervical junction C1, or at C2

 Uncomplicated cases of Whiplash Associated Disorder (WAD)

“Whiplash”(WAD) cases that are uncomplicated are the result of sprained ligaments in the neck. The muscles of the neck spasm naturally, as a protective reaction. The “Whiplash”(WAD) injury may cause stiff neck and pain that may be present down one or both arms if the nerves of neck part of spinal cord get compressed. Pain Relief for “Whiplash”(WAD) can be found with Chiropractic care or Physiotherapy including pain medication.

****** Studies have shown that 35 of 39 patients, or 91%, of patients with chronic Whiplash associated disorder (WAD) “Whiplash” benefited from chiropractic care and Physiotherapy ********

Severe cases of Whiplash Associated Disorder (WAD).

In severe cases of “Whiplash”(WAD) the symptoms 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” disc, also known as a prolapsed, bulging, ruptured or herniated disc in the back.

(View  our Cold Low Level  Laser Therapy section,a five star rating has been given to Cold/Low Level Laser Therapy, for healing & pain relief ).

( Cold/Low Level Laser Therapy Section.)

The symptoms of Whiplash Associated Disorder (WAD)

• 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?

It is common for “Whiplash”(WAD) symptoms to occur right away but often there is a delay 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. About 35 percent of people with “Whiplash”(WAD) report symptoms for up to a year. Around 15 percent of patients report permanent symptoms as a result of their injuries.

Diagnosis of Whiplash Associated Disorder

Determining the source of the pain is essential in establishing 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, Chiropractor or Physiotherapists 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 or Physiotherapist will take a complete medical history. The Chiropractor or Physiotherapists  may ask you about other illnesses, any injuries 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 or Physiotherapy to look at the Vertebrae (bones) in your neck. This entails simple diagnostic imaging study (radiography) and aids your Chiropractor and Physiotherapist 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 for Whiplash Associated Disorder (WAD).

The treatment of neck pain depends on the diagnosis. Most patients are treated successfully with Chiropractic care. 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. Cold/Low Level Laser Therapy is extremely effective in the treatment of inflammation. Surgery is required in very few cases to relieve neck pain. For most patients, a combination of Chiropractic care or Physiotherapy, rest, medication, 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.

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).

Cold/low level Laser Therapy (LLLT). Research,for neck pain and injuries, published by The Lancet.

Neck pain is a pain in the neck. It is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser – is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders.

1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5; 374(9705):1897-908.

Cold/ Low Laser Therapy(LLLT) has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force (published in the journal Spine).

(View our Cold / Low Level Laser Therapy(LLLT) section. Cold/low level Laser Therapy has a five star rating for  healing & pain relief  for Whiplash  soft tissue injuries ).

What can I do to help prevent Whiplash associated disorder (WAD)

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.

Causes and Risk Factors of Cervical disc injuries

Most cervical disc syndromes are caused by injuries that involve hyperextension, which results in compression of the anatomic structures.

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

Symptoms of Cervical disc injuries

Pain, loss of sensation or new sensations, and weakness are the main symptoms and signs of cervical disc injury. The most common symptom is pain and it is usually the only one. Rarely, cervical disc injury is complicated by compression of either a cervical nerve root or even more rarely by a compression of the spinal cord. When compression of the nervous tissue occurs, patients will report abnormal sensations other than pain and will report loosing strength in one arm (nerve root compression) or in both arms and legs (spinal cord compression).

1. Pain is the most common complaint and can be felt in the neck or arm.

a. Pain is usually limited to the neck and upper back between the shoulder blades. It occurs because of low-grade inflammation of the disc and the cervical vertebra joints. While the disease is chronic, inflammation can flare up after a minor added injury or for other reasons that are not yet well understood. Less commonly, neck and shoulder pain occur because the disc bulges acutely (herniates) and stretches the posterior longitudinal ligament. With conservative treatment, this pain usually goes away in a few weeks, but it is likely to happen again, especially if the affected individual does not change his/her lifestyle.

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 usual.

Back to Top

Call 02476 222002.Registered with BUPA, AXA  PPP,  AVIVA, Simplyhealth, HSA, Standard Life, Mercia health, BHSF, Pru health,Cigna, Police health care scheme, Medicare,  Medisure, Medicash, Groupma, Allianz, and all other healthcare insurers .

The Neck Cervical Spine Anatomy.

The cervical spine begins at the base of the skull. Seven vertebrae make up the cervical spine with eight pairs of cervical nerves. The individual cervical vertebrae are abbreviated C1, C2, C3, C4, C5, C6 and C7. The cervical nerves are also abbreviated; C1 through C8.

Cervical Vertebrae and Supporting Structures

The cervical bones, the vertebrae are smaller in size when compared to other spinal vertebrae. The purpose of the cervical spine is to contain and protect the spinal cord, support the skull, and enable diverse head movement ( rotate side to side, bend forward and backward).

A complex system of ligaments, tendons, and muscles help to support and stabilize the cervical spine. Ligaments work to prevent excessive movement that could result in serious injury. Muscles also help to provide spinal balance and stability, and enable movement. Muscles contract and relax in response to nerve impulses originating in the brain. Some muscles work in pairs or as antagonists. This means when a muscle contracts, the opposing muscle relaxes. There are different types of muscle: forward flexors, lateral flexors, rotators, and extensors.

Spinal Cord and Cervical Nerve Roots

Nerve impulses travel to and from the brain through the spinal cord to a specific location by way of the peripheral nervous system (PNS). The PNS is the complex system of nerves that branch off from the spinal nerve roots. These nerves travel outside of the spinal canal or spinal cord into the organs, arms, legs, fingers – throughout the entire body.

Injury or mild trauma to the cervical spine can cause a serious or life-threatening medical emergency (spinal cord injury or SCI, fracture). Pain, numbness, weakness, and tingling are symptoms that may develop when one or more spinal nerves are injured, irritated, or stretched. The cervical nerves control many bodily functions and sensory activities.

C1: Head and neck
C2: Head and neck
C3: Diaphragm
C4: Upper body muscles ( Deltoids, Biceps)
C5: Wrist extensors
C6: Wrist extensors
C7: Triceps
C8: Hands

Neck 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 5 kg 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.

Causes

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.

Neck pain may result from abnormalities in the soft tissues, muscles, ligaments, and nerves as well as in bones and joints of the spine. The most common causes of neck pain are soft-tissue abnormalities due to injury or prolonged wear and tear. In rare instances, infection or tumors may cause neck pain. In some people, neck problems may be the source of pain in the upper back, shoulders, or arms. Cold Laser Therapy section this therapy has a five star rating for treating neck injuries and conditions.

Neck 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 a car accident may result in hyper-extension, 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.

Arthritis of the Neck

The neck is a common site for arthritis to develop.

The most common type of arthritis that affects the neck is osteoarthritis. This condition is also known as cervical spondylosis, cervical osteoarthritis, or degenerative joint disease of the neck.

Other forms of arthritis that can affect the neck are rheumatoid arthritis, psoriatic, ankylosing spondylitis, Reiter’s disease, gout, pseudogout, and diffuse idiopathic skeletal hyperostosis (DISH).

Rheumatoid arthritis can destroy joints in the neck and cause severe stiffness and pain. Rheumatoid arthritis typically affects upper neck area. View our Cold Laser Therapy section this therapy has a five star rating for treating  this condition

Cervical spondylosis is a condition that mainly affects older people, usually over the age of 45. Men are affected more often than women. This condition results from degenerative changes that occur in the cervical spine (the spine of the neck). Changes in cartilage metabolism lead to slow wear and tear of discs and joints in the neck. Over time, the degenerative changes can lead to a bulging or herniated disc, calcium build-up within the disc, or bony growths on the spine. The end result is nerve compression or inflammation.

Also, depending on which way the disc herniates or the direction of the bony growths, there is a possibility that the spinal cord or nerve roots leading from the spinal cord could be compressed.

There is also the possibility that the blood flow to certain nerves may be affected.

Symptoms depend on the location of the nerve compression, but can include pain, numbness, weakness, headaches, urinary problems, etc.

Initially the person may not have any symptoms.

Others will have neck or shoulder pain, headaches in the back of the head, or stiffness of the neck. They may have difficulty turning or bending the neck from side-to-side.

Some will have pain that shoots down a certain part of the arm. They may also notice numbness, weakness, or pain in the arm. One or both sides may be affected. Often it causes the hands to become clumsy.

Some individuals will have numbness or weakness in their legs. This indicates that there may be pressure on the spinal cord. This is considered a surgical emergency. Many with this condition will have decreased vibration-sense in their legs. They may be unsteady while walking. In fact, spondylosis with myelopathy is a fairly common cause of unsteadiness in the elderly.

Others will have a specific level on the chest or abdomen where there is a noticeable change in sensation.

Problems with urination may occur. Some will have to urinate more often, while others will have to urinate urgently. A few will develop urinary incontinence.

The symptoms may get worse with turning, extending, or bending the neck. In others, coughing or straining may temporarily cause shooting pain in the arms or shoulders or it may worsen weakness in the legs.

Physical exam may reveal numbness or pain along a certain nerve distribution. Certain muscles may be weak and the reflexes not as brisk as normal. The affected individual may have difficulty with turning the neck or bending it from side to side. The arms or legs may be stiff. The hands may be weak and the muscles of the hands atrophied.

X-rays can be helpful in making the diagnosis. However, though X-ray findings of degenerative changes are often found in many older people, only a few will truly evidence the neurological changes caused by this condition. Alone, finding degenerative changes on X-rays is not conclusive but part of an overall determination of this condition that must take into consideration other factors. X-rays done with flexion and extension may show instability.

CT scan can be used to look at the spinal column and see if there is any narrowing or other abnormality.

MRI can also be used to look at the spinal column and see if there is any narrowing or other abnormality.

Nerve conduction studies and electromyography can be done to test the nerves and muscles.

The primary treatment for this condition is first to determine what type of arthritis is causing the problem. The second is making sure the neck is not unstable. Then, it is important to restrict neck movements. This is usually done with a cervical collar.

Medical treatment is usually with anti-inflammatory medicines, analgesics, and muscle relaxants. However, if this fails, then surgery may be necessary.

Physical therapy modalities such as Cold/Low level laser therapy, including stretching and strengthening exercises.

Patients may respond to steroid injections placed in the epidural space.

If that does not work, then surgery to decompress the nerve and stabilize the neck may be necessary.

Surgery is usually done if:

Conservative measures such as a cervical collar do not work.
There is severe pain.
There are significant neurological deficits, such as difficulty walking, severe hand weakness, or bladder problems.
There is compression of the spinal cord.

With any nerve condition, if it is not treated early, there is a danger that the loss of nerve function may be permanent. Nerves are very delicate. Once they are injured beyond a certain point, they do not recover. Therefore, the symptoms that can be caused by this condition could become permanent if not treated appropriately (i.e., numbness, weakness, and urinary problems).

There is no specific way to prevent this condition. However, good posture should be maintained.

Also, avoid repetitive injuries to the neck and cervical spine.

Neck Disc Injury, “Slipped Disc”, also known as Prolapsed, Bulging, Herniated or Extruded Disc

Disc Problems

What Causes Disc Problems?

Discs are the soft but strong cushions that separate the bones (vertebrae) in your spine and absorb shock as you move. Repeated strain over time, an injury, or sudden, forceful movements can damage discs and irritate nerves, causing pain, numbness, or tingling in your back and legs, neck,Shoulders and arms.

Common Slipped Disc, Neck Disc Injury

A Slipped Disc or (Disc Prolapsed) in the neck is a common cause of neck pain. Slipped disc treatment during the early stages involves limited mobilisation. Later, more active physical therapy rehabilitation is useful. During the later stages neck pain treatment can be enhanced if a pillow is used to support the neck.

Other Causes

Less common causes of neck pain include tumors, infections, or congenital abnormalities of the vertebrae.

Whiplash Associated Disorder (WAD) and Cervical Spine Injury

What is whiplash? 

An acute “whiplash” injury follows sudden or excessive hyper-extension, hyper-flexion, or rotation of the neck and causes neck pain and other symptoms. “Whiplash” injury is common in road traffic accidents, and may also be caused by sports injuries, falls or assaults. Most cases of “whiplash” injury occur as the result of rear-end vehicle collisions at speeds of less than 10 miles per hour. Patients present with neck pain and stiffness, occipital headache, thoracic back pain and/or lumber back pain, and upper-limb pain and paraesthesia.

There are two types of injury:

• Typical cervical hyper-extension injuries occur in passengers an drivers of a stationary or slow-moving vehicle that is struck from behind. Body is thrown forward but the head lags, resulting in hyper-extension of the neck. When the head and neck have reached maximum extension, the neck then snaps into flexion.
• A rapid deceleration injury throws the head forwards and flexes the neck. When the chin hits the chest it limits forward flexion but the forward movement may be sufficient to cause longitudinal distraction and neurological damage. Hyper-extension may occur in the subsequent recoil.

“Whiplash” injuries may occur at relatively low vehicle velocity impacts. One study showed the cervical muscle injury threshold to be about 10 km/hour. Whiplash-associated disorders (WAD) can be classified by the severity of signs and symptoms:

• Grade 1: no complaints or physical signs.
• Grade 2: indicates neck complaints but no physical signs.
• Grade 3: indicates neck complaints and musculoskeletal signs.
• Grade 4: neck complaints and neurological signs.
• Grade 5: neck complaints dislocation and fracture. Most cervical spine fractures occur predominantly at two levels:

1. One third of injuries occur at the level of C2, and one half of injuries occur at the level of C6 or C7.

2. Most fatal cervical spine injuries occur in upper cervical levels, either at cranio-cervical junction C1, or at C2

 Uncomplicated cases of Whiplash Associated Disorder (WAD)

“Whiplash”(WAD) cases that are uncomplicated are the result of sprained ligaments in the neck. The muscles of the neck spasm naturally, as a protective reaction. The “Whiplash”(WAD) injury may cause stiff neck and pain that may be present down one or both arms if the nerves of neck part of spinal cord get compressed. Pain Relief for “Whiplash”(WAD) can be found with Chiropractic  or Physiotherapy including pain medication and Cold/ low level laser therapy,

Patient’s with chronic whiplash benefited from Chiropractic  or Physiotherapy

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 discs rupturing and trapped nerves in the neck. This may also predispose to a “slipped”disc, also known as a prolapsed, bulging, ruptured or herniated disc in the back. (View our Cold/low level laser therapy Section, a five star rating has been given to cold/low level laser therapy for soft tissue neck injuries)

Cold/Low level Laser Therapy (LLLT). treatment research  for Neck Pain

Neck pain  is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser – is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders. (View our Cold/Low Level Laser Therapy section)

1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5;374(9705):1897-908.

Cold/Low Laser Therapy(LLLT) has been tested in over 200 clinical trials (RCTs) and published in the world’s top medical journals including a review by The Lancet, a clinical study in the journal PAIN and is acknowledged by the World Health Organisation Bone and Joint Task Force (published in the journal Spine).

(View our Cold/Low Level Laser Therapy section)

Whiplash Associated Disorder (WAD Research)

“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” (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.

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 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.

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 care or Physiotherapy. 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, this therapy is extremely affective in the treatment of inflammation. Cold/Low level laser therapy a five star rating for soft tissue neck injuries (“Whiplash”). Surgery is required in very few cases to relieve neck pain. For most patients, a combination of Chiropractic care, rest, medication, and Physiotherapy 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.

Cervical Disc Injury.

Causes and Risk Factors of Cervical disc injuries

Most cervical disc syndromes are caused by injuries that involve hyperextension, which results in compression of the anatomic structures.

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

Symptoms of Cervical disc injuries

Pain, loss of sensation or new sensations, and weakness are the main symptoms and signs of cervical disc injury. The most common symptom is pain and it is usually the only one. Rarely, cervical disc injury is complicated by compression of either a cervical nerve root or even more rarely by a compression of the spinal cord. When compression of the nervous tissue occurs, patients will report abnormal sensations other than pain and will report loosing strength in one arm (nerve root compression) or in both arms and legs (spinal cord compression).

1. Pain is the most common complaint and can be felt in the neck or arm.

a. Pain is usually limited to the neck and upper back between the shoulder blades. It occurs because of low-grade inflammation of the disc and the cervical vertebra joints. While the disease is chronic, inflammation can flare up after a minor added injury or for other reasons that are not yet well understood. Less commonly, neck and shoulder pain occur because the disc bulges acutely (herniates) and stretches the posterior longitudinal ligament. With conservative treatment, this pain usually goes away in a few weeks, but it is likely to happen again, especially if the affected individual does not change his/her lifestyle.

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 usual.

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 fibers 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.

Temporomandibular Jaw Disorders (TMD, TMJ Syndrome)

“TMD” temporomandibular (jaw) disorders, also called “TMJ syndrome.” If you felt pain sometimes in your jaw area, or maybe your dentist or Chiropractor has told you that you have TMD.

If you have questions about TMD, you are not alone. Researchers, too, are looking for answers to what causes TMD, what are the best treatments, and how can we prevent these disorders. The National Institute of Dental and Craniofacial Research has written this pamphlet to share with you what we have learned about TMD.

TMD is not just one disorder, but a group of conditions, often painful, that affect the jaw joint (temporomandibular joint, or TMJ) and the muscles that control chewing. Although we don’t know how many people actually have TMD, the disorders appear to affect about twice as many women as men.

The good news is that for most people, pain in the area of the jaw joint or a muscle is not a signal that a serious problem is developing. Generally, discomfort from TMD is occasional and temporary, often occurring in cycles. The pain eventually goes away with little or no treatment. Only a small percentage of people with TMD pain develop significant, long-term symptoms.

What is the Temporomandibular Joint?

The temporomandibular joint connects the lower jaw, called the mandible, to the temporal bone at the side of the head or neck. If you place your fingers just in front of your ears and open your mouth, you can feel the joint on each side of your head. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew and yawn. Muscles attached to and surrounding the jaw joint controls its position and movement.

When we open our mouths, the rounded ends of the lower jaw, called condyles, glide along the joint socket of the temporal bone. The condyles slide back to their original position when we close our mouths. To keep this motion smooth, a soft disc lies between the  condyle and the temporal bone. This disc absorbs shocks to the TMJ from chewing and other movements.

What Are Temporomandibular Disorders?

Researchers generally agree that temporomandibular disorders fall into three main categories:

• Myofascial pain, the most common form of TMD, which is discomfort or pain in the muscles that control jaw function and the neck and shoulder muscles;
• Neck Pain/Ache.
• Internal derangement of the joint, meaning a dislocated jaw or displaced disc, or injury to the condyle;
• Degenerative joint disease, such as osteoarthritis or rheumatoid arthritis in the jaw joint.

A person may have one or more of these conditions at the same time.

T M J Treatment

If you place your fingers in front of each ear and open your jaw, you’ll feel lots of clicking, or a grinding movement. This is the temporomandibular joint (TMJ), a place where your skull’s temporal bone attaches to your mandible (Jaw).

Because this joint comprises of a large number of ligaments, cartilage, fascia, discs, muscles, nerves and blood vessels that run around and through it, you can have all kinds of problems: trouble opening the mouth wide; a locked jaw; headache; clicking or popping sounds, tinnitus (ringing in the ears); throat fullness; shoulder, cheek or jaw pain; neck ache; facial nerve pain; ear or eye pain; dental pain; nausea; blurred vision and dizziness when the TMJ joint is misaligned.

An unhealthy skull/jaw alignment can put great stress upon the spinal column. By relieving pressure on the upper neck and bones of the skull, chiropractic treatment may relieve or correct TMJ problems. There are also documented cases of dental problems that, once corrected, help patients to hold their spinal adjustments for longer periods between chiropractic treatments.

All TMJ sufferers need chiropractic treatment; anyone who has been to the dentist should follow up with a check up from their chiropractor.

Trapped Nerve or “Pinched” Nerve.

Having a Trapped nerve hurts often feeling like  severe, sharp, excruciating and intense pain. Trapped nerves could happen nearly anywhere affecting nerves that go to the arms, fingers, wrists, neck, head, back, shoulders, legs, muscles and internal organs. “Pinched” or Trapped nerves can affect your health, posture, vitality, resistance to disease, even your emotional health. “Pinched”/trapped nerves can make life a misery.

Trapped ?

Do nerves really get trapped? Actually directly trapping the nerve  is quite rare. Much more common is what chiropractors call the vertebral subluxation complex or subluxations. Other terms for this are: nerve impingement, nerve irritation, nerve lesion, spinal stress and meningeal tension.

Even though there may be no actual trapping, people like the word because it’s so descriptive. It can really feel like something is being trapped in there. Some health professionals even use it. People at times seeing a chiropractor’s  saying their GP, osteopath, massage therapist referred them because they had a trapped nerve and should visit a chiropractor to get  the trapped nerve freed.

What Can Cause Subluxations?

Nearly any kind of stress can cause a subluxation: a fall or an accident, even a very small one that happened years ago; a poor sleeping position; poor posture; fatigue; emotional stress; poor nutrition or a combination of stresses. A subluxation need not happen all at once. It could  set in the body over time. 

 Trapped Nerves Don’t Normally Hurt

Chiropractors sometimes say that people with painful  Trapped nerves might be considered lucky-they know they have a problem and they (hopefully) will  go to a chiropractor.

 If  You  don’t Experience The pain From a  Trapped Nerve?  What Would Be The Outcome?

Some patients  may watch their body suffer and their health deteriorate for years without the faintest idea that the problem may be coming from their spine. These people desperately need to see a chiropractor but because they don’t have spine or nerve pain they may never receive the care they need. This is the big job facing chiropractors today – educating people about vertebral subluxations and the need for periodic spinal checkups.

Treatment Of Trapped Nerves

Trapped nerves do not get untrapped by themselves. No amount of painkillers or muscle relaxants can fix them. Only doctors of chiropractic are able to analyze your spinal column for trapped nerves or vertebral subluxations and use spinal adjustment techniques to gently realign the spine, release the internal stress and free the body from the trapped nerves.

Chiropractors are heakth care practitioners who are most experienced in freeing body of vertebral subluxations.

Nerves  Travel Through the Body?

Individual nerve fibers are tiny. Although they may be many inches long they are so thin you need a powerful microscope to see them. Nerve fibers are also found in large bundles called nerves. Billions of nerve fibers are bundled inside your spinal cord – an extension of your brain, which passes through the spinal column. Nerves branch off from spinal cord and exit spine through openings between the vertebrae to connect to every cell in the body.

Life without Nerves

Without nerves you couldn’t see, hear, touch, taste or smell or feel hot, cold, pleasure or pain,and no messages could come in and no messages could go out; without nerves no muscles could move.

Nerves Keep the Body Alive and Healthy

Nerve messages also help regulate the body’s activities such as breathing, heartbeat, digestion, excretion,  blood pressure and immune system so that the body can respond to germs, changes in temperature and all kinds of stress. In addition to nerve impulses, nutrients flow over your nerves to nourish the muscles and tissues. If this flow is blocked it may cause your muscles to waste away.

If the nerves are trapped, “impinged” or otherwise interfered with, the flow of messages and nutrients over them can be disrupted and the body can become “diseased” or weakened. When you are diseased you have less energy and vitality and are less able to deal with physical and emotional stress.

Lowered resistance to disease, infection, colds, flu, allergies, ulcers, constipation, diarrhea, asthma, fevers, headaches, seizures, bedwetting, hearing, balance or visual disturbances and many other health problems have been related to an unhealthy nervous system.

How Do Nerves Get Impinged or Trapped

The skeletal system, especially the spinal column, protects the spinal cord and other nerves. If  the spinal bones (vertebrae) are misaligned even slightly they may “pinch,” impinge, irritate, compress or stretch the nerves they are supposed to protect.

This in turn can affect other structures in the area including blood vessels, discs, ligaments, joints, muscles, fascia, tendons and meninges. As mentioned earlier, this is referred to as a subluxation.

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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 5 kg 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.

Causes

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.

Neck pain may result from abnormalities in the soft tissues, muscles, ligaments, and nerves as well as in bones and joints of the spine. The most common causes of neck pain are soft-tissue abnormalities due to injury or prolonged wear and tear. In rare instances, infection or tumors may cause neck pain. In some people, neck problems may be the source of pain in the upper back, shoulders, or arms.

The vertebral column.

Rheumatoid arthritis can destroy joints in the neck and cause severe stiffness and pain. Rheumatoid arthritis typically affects upper neck area.

Cervical Disc Degeneration (Spondylosis).

Cervical disc degeneration usually occurs in people aged 50 and older. Discs act as shock absorbers between the bones. In cases of 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 a car accident may result in hyper-extension, 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.

Common name Slipped Disc, also known as Prolapsed, Bulging, Herniated or Extruded Disc

Disc Problems

What Causes Disc Problems?

Discs are the soft but strong cushions that separate the bones (vertebrae) in your spine and absorb shock as you move. Repeated strain over time, an injury, or sudden, forceful movements can damage discs and irritate nerves, causing pain, numbness, or tingling in your back, legs, neck, and arms.

Common Slipped Disc, Neck Disc Injury

A Slipped Disc or (Disc Prolapsed) in the neck is a common cause of neck pain. Slipped disc treatment during the early stages involves limited mobilisation. Later, more active physical therapy rehabilitation is useful. During the later stages neck pain treatment can be enhanced if a Pillow is used to support the neck.

Other Causes

Less common causes of neck pain include tumors, infections, or congenital abnormalities of the vertebrae.

What is whiplash? 

Whiplash injury occurs when the body reacts to sudden deceleration or acceleration force causing hyper- flexion or hyper-extension of the neck.

Whiplash 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 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 benefited from chiropractic treatment

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 discs rupturing and trapped nerves in the neck. This may also predispose to a “slipped”, prolapsed, bulging, ruptured or herniated disc in the back. (View our Cold Laser Therapy Section.)

Whiplash Associated Disorder (WAD Research)

“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” (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.

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 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.

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, (View  our Cold Laser Therapy) 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 (LILT) Treatment  for Neck Pain

Neck pain is a pain in the neck. It is common, often persistent, and responds poorly to medication. So it is encouraging to read that a relatively novel, non-invasive treatment shows evidence of effectiveness. A systematic review and meta-analysis of 16 randomised controlled trials of low-level laser therapy (LLLT)’ yielded 820 patients, for whom data was pooled. LLLT was found to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain. Low-level laser – or cold laser – is yet to be established as a medical treatment but, according to Wikipedia, papers are appearing at the rate of around 25 per month, mainly investigating treatment of musculoskeletal disorders. (View our Cold Laser Therapy section)

1. Chow RT, Johnson Ml, Lopes-Martins RA, Bjordal JM. Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Lancet 2009 Dec 5;374(9705):1897-908.

Is a Trapped  Nerve or Pinched Nerve Making Life a Misery?

Having a ” Trapped’ nerve hurts, but to trapp a nerve?  That will feel like a severe, sharp, intense pain. “Trapped” nerves could happen nearly anywhere and affect nerves that go to your arms, fingers, wrists, neck, head, back, shoulders, legs, muscles and internal organs. “Pinched” or Trapped nerves can affect your health, posture, vitality, resistance to disease, even your emotional health. “Pinched”/Trapped nerves can make your life miserable.

Trapped ?

Do nerves really get Trappe”? Actual Trapping is quite rare. What is much more common is what chiropractors call the vertebral subluxation complex or subluxations. Other terms for this are nerve impingement, nerve irritation, nerve lesion, spinal stress and meningeal tension.

Even though there may be no actual Trapping, people like the word because it’s so descriptive. It can really feel like something is being Trapped in there. Some health professionals even use it. People at times seeing a chiropractor’s  saying their GP, osteopath, massage therapist or other healer referred them because they had a” Trapped” nerve and should see a chiropractor to get  the trapped.nerve freed

What Can Cause Subluxations?

Nearly any kind of stress can cause a subluxation: a fall or an accident, even a very mild one that happened years ago;
bad sleeping position; poor posture; fatigue; dental work; a difficult birth; emotional stress; poor nutrition or a combination of stresses. Subluxation need not happen all at once. It could “set” in your body over time–coming on so gradually that you won’t be aware you have one.

Most Trapped Nerves Don’t Hurt

Most people with Trapped nerves are not in pain since most nerves do not carry pain messages. Chiropractors sometimes say that people with painful” Trapped” nerves might be considered lucky-they know they have a problem and they (hopefully) will seek treatment.

But what of those not “lucky” enough to have painful Trapped nerves?

They may watch their body suffer and their health deteriorate for years without the faintest idea that the problem may be coming from their spine. These people desperately need to see a chiropractor but because they don’t have spine or nerve pain they may never receive the care they need. This is the big job facing chiropractors today; educating people about vertebral subluxations and the need for periodic spinal checkups.

Correct Your Trapped Nerves

“Trappeded” nerves do not go away by themselves. No amount of painkillers or muscle relaxants can fix them. Only doctors of chiropractic are able to analyze your spinal column for “Trapped” nerves or vertebral subluxations and use spinal adjustment techniques to gently realign your spine, release your internal stress and free you from your “Trapped” nerves.

Only a chiropractic spinal analysis and spinal adjustment can relieve your body of vertebral subluxations-nothing else will do.

How Do Nerves Get Impinged or Trapped

Your skeletal system, especially your spinal column, protects your spinal cord and other nerves. If your spinal bones (vertebrae) are misaligned even slightly they may “pinch,” impinge, irritate, compress or stretch the nerves they are supposed to protect.

This in turn can affect other structures in the area including blood vessels, discs, ligaments, joints, muscles, fascia, tendons and meninges. As mentioned earlier, this is referred to as a subluxation.

Musculoskeletal system

The head is positioned upon the superior portion of the vertebral column, attaching the skull upon C-1, (The Atlas). The skeletal section of the head and neck forms the superior segment of the axial skeleton and comprises skull, hyoid bone, auditory ossicles, and cervical spine. The skull can be further subdivided into:

• (a) Cranium (8 bones: frontal, 2-parietal, occipital, 2-temporal, sphenoid, ethmoid), and
• (b) Facial bones, (14 bones: 2-zygomatic, 2-maxillary, 2-palatine, 2-nasal, 2-lacrimal, vomer, 2-inferior conchae, mandible).

As the fetus develops, the facial bones usually form into pairs, and then fuse together. As the cranium fuses, sutures are formed that resemble stitching between bone plates.

In a newborn, the junction of the parietal bones with the frontal and occipital bones, form the anterior (front) and posterior (back) fontanelle, or soft spots. The separation of the cranial bone plates at time of birth facilitates passage of the head of the fetus through the mother’s birth canal, or pelvic girdle. The parietal bones and occipital bone can overlap each other in the birth canal, and form the unusual looking “cone head” appearance in a newborn when delivered in a natural, or vaginal, delivery.

The occipital bone articulates with the atlas near the foramen magnum. The atlas articulates with the occipital condyle superiorly and the axis inferiorly. The spinal cord passes through the foramen magnum providing continuity for the central nervous system (CNS). Articulation of the neck includes: flexion, extension, hyperextension (nodding yes), and rotation (shaking head no).

The Cervical Spine.

The cervical spine begins at the base of the skull. Seven vertebrae make up the cervical spine with eight pairs of cervical nerves. The individual cervical vertebrae are abbreviated C1, C2, C3, C4, C5, C6 and C7. The cervical nerves are also abbreviated; C1 through C8.

Cervical Vertebrae and Supporting Structures.

The cervical bones – the vertebrae – are smaller in size when compared to other spinal vertebrae. The purpose of the cervical spine is to contain and protect the spinal cord, support the skull, and enable diverse head movement (e.g., rotate side to side, bend forward and backward).

A complex system of ligaments, tendons, and muscles help to support and stabilize the cervical spine. Ligaments work to prevent excessive movement that could result in serious injury. Muscles also help to provide spinal balance and stability, and enable movement. Muscles contract and relax in response to nerve impulses originating in the brain. Some muscles work in pairs or as antagonists. This means when a muscle contracts, the opposing muscle relaxes. There are different types of muscle: forward flexors, lateral flexors, rotators, and extensors.

Spinal Cord and Cervical Nerve Roots

Nerve impulses travel to and from the brain through the spinal cord to a specific location by way of the peripheral nervous system (PNS). The PNS is the complex system of nerves that branch off from the spinal nerve roots. These nerves travel outside of the spinal canal or spinal cord into the organs, arms, legs, fingers – throughout the entire body.

Injury or mild trauma to the cervical spine can cause a serious or life-threatening medical emergency (e.g. spinal cord injury or SCI, fracture). Pain, numbness, weakness, and tingling are symptoms that may develop when one or more spinal nerves are injured, irritated, or stretched. The cervical nerves control many bodily functions and sensory activities.

C1: Head and neck
C2: Head and neck
C3: Diaphragm
C4: Upper body muscles (e.g. Deltoids, Biceps)
C5: Wrist extensors
C6: Wrist extensors
C7: Triceps
C8: Hands

Nervous system

The nervous system is composed of a central nervous system (CNS), brain and spinal cord, and the peripheral nervous system (PNS), cranial nerves and spinal nerves. The CNS is located within the dorsal cavity, and the PNS extends through the ventral cavity. The central nervous system provides control and coordination of all eleven body systems and utilizes the endocrine system to form hormone chemical messengers that transport through the blood to influence the activity of individual cells of the body and their associated tissues, organs and systems.

The CNS receives sensory (afferent) input from the PNS and directs the flow of information to association neurons (interneurons), located in the grey matter of the spinal cord and brain to create chemical synapse responses which in turn cause the formation of motor (efferent nerve) responses to stimulus.

The CNS is protected by the cranium, vertebral column, meninges, cerebrospinal fluid. The spinal cord, which is an extension of the brain, and brain stem are joined at the base of the cranium at the foramen magnum. Most of the functions of the head and neck are directly influenced by the brain and transmitted to the PNS via the cranial nerves and spinal nerves of the cervical portion of the spine.

The PNS has two subdivisions

• Somatic nervous system (SNS). The SNS is associated with the voluntary control of body movements through the action of skeletal muscle and also reception of external stimuli.
• The autonomic nervous system (ANS). The ANS is divided into subsystems: the sympathetic nervous system (SNS) and the parasympathetic (PNS) nervous systems. The SNS and PNS often have opposing effects in the same organs or physiological systems, and the ANS is a major factor in maintaining homeostasis.

The spinal nerves

The spinal nerves arise from the spinal column. The top section of the spine is the cervical section, which contains nerves that innervate muscles of the head, neck and thoracic cavity, as well as transmit sensory information to the CNS.

The cervical spine section contains seven vertabrae, C-1 through C-7, and eight nerve pairs, C-1 through C-8.

There is the formation of an extensive network of nerve groups or tracts attaching to the spinal cord in arrangements called rami or plexus.

The sensory branches of spinal nerves include: lesser occipital, C-2, great auricular, (C-2 and C-3); transverse cervical, C-2 and C-3; and supraclavicular, C-3 and C-4. These nerve groups transmit afferent (sensory) information from the scalp, neck, and shoulders to the brain.

The motor branches of spinal nerves include: ansa cervicalis, dividing into a superior root, C-1, and an inferior root, C-2 and C-3, and the phrenic nerve, C-3 to C-5, the segmental nerve branches, C-1 to C-5. These nerve groups transmit efferent nerve (motor) information from the brain to muscle groups of the scalp, neck, diaphragm (anatomy), and shoulders.

Additionally there are: (C5-C8, and T1) Brachial plexus, providing the entire nerve supply of the shoulder and upper limb; and includes supraclavicular branches (dorsal scapular, suprascapular, long thoracic) lateral cord (musculocutaneous, lateral antibrachial cutaneous, lateral head of median nerve), medial cord (ulnar, medial head of median nerve, medial antibrachial cutaneous, medial brachial cutaneous), posterior cord (auxiliary, radial), controlling the arm.

Note: Damage to the spinal cord above C-5 may result in respiratory arrest and death if not medically treated.

The neck musculoskeletal system including the cervical spine and spinal cord and cervical nerve Roots, injury to the spinal cord above C-5 may result in respiratory arrest and death if not medically treated.

Musculoskeletal system

The head is positioned upon the superior portion of the vertebral column, attaching the skull upon C-1, (The Atlas). The skeletal section of the head and neck forms the superior segment of the axial skeleton and comprises skull, hyoid bone, auditory ossicles, and cervical spine. The skull can be further subdivided into:

• (a) Cranium (8 bones: frontal, 2-parietal, occipital, 2-temporal, sphenoid, ethmoid), and
• (b) Facial bones, (14 bones: 2-zygomatic, 2-maxillary, 2-palatine, 2-nasal, 2-lacrimal, vomer, 2-inferior conchae, mandible).

As the fetus develops, the facial bones usually form into pairs, and then fuse together. As the cranium fuses, sutures are formed that resemble stitching between bone plates.

In a newborn, the junction of the parietal bones with the frontal and occipital bones, form the anterior (front) and posterior (back) fontanelle, or soft spots. The separation of the cranial bone plates at time of birth facilitates passage of the head of the fetus through the mother’s birth canal, or pelvic girdle. The parietal bones and occipital bone can overlap each other in the birth canal, and form the unusual looking “cone head” appearance in a newborn when delivered in a natural, or vaginal, delivery.

The occipital bone articulates with the atlas near the foramen magnum. The atlas articulates with the occipital condyle superiorly and the axis inferiorly. The spinal cord passes through the foramen magnum providing continuity for the central nervous system (CNS). Articulation of the neck includes: flexion, extension, hyperextension (nodding yes), and rotation (shaking head no).

The Cervical Spine.

The cervical spine begins at the base of the skull. Seven vertebrae make up the cervical spine with eight pairs of cervical nerves. The individual cervical vertebrae are abbreviated C1, C2, C3, C4, C5, C6 and C7. The cervical nerves are also abbreviated; C1 through C8.

Cervical Vertebrae and Supporting Structures.

The cervical bones – the vertebrae – are smaller in size when compared to other spinal vertebrae. The purpose of the cervical spine is to contain and protect the spinal cord, support the skull, and enable diverse head movement (e.g., rotate side to side, bend forward and backward).

A complex system of ligaments, tendons, and muscles help to support and stabilize the cervical spine. Ligaments work to prevent excessive movement that could result in serious injury. Muscles also help to provide spinal balance and stability, and enable movement. Muscles contract and relax in response to nerve impulses originating in the brain. Some muscles work in pairs or as antagonists. This means when a muscle contracts, the opposing muscle relaxes. There are different types of muscle: forward flexors, lateral flexors, rotators, and extensors.

Spinal Cord and Cervical Nerve Roots

Nerve impulses travel to and from the brain through the spinal cord to a specific location by way of the peripheral nervous system (PNS). The PNS is the complex system of nerves that branch off from the spinal nerve roots. These nerves travel outside of the spinal canal or spinal cord into the organs, arms, legs, fingers – throughout the entire body.

Injury or mild trauma to the cervical spine can cause a serious or life-threatening medical emergency (e.g. spinal cord injury or SCI, fracture). Pain, numbness, weakness, and tingling are symptoms that may develop when one or more spinal nerves are injured, irritated, or stretched. The cervical nerves control many bodily functions and sensory activities.

C1: Head and neck
C2: Head and neck
C3: Diaphragm
C4: Upper body muscles (e.g. Deltoids, Biceps)
C5: Wrist extensors
C6: Wrist extensors
C7: Triceps
C8: Hands

Nervous system

The nervous system is composed of a central nervous system (CNS), brain and spinal cord, and the peripheral nervous system (PNS), cranial nerves and spinal nerves. The CNS is located within the dorsal cavity, and the PNS extends through the ventral cavity. The central nervous system provides control and coordination of all eleven body systems and utilizes the endocrine system to form hormone chemical messengers that transport through the blood to influence the activity of individual cells of the body and their associated tissues, organs and systems.

The CNS receives sensory (afferent) input from the PNS and directs the flow of information to association neurons (interneurons), located in the grey matter of the spinal cord and brain to create chemical synapse responses which in turn cause the formation of motor (efferent nerve) responses to stimulus.

The CNS is protected by the cranium, vertebral column, meninges, cerebrospinal fluid. The spinal cord, which is an extension of the brain, and brain stem are joined at the base of the cranium at the foramen magnum. Most of the functions of the head and neck are directly influenced by the brain and transmitted to the PNS via the cranial nerves and spinal nerves of the cervical portion of the spine.

The PNS has two subdivisions

• Somatic nervous system (SNS). The SNS is associated with the voluntary control of body movements through the action of skeletal muscle and also reception of external stimuli.
• The autonomic nervous system (ANS). The ANS is divided into subsystems: the sympathetic nervous system (SNS) and the parasympathetic (PNS) nervous systems. The SNS and PNS often have opposing effects in the same organs or physiological systems, and the ANS is a major factor in maintaining homeostasis.

The spinal nerves

The spinal nerves arise from the spinal column. The top section of the spine is the cervical section, which contains nerves that innervate muscles of the head, neck and thoracic cavity, as well as transmit sensory information to the CNS.

The cervical spine section contains seven vertabrae, C-1 through C-7, and eight nerve pairs, C-1 through C-8.

There is the formation of an extensive network of nerve groups or tracts attaching to the spinal cord in arrangements called rami or plexus.

The sensory branches of spinal nerves include: lesser occipital, C-2, great auricular, (C-2 and C-3); transverse cervical, C-2 and C-3; and supraclavicular, C-3 and C-4. These nerve groups transmit afferent (sensory) information from the scalp, neck, and shoulders to the brain.

The motor branches of spinal nerves include: ansa cervicalis, dividing into a superior root, C-1, and an inferior root, C-2 and C-3, and the phrenic nerve, C-3 to C-5, the segmental nerve branches, C-1 to C-5. These nerve groups transmit efferent nerve (motor) information from the brain to muscle groups of the scalp, neck, diaphragm (anatomy), and shoulders.

Additionally there are: (C5-C8, and T1) Brachial plexus, providing the entire nerve supply of the shoulder and upper limb; and includes supraclavicular branches (dorsal scapular, suprascapular, long thoracic) lateral cord (musculocutaneous, lateral antibrachial cutaneous, lateral head of median nerve), medial cord (ulnar, medial head of median nerve, medial antibrachial cutaneous, medial brachial cutaneous), posterior cord (auxiliary, radial), controlling the arm.

Note: Damage to the spinal cord above C-5 may result in respiratory arrest and death if not medically treated.