Also available are 32 3D animated educational videos for various pains injuries and conditions such Back Neck and Pain Decompression (they can be found under the listing ”Types of Pain” in our “Neck Pain and Back Pain” Sections).    

For the management of pain and Neck Pain at Central Chiropractic and Physiotherapy Clinic, we use the latest Low Level Lasers which accelerate the recovery and healing process, leading to a significant reduction in pain inflammation. A 5 star rating has been awarded to Low Level Laser Therapy, our laser section can be found listed under ”Pain Relief”, please also view our  ”Low level Laser Testimonial Video”.   

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

The neck or cervical spine and cervical spondylosis 

The neck or cervical spine consists of seven vertebrae that begin at the base of the skull and end in the upper torso. The structures of the neck are the bones and the ligaments provide stability to the spine. The muscles also provide support and protection to the structures of the neck as well as allowing for the motion. The neck supports the head allowing a significantly wider range of movement comparing to the other regions of the spine. However, the neck has less protection than the rest of the spine, the neck can be vulnerable to disorders and injury that result in pain, stiffness and restrict motion.  

The cervical spine starts 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.

What is cervical spondylosis?

Cervical spondylosis is a cause of neck pain. It tends to develop after the age of 30, and becomes more common with increasing age. The underlying cause is the age-related degeneration or wear and tear of the vertebrae and discs in the neck.

Everybody develops a degree of degeneration in the vertebrae and discs as we become older. However, cervical spondylosis is a term used if the degree of degeneration is more severe, and causes more symptoms whatever one’s age.

As the ‘discs’ degenerate, they become thinner.  The vertebrae develop  rough bony edges.  The nearby muscles, ligaments, and nerves become irritated by these degenerative changes which can cause symptoms of pain.

What are the symptoms of cervical spondylosis

Symptoms may vary from mild to severe, having a flare up of symptoms by over-use of the neck, or by spraining a neck muscle or ligament.

Symptoms include:

The neck pain may spread to the base of the skull and into the shoulders. Any movement of the neck can make the pain worse. The pain sometimes spreads down an arm, hand or even fingers. This is caused by irritation of a nerve which goes to the arm from the spinal cord in the neck. The pain is prone to flare ups from time to time; some people may also develop chronic and persistent pain.

Some neck stiffness, particularly after a night’s rest.

Headaches may occur from time to time. The headaches often start at the back of the head just above the neck and travel over the top to the forehead.

Numbness, pins and needles or weakness may occur in part of the arm or hand. Tell a doctor if these symptoms occur as they may indicate a problem with a ‘trapped nerve’.

Neck Pain

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).

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, new sensations and weakness are the main signs and symptoms 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 compression of the spinal cord. When compression of the nervous tissue occurs, patients will report abnormal sensations other than pain and will report losing 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 vertebral 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 feel like 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.

Shoulder Pain and Injuries, 

Frozen Shoulder, Rotator Cuff Tendonitis, Bursitis, Rotator Cuff Tear, Shoulder Joint Tear (Glenoid Labrum Tear) Tendonitis, Tennis elbow, Biceps Tendon Tear, Triceps, Trigger finger, Shoulder Dislocation, Shoulder Instability, Collarbone, Scapula Fracture, are listed below. 

Who gets Frozen Shoulder?

Frozen Shoulder or Adhesive capsulitis is a painful condition mostly affecting people aged 30-70. It is estimated that 3% of population will develop the condition in their lifetime. There is no known racial preference; however, adhesive capsulitis is associated with certain conditions, particularly insulin-dependent diabetes.

Predisposing Factors

There are multiple risk factors predisposing an individual to developing adhesive capsulitis. These predisposing factors may include, shoulder or neck surgery, diabetes, shoulder trauma, inflammatory conditions. Other systemic conditions such as cervical cancer, autoimmune diseases and hypotyriodosm (underactive thyroid) may also to be linked to the condition.

How Frozen Shoulder is Diagnosed

Diagnosis of adhesive capsulitis is made basing on symptoms and on physical examination of the shoulder. The use of X-rays may show abnormalities such as narrowing of the joint and reduced bone density; however in early phases of adhesive capsulitis shoulder joint appearance in X-ray is normal.

Treatment of Frozen shoulder including other shoulder injuries and conditions.

Rotator Cuff Tendonitis or Bursitis Therapy and Treatment

The tendons of the Rotator Cuff rotate the upper shoulder bone (humerus) and help raise the arm by pulling the Humeral head down as the Deltoid muscle pulls the arm up. These tendons may be irritated by pressure from the Acromion process of the Scapula (the upper part of the shoulder blade) and the Coraco-Acromial Ligament. This irritation of the tendons or the lubricating Bursa (connective tissue sack) is referred to as “Tendinitis” or “Bursitis”. This is known collectively as the “Impingement syndrome.

The symptoms of Impingement syndrome present not only as pain on movement, but also as constant pain. This can be accompanied by snapping or cracking sensations on movement. Symptoms may start after an injury which may result in a weakening of the shoulder muscles caused by the pain from the injury.

A clinical diagnosis of Impingement Syndrome is made by physical examination, and X-rays. Sometimes an M.R.I. scan is necessary to exclude rotator cuff tears.

Tendonitis

Tendon problems what are they?

Two main problems associated with tendons include Tendonitis and Tenosynovitis. Tendonitis is an inflammation of the tendons-the tough cords of tissue that connect muscles to bones. This inflammation can affect any tendon, but is most commonly seen in the wrist and fingers. As the tendons become irritated, pain and swelling will occur.

Tenosynovitis is the inflammation of the lining of the tendon sheaths which enclose the tendons. Sometimes both the sheath and the tendon may become inflamed. The cause of Tenosynovitis is usually strain, excessive use, or injury. Tendonitis may also be related to diseases such as Rheumatoid Arthritis or Diabetes can be implicated in this condition.

Common tendon disorders include:

Lateral Epicondylitis. ( Also Known as tennis elbow)
This condition is characterised by pain in the back of the elbow and forearm, and along the thumb side of the forearm when the arm is alongside the body when the thumb is turned out. The cause of pain is the damage to the tendons that bend the wrist backwards away from the palm (wrist extensors).

Medical Epicondylitis  ( Also Known as Golfer’s Elbow).
This is a condition characterised by pain from the elbow to the wrist on the palm side of the forearm the pain is caused by damage to the tendons that bend the wrist toward the palm (wrist flexors).

DeQuervain’s Tenosynovitis.
This is far the most common type of Tenosynovitis disorder, when the sheath of the tendons of the thumb gets swollen.

Trigger Finger.
A Tenosynovitis condition in which the tendon sheath of one of the finger flexors becomes inflamed and thickens, preventing the smooth extension or flexion of the finger. The finger may lock or suddenly hence the name “Trigger Finger”.

What are the Symptoms of Tendonitis?

The most common symptoms of Tendonitis are:

• Pain in the tendon with movement
• Fluid accumulation, swelling and inflammation
• There may be grating sensation in absence of swelling

Tendonitis Diagnose

Tendonitis is usually diagnosed after careful medical history and physical examination. The diagnosis is established after diagnostic tests have been completed to rule out other conditions or diseases. Joint aspirations may help to rule out gout or an infection, while X-rays may help to rule out arthritis.

Treatment for Tendonitis:

• Modification of your activity
• Splinting or immobilization
• Steroid injections
• Anti-inflammatory medications
• Surgery

Shoulder Joint Tear (Glenoid Labrum Tear) injury Treatment. 

Three bones make up the shoulder joint, the shoulder blade (scapula), the collarbone (clavicle), and the upper arm bone (humerus). The head of the upper arm bone (humeral head) rests in a socket in the shoulder blade called the glenoid. The upper arm bone called the head is larger than the socket; a soft fibrous rim of tissue rim called the labrum surrounds the socket to help stabilize the joint. This rim deepens the socket, so that the head of the upper arm bone fits better. They also serve as an attachment site for several ligaments. Injuries to the tissue rim surrounding the shoulder socket can occur from acute trauma or repetitive shoulder motion.

Examples of traumatic injury include:

• Falling on an outstretched arm
• A blow to the shoulder
• A sudden jerk, as in trying to lift to heavy an object
• A violent overhead stretch or reach, as in when trying to stop a fall

Symptoms of a Shoulder Tear

• Pain, in overhead activities
• Pulling locking, cracking or grinding
• Occasional pain with daily activities
• Perhaps a sense of instability in the shoulder
• Decreased range in movement
• Lack of strength

Orthopaedic consultant is available at Central Chiropractic Clinic.

Biceps Tendon Tear at the Shoulder

The tendons attach muscle to bone. The biceps muscle in the upper arm divides into long head and a short heads near the shoulder both attach to the shoulder at different points. At the other end of the muscle the distal biceps tendon connects to the smaller bone in the lower arm called the radius. These connections help the muscle stabilize the shoulder and rotate the lower arm; it also controls the acceleration or deceleration of the arm during overhead motion.

 The long head of the biceps tendon is vulnerable to injury because it travels through the shoulder joint to its point of attachment. The tears of the long head of biceps result in arm weakness; this could also affect arm further by being unable to turn the arm from palm down to palm up. Because the torn tendon can no longer keep the muscle taut, a bulge may also appear it eh upper arm. In case of the distal tendon tears the arm is unable to bed at the elbow.

Causes

Ruptures of the distal tendon near the elbow are not common. They usually occur when an unexpected or extreme force is applied to a bent arm.

The proximal biceps tendons ear the shoulder tear more readily. The tears can be partial or complete, more prevalent in people aged 35 or over and in people with previous shoulder injuries.

Symptoms

• Perhaps an audible snap.
• A bulge in the upper arm
• Bruising to the upper arm, down towards the elbow
• Sudden, sharp pain in the upper arm.
• Pain or tenderness at the shoulder

Diagnosis

A Chiropractor will examine the neck, shoulder and arm and ask you to bend the arm and tighten the biceps muscle. This is done to determine the extent of the injury.

Treatment

• Non-surgical treatment is usually all that is needed for tears in the proximal biceps tendon
• ice applications 20 minutes every hour keep down the swelling
• Anti-inflammatory medications, such as ibuprofen will reduce the pain
• Rest the muscle completely
• Flexibility and strengthening exercises will keep the shoulder mobile
• Surgical repair of a complete tendon tear
• Complete tears of the distal biceps tendon require surgery to reattach the tendon to the bone
• Partial tears of the distal biceps tendon may be treated either non surgically or surgically

Triceps Anatomy

The Triceps Brachii consists of three heads: the lateral, medial, and long heads. Triceps joins the Humerus (shoulder bone) and the Scapula (shoulder blade) to the ulna which is the forearm bone. If you working out in gym you must assure you implement Triceps exercises that target all three of the Triceps heads, as this will fully develop the heads of triceps muscle.

In Training the triceps muscles, you must keep a constant tension throughout triceps isolation movements over the full range of motion. It is also imperative to flex the entire triceps muscle by simply extending the arms fully to get the most muscle fibre recruitment.

Triceps Injuries Treatment

Chiropractic treatment including Cold or Low Level Laser Therapy (used by professional weight lifters and body builders and football clubs such as Chelsea FC.)

For further information on shoulder pain, triceps, Biceps, and other shoulder conditions, go to top left under “Pain” or “Conditions” and “Treatments” for Cold Laser Therapy,  

Shoulder Dislocation

West Midlands shoulder dislocations occur when the head of the humerus which is the upper arm bone, jumps out of the shoulder socket of the scapula, which is called the glenoid. This can happen during severe wrench pulling the shoulder upward or outward, or from combined over-extension and external rotation of the humerus.

Glenohumeral dislocations are generally classified by the direction of dislocation of the humerus.

A dislocation can be full or partial:

• A partial dislocation which also known as subluxation, when the head of the humerus slips out of the socket momentarily and then snaps back into place (socket)
• A full dislocation, when the head of the humerus comes completely out of the socket

Shoulder dislocations are normally associated with fractures to different parts of the shoulder; there may be a fracture and dislocation at the same time. Nerves and blood vessels can sometimes be injured with a severe shoulder dislocation.

Causes

• Falling on an outstretched arm
• A direct or powerful blow to the shoulder area.
• Repetitive sports or activities i.e. throwing or lifting
• Any kind of force applied to an outstretched arm

Symptoms

•   Swelling
•   Bruising
•   Pain, often severe
•   Shoulder contour appears abnormal
•   Bruising Instability and weakness in the shoulder area
•   Inability to move the shoulder
•   Bruising Instability and weakness in the shoulder area
•   Numbness and tingling around the shoulder or in the arm or fingers
•    Seek immediate medical attention.

Shoulder instability

Shoulder instability is a condition in which one of the bones in the shoulder joint moves partially or fully out of place. The head of the humerus, the upper arm bone, moves within the socket of the shoulder in more than one direction. Instability happens when the head of the humerus slips outside its normal position. The classification of this disorder is defined by the changes in degree of movement in the joint and by the change of direction in the movement of the joint.

Dislocation
when the humeral head moves completely out of the socket

Subluxation.

Humeral head moves partially out of the shoulder socket.

• Anterior
  when the humeral head moves forwards. This is a very common injury in young men. Men having great shoulder flexibility are more prone to this injury.
• Posterior
  when the humeral head moves backwards. This is due to severe muscle spasm during an electric shock or epileptic seizure.
• Multidirectional
  this occurs in people born with loose joints. Muscles contracting and relaxing may trigger a multidirectional instability episode. Also certain sports that require greater shoulder range of motion such as swimming may also lead to multidirectional instability.

Shoulder instability usually results from an old injury producing a dislocation that, even when healed, leads to stretching of the shoulder capsule and ligaments.  

 Diagnosis

 Symptoms of shoulder instability may include:

• Numb feeling down the arm
• Shoulder can slip out of place
• Pain in and around the shoulder area
• Shoulder or arm may feel weak
• Shoulder feels loose. (Slack)
• X-Ray may be needed
• Treatment Options
• Rest
• Ice will help control pain
• Nonsteroidal anti-inflammatory drugs these include: aspirin, ibuprofen (Motrin, Advil)

Low Level Laser Therapy has a 5 Star Rating for most Shoulder Pain and Injuries

 Rehabilitation

Can last several months and may include: physical therapy to strengthen the muscles that control the shoulder joint.

For further in depth information on shoulder pain or conditions please go to top left corner under “Pain” or “Conditions” and “treatments” for Cold laser Therapy.

Collarbone fracture

The collarbone is a part of the shoulder. Its function is to connect the arm to the body. The collarbone sits directly above several important nerves and blood vessels. These vital soft tissues are rarely injured when the collarbone breaks. The collarbone is a long bone, and most breaks occur in the middle of the bone.

Causes 

A broken collarbone, or the medical term a fractured clavicle is a common injury. Many babies are born with a broken collarbone this is due to child birth, also to people in contacted sports such as rugby or just  general accidents where a fall results in a  severe blow or  a heavy fall to the shoulder .  

The collarbone doesn’t harden until a person is about 21 years old; a child’s collarbone can easily be broken from a direct blow or fall.

Symptoms include.

• A hump or “bump” over the fracture area
• Shoulder hanging down and forward
• Unable to lift the arm due to the pain
• A grinding sensation attempting to raise the arm

Diagnosis

There is always an obvious deformity, or “bump,” around the fractured area. A small amount of pressure over the fracture area will bring about pain. Also, a grinding feeling can be felt when the patient attempts to raise the arm. It’s rare for a fragment of bone to break through the skin, An X-ray is often done to pinpoint the location and severity of the break. Then an assessment should be carried out by a medical trained practitioner.

Nonsurgical Treatment

• Most broken collarbones heal well without surgery.
• A simple arm sling will be used to immobilize the arm. A child may have to wear the sling for 4 to 6 weeks; an adult may have to wear it for 4 to 8 weeks. Depending on the location of the break
• Medications, such as aspirin or ibuprofen, will help reduce pain. But for a speedy recovery see our cold laser therapy section this is under inflammatory conditions on the home page   

Scapula Fracture

The scapula is of triangular shape and mobile. It’s also protected by a complex system of surrounding muscles. The shoulder blade or scapula fractures are very rare. Scapular fractures are usually classified at the high end of the impact scale. Falling from a significant height or a major car accident are usually the types of impact that required the scapula to fracture and is usually associated with other major injuries including broken ribs, damage to the head, lugs or spinal cord. Without treatment fractured scapula may result in chronic shoulder pain.

 Symptoms

• Abrasions to the skin.
• Swelling at the back of the shoulder.
• Sever pain when moving the arm.

Diagnosis

For appropriate treatment, your Chiropractor will probably need to take X-rays of the chest and shoulder. This can determine if one or more parts of the scapula may be fractured. The parts of the scapula that are prone to fracture are:

• Scapular body
• Scapular neck
• Glenoid
• Acromion
• Coracoid

Treatment

Non-surgical treatment such as sling works for most fractures of the scapula. The immobilization due to the sling holds the shoulder in place while the bone heals. This type of fractures may need 2 to 6 weeks of immobilization.

The shoulder may feel stiff when the sling is removed. You should begin limited active use of your shoulder immediately

Neck Pain

Stiff or sore neck may result from chronic muscle fatigue or strain. Neck pain can result from the strain of trapezius and the sternocleidomastoid (SCM) muscles. Activities such as leaning over a desk or machinery would stress the trapezius muscle which runs from the base of the scull to the outside of the shoulder blade and back. Sternocleidomastoid muscle originates from the base of the scull below the ear and runs down the neck to the collar bone (close to its insertion to the breastbone). This muscle can be strained by carrying a heavy briefcase or load or holding the telephone receiver between the shoulder and the ear.

Neck pain is a very common condition affecting more or less everyone at some point in their lives. The neck itself is quite a delicate structure consisting of seven small vertebrae, ligaments and muscles that allow support and movement of the head which weights up to 12 lbs. Each movement, even a slight nod, would involve muscle contractions. The biomechanics of the neck make it susceptible to any type of stress or injury more than any other part of the spine.

Cold or Low Level Laser Therapy

The lasers used at Central Chiropractic Clinic are certified as Cold Laser.  For the past 30 years the technology of Cold Laser Therapy (also known as Low Level Laser Therapy) has been formally accepted in North America and in many other parts of the world such as Europe, Russia and Japan.  In all this time there have been no recorded long-term adverse effects from low level laser therapy.  It is considered to be non-invasive, painless and safe.

Cold Laser Therapy uses laser light energy to stimulate cells to function optimally.  In the body, light sensitive chromophores and other elements within the cell absorb energy, initiating a series of important photochemical changes such as increased production of ATP. The mitochondria and Kreb’s Cycle stimulation initiates the production of ATP, providing the cell with the extra energy needed to accelerate the healing process and positively influence pain.  These activities can occur in all types of cells and includes ligament, nerves, cartilage and muscle.

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

Whiplash- Associated Disorder (WAD)

Chronic Neck Pain Conditions and Injuries