At sometime most of us have experienced a “pain in the neck” either figuratively or for real. However like most pain, with time and good management, they disappear. It’s when pain and dysfunction persist for weeks, months or even years that we should be concerned and seek answers and solutions for the problem.
The larger subject of neck pain is big enough to write a heavy book, however the persistence of chronic pain narrows down the inclusion of many typical acute pathologies. The focus of this article is to examine a sub set of chronic neck pain that is very treatable and fixable.
The Role of Arthritic Change
There is a lot of bad press around the presence of wear and tear or arthritic changes within the spine. The reality is that most of us over the age of 40 will show signs of joint wear on x-ray and yet many seniors over 70 or 80 years of age that have little or no neck pain. Why is it then that so much weight is given to radiographic changes as the main cause of neck pain? Joint structure and health is only one potential source of pain which can cause chronic ongoing symptoms.
The Nervous System
One system that underpins so many chronic pain conditions is the neural system. This includes the Brain, Spinal cord, Nerve roots and nerve trunks. Like all other tissues, the neural structures are vulnerable to trauma. Direct damage to the nerve results in obvious neural symptoms such as numbness, tingling, altered sensation, loss of power or deep, diffuse radiating pain. Less obvious and associated with chronic pain are the symptoms of muscle tightness, restricted mobility and erratic pain behaviour, including headaches. If symptoms persist beyond an acute phase without the presence of obvious neural symptoms, the other critical factor is if the movement of the neural system is compromised.
Neural dynamics and its role with Chronic neck pain
The spinal cord and nerve trunks are like wires that transmit information to and from the brain. As we move, these wires are required to slide and glide between muscles, bones and other tissue. If normal movement of the nerves is compromised then the result may be pain or persistent tightness of muscles. Nerve branches are relatively stretch intolerant and if they are bound down through injury or trauma, chronic pain patterns can result.
How can this be detected or tested?
Testing neural dynamics is a relatively simple orthopaedic test that when performed by an experience practitioner, can be detected easily. This is an easily reproducible test that when performed with sensitivity, causes local muscle spasm. With improvement, the length and movement of the test increase and reduces spasm.
How is it treated?
Research has demonstrated that nerve root restriction can be very effectively released through specific, simple mobilisation of the spine. This technique is very gentle, non aggressive and can demonstrate rapid change. Other soft tissue manipulation may also be required to clear a nerve trunk further along its path to restore normal neural biomechanics.
In summary, chronic pain does not have to mean forever. Effective management for the chronic neck or upper back pain sufferer may be a relatively simple solution.