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Common musculoskeletal complaints

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WHAT CAN CAUSE NECK PAIN?

Your neck is the vital passageway through which the spinal cord passes to connect the brain to the arms and legs and key bodily organs and tissues. The brain, spinal cord, and spinal nerves control and coordinate almost all body functions.

The seven cervical vertebrae (spinal bones) in the neck have highly mobile joints so that you can easily move your head in multiple directions and a large range of motion. Since the neck is exceptionally flexible, it lends itself easily to injury and pain.

Depending upon its severity, an insult to the head or neck may injure the supporting muscles, tendons and ligaments of the neck and perhaps interfere with essential circulation to the head and brain. A neck injury may even disrupt the functioning of the spinal cord and the spinal nerves distributed by the cervical vertebrae. This can result in serious interference with the life-support communications network of the body.

Some neck pain may be job related (micro-damage). Individuals who sit in the same position and face the same direction for long periods, such as administrative workers and computer operators, may experience neck stiffness and/or muscular spasms. Other industry type jobs, such as those involving repetitive motions may also lead to neck pain. Workers who operate a drill press, power equipment or continuos assembly line operations may feel fatigue and soreness in the supporting head-and-neck muscles. These and similar situations can bring on muscle tension and irritation of the nerves and blood vessels in the neck.

Strains to the cervical vertebrae are another common cause of neck pain. Strains can be brought on by a forceful movement of the neck, strenuous lifting, swinging or pulling motions of the arms, or a fall. One of the most frequent of neck ailments – whiplash – can produce mild or severe reaction, even resulting in debilitating, permanent damage.

Osteoarthritis, a degenerative disease of the bones and joints can also be a source of neck pain. Sometimes called “wear and tear” disease or “old-age”, it can be the result of a lifetime of physical traumas (shocks) or even poor posture. Slumping, rounded shoulders, and even a straight military posture can be harmful. Osteoarthritis occurs when the discs become thin – pulling the bones closer together and producing grinding sounds. This leads to pain and nerve disturbances, and may eventually cause the vertebrae to fuse together.

Still other causes of neck pain may include osteoporosis, swelling of tissue, irritation of joints, damage to the nerves or spinal cord, fracture of a vertebra, tumors and cancerous conditions, and less obvious sources such as referred pain from a heart attack.

Symptoms of neck pain may include headaches, numbness, tingling in the arms and legs, and localized swelling and inflammation.

BACK PAIN

backspine Magnetic resonance imaging shows how disc bulging can put pressure on adjacent nerve tissue.

LOWER BACK

Poor posture, high-stress, a sedentary life-style, excessive physical exercise, and habitually sitting in one position or doing repetitive movements can make you a prime candidate for low back problems. The result is pinched nerves, causing pain and, if not relieved, even causing serious disability.

The lower back, or lumbar spine, bears most of the body’s weight-making it especially vulnerable to pains and problems. Between the vertebrae are circular discs of jelly like material encased in tough cartilage. Discs facilitate movement of the spine, serving as shock absorbers and reducing friction.

The underlying cause of back pain is an imbalance of the bony framework of the body, especially the spinal column.

The structure and balance of the spine may be disturbed by the common incidents of everyday life such as a fall or misstep, getting into or out of the car the wrong way, lifting the wrong way, and by an auto accident or other major and minor accidents.

Weak, flabby, under-exercised muscles contribute significantly to low back problems, as well as, over-exerted or overused muscles. Muscles subjected to the same stresses and strains day after day inevitably lead to back trouble. Fatigue makes the back more susceptible to injury, and emotional tension takes its toll by keeping muscles tense, shortened and tightened.

In some cases, low back pain may result from disease or infection, though less likely than the other causes.

Low back pain may indicate a problem within the structural elements of the back itself, or it may indicate a problem elsewhere in the body, since the spine is the body’s main line of service and communication. Problems related to the structure of the lower back include:

  • Misaligned Vertebrae: If vertebrae are misaligned or slipped into abnormal position, the result may be disc and/or nerve problems.
  • Pinched Nerves: Hundreds of thousands of nerve fibers pass through each small opening of the spine from the brain to the rest of the body. When a dislocation of a vertebra occurs, the small openings of the spine are partially closed, interfering with the normal nerve impulse pattern. The result is pinched nerves, causing pain and, if not relieved, even causing serious disability. Pinched nerves are deceiving, since they may masquerade as a number of illnesses: in this case, an organ supplied by the nerve is being affected and signaling its distress.
  • Slipped Discs: Any of the spinal discs may be injured or degenerate. But because of their location, discs in the lower spine are subjected to the greatest weight-bearing stress and are most likely to slip or be compressed. The disc’s outer covering weakens and bulges, putting pressure on spinal nerves.
  • Ruptured Discs: Occasionally a disc ruptures. In a rupture, the tough outer portion of the disc is torn or split and the soft inner portion then protrudes, often pressing against spinal nerves.
  • Sciatica: Sciatica is a painful inflammation of the sciatic nerve which supplies the tissues of the thigh, lower leg and foot. Slipped discs and pinched nerves may cause sciatica. The roots of the sciatic nerve are in the lower spinal column. Most often, sciatica begins with a long period of intermittent low back pain, only erupting into violent pain following a sudden jarring or simply a wrong move.
  • Disease and infection: Low back pain sometimes, though not often, indicates disease elsewhere in the body. Since the nerve system carries impulses from the brain along the route of the spinal column and out to the other parts of the body, it also transmits impulses from the various parts back to the brain. Infections, such as those of the genital or urinary tract, may produce low back pain. But diseases of the spine, such as arthritis and tuberculosis account for less than 5 percent of back pain.

HEADACHES

Headaches are one of the most common reasons for visiting the doctor. More than 250 million work days are lost each year due to headache at a cost of 25 billion dollars per year. There are many types and causes of headaches Muscle tension headaches and migraine headaches are by far the most common types of headaches, but sinus infections and other problems such as high blood pressure can also lead to headaches. Regardless of the cause, no one likes to endure a headache.

This has produced a huge market for medications that cover up the symptoms of headaches. Powerful drugs can numb your nervous system so the pain doesn’t register. While these approaches may be convenient, they can cause adverse effects and kidney or liver damage. Worse, they don’t correct the underlying cause of he headache.

Headaches are rarely a sign of immediately serious or life threatening health problems. Some headaches are so painful, however, that it may seem that something is very wrong inside the head. A person may present to the medical doctor seeking an explanation of the cause of the headache. Many medical doctors order expensive tests such as MRI or CT scans of the brain to try to visualize the cause of the headache. It has been reported that only one in 11,200 patients with headache have a problem that shows-up on these types of tests. It is surprising, then, to note that between one-quarter to one-third of headache sufferers have had a CT or MRI scan. Most often the doctor and/or patient are searching for answers in the wrong direction.

Headache is a very common condition in patients with chiropractic problems. A cause of headaches can be from spinal bones in the neck that aren’t supporting your head properly. This can affect nerves, muscles and even the blood supply to your head. Research has shown that the most common types of headaches respond well to chiropractic care. The vast majority of even the most severe headaches are relieved when spinal subluxations (spinal joints that are out of alignment, don’t move well and also irritate the nerves) and jaw problems are corrected. The effects that these types of problems have on the nerves often results in pain in the head.
Chiropractic care and periodic checkups are useful ways of eliminating the most common cause of headaches – subluxation.

ARM AND SHOULDER PAIN

Pain and other symptoms in the arm and shoulder may be due to injury of the neck or cervical spine. The seven cervical vertebrae (spinal bones) in the neck have highly mobile joints so that you can bend and tilt your neck. Since the neck is exceptionally flexible, it is susceptible to injury and pain which can be referred to the shoulder and the arm. However, pain in the arm and shoulder may be due to other conditions not related to the cervical spine such as frozen shoulder and strain/sprain syndromes.

The vertebrae are separated by discs, which are stiff jelly like pads that act as elastic cushions between the spinal bones. Neck, shoulder and arm pain may be caused by an abnormal bulging or protrusion of a disc in the cervical spine, The disc may impinge on the spinal nerve roots or irritate the spinal cord itself. This is also known as a herniated or slipped disc.
Cervical disc lesions that can cause arm and shoulder pain can be acute or chronic. For example, sudden and severe pain (acute torticollis) can result from lying too still for too long, on a pillow too thick or too thin, or in a position that keeps the neck in a sideways position for a long period.

Another way of developing acute torticollis is a whiplash injury or by simply stretching. Severe neck stiffness can result, sometimes with discomfort in both arms, and pins and needles in the fingers.

Pain in the shoulder blade may also be due to cervical disc trouble. It is also a common site for referred pain secondary to gall stones or a transverse humeral ligament tear or rupture. This shoulder blade pain may radiate from the shoulder blade up to the base of the skull. Pressure on the nerve that innervates the arm area from cervical disc injury can also cause pain in the shoulder, arm and chest.

Still other causes of shoulder and arm pain may include referred pain, such as from a heart attack, as well as regional disorders of the shoulder, elbow, wrist and hand. These conditions may include osteoporosis, tumors or cancerous growths, bursitis, neuritis and damage to the nerves and spinal cord.

CARPAL TUNNEL SYNDROME

Carpus is the medical term referring to the wrist. The carpal tunnel is the passage for the major nerve in the wrist (the median nerve) and the tendons in the wrist formed by the ligament of the wrist and the carpal bones. The median nerve passes through the carpal tunnel to innervate the hand and fingers.

In carpal tunnel syndrome, the median nerve is compressed as it passes through the canal made by the wrist bones and the ligament of the wrist. The nerve may be compressed or trapped in its path due to joint changes in rheumatoid arthritis or other systemic diseases. In most cases, however, inflammation of the tendons and tissues of the wrist which causes the syndrome is not associated with systemic illness.

The majority of patients affected by this syndrome are middle-aged women. The usual symptoms are pricking numbness and pain which is most prominent in the first three fingers, the thumb, and the palm. This pain comes on especially during the night and is relieved by shaking the hand. Aching may accompany the numbness and extend up the arm. In late cases, there may be wasting of the hand and finger muscles innervated by the median nerve.

Why is posture so important?

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Good posture depends upon several factors. While exercise, attitude, and practice can positively affect posture, some postural problems need more aggressive attention due to complications which can jeopardize good health and well-being.

The foundation for normal spinal posture is laid out early in life. Improper development of the spine’s normal curvature will set the stage for eventual distortions. If the base of a child’s spine is tilted incorrectly, it can wreak havoc with the structure that builds upon it.

Normally the human body attempts to maintain erect posture by balancing “back and forth” over the lower spine. If the lower vertebrae are wedged to one side it can cause the spine to compensate by bending into an abnormal curve. This condition is commonly referred to as scoliosis. The medical approach to scoliosis has been to administer braces and electrical stimuli; neither of which have proven very successful. Upon termination of such practices the abnormal curve usually returns to its initial state within five years.

Why are abnormal spinal curves unhealthy?

When vertebrae move out of their normal alignment, neurological disturbances known as subluxations can result. This condition impedes the normal transmission of mental impulses through the nerves from the brain to the body, thus inhibiting body function. Besides interfering with the innate ability of the body to heal, subluxations disturb the “righting reflex” which allows the body to adapt to abnormal equilibrium permitting the body to stand upright.

How can parents help?

As the parent of a child with poor posture and/or scoliosis, there are several things you can do to help.

First, it is crucial to keep all of your child’s corrective chiropractic appointments so that proper spinal balance may improve. Specific adjustments work not only to restore normal posture, but also to improve overall health by facilitating nerve function.

Second, avoid placing infants in a walker, jumper, or other restraining device that allows him/her to stand. An infant’s spine is not completely developed and these devices can cause permanent damage. Instead, one of the best positions for your baby is on his/her stomach. In addition to developing the muscles of the neck, this position lays ground for the proper development of the lower back’s secondary curve. Crawling also helps to develop this important curve of the spine. Exercises such as these allow for better physical growth and encourage strong spinal musculature.

Lastly, be a good role model for your child. Seek chiropractic care yourself, exhibit good posture, and exercise daily. Encourage your child to ride a bike or run and play outside instead of watching TV.

Any child suffering from poor posture and/ or scoliosis should be thoroughly analyzed for vertebral subluxations that may be causing the problem. Although this condition is difficult for both the parents and the child, continued patience seems to pay off with visible improvements in overall posture and health.

STRESS

In today’s fast paced, ever-changing society, many factors or stressors are believed to contribute significantly to our most serious health problems. Individual perception of stress varies from person to person, but most often stress is related to situations in which you are forced to adapt to in a way that is difficult or unpleasant.

Many life events and the ability to cope with them are closely related to stress-related health problems. Some stressful events are the death of a loved one, alienation of affection, geographical moves, decline in self-esteem, or change in job status. Threats to marital, family or social status, to health or security may also be particularly stressful. Patterns of change, both for better or worse, can also cause stress.

Particular kinds of work seem to cause special stresses related to the nature of the work or imposed irregularities, For example, rotating shift work which disturbs the normal sleep cycle, produces chronic stress by repeatedly upsetting daily rhythms that control specific hormones and other responses. Jobs that entail little variation but close attention, such as assembly line work involving dangerous machinery, also seem particularly stressful. People in high-stress jobs often view their situation as controlling: too much to do, too little time, unstimulating and no way to escape.

Much has also been written about the role of personality and stress-related conditions, particularly heart disease. Individuals who are very tense, impatient, highly competitive and seem to be driven by time and the need to succeed (Type A persons) seem to be at a higher risk for stress-related diseases than others who are more relaxed and less competitive.

How to manage pain?

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Pain is a warning sign. Like the piercing sound from a smoke alarm, the alarm isn’t the problem. The alarm has a cause, just like every ache or pain has a cause. Some people choose to cover up the pain instead of correcting the cause. What’s your approach?

The nerve-rich facet joints on the back side of each spinal bone are a common cause of back pain. If these pairs of interlocking “fingers” aren’t moving right, they can cause painful symptoms.
The discs between spinal bones can be a source of back pain, too. These rings of fibrous tissues act as spacers, connectors and “shock absorbers” for the spine. Trauma can cause the soft, pulpy material in the middle to bulge or herniate, putting pressure on delicate nearby nerves.

Once you know the cause, you have several choices. One approach is bed rest. But research shows that prolonged bed rest can actually delay recovery and make the problem worse!
Physical therapy is another option. But exercising spinal joints that aren’t working right is like continuing to drive your car with misaligned tires!

Another choice is to numb or cover up the pain with drugs. While drugs can offer temporary relief, they can’t correct functional problems of affected spinal joints.

The most drastic measure is surgery. A laminectomy cuts off the offending facet joints, leaving the spinal cord exposed! A spinal fusion cuts out the disc tissue and immobilizes the joint. While there may be times when surgery makes sense, it’s expensive, risky and more than half of all back surgeries fail.

More and more people are choosing chiropractic care first. Specific chiropractic adjustments can help improve spinal function.

Better yet, chiropractic is safe. Chiropractic is natural. And chiropractic looks to correct the underlying cause of the problem.

  • While a sedentary lifestyle can make symptoms worse, back pain affects those who are tall, short, thin, heavy, young and old.
  • While overexertion can cause back pain flare-up, the underlying problem may have gone undetected for years.
  • Besides being dangerous and the results temporary, more than half of all back surgeries are considered failures.

Ironically, many insurance companies would rather pay for expensive surgery than conservative chiropractic care!

What is a pinched nerve?

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The human body is a self-contained, self-governing and self-protecting vehicle which is designed to “live” many years. The body, with its framework of bones, its moving parts and motors of muscles and organs and its communication system of nerves, is controlled by the rational and sentient capacity of the brain. With all the parts functioning smoothly life is known, experienced and enjoyed.

The nerves can be traced back to a point where they leave the backbone and enter the spinal column through small bone sections called vertebrae. These separate sections are bound together into a strong, flexible vertebral column by muscles and fibers. Between these sections or segments are protective cushions of cartilage.

It is possible for one or several of the individual vertebrae to slip or turn slightly from their proper position by sudden twists, prolonged stress of remaining in one position, falls, blows or other accidental strains. Displacement of the vertebral section tends to change the size and shape of the nerve trunk openings resulting in pressure upon or obstruction of the nerve trunk. This physical obstruction creates an abnormal flow of nerve impulse.

There are 24 moveable vertebrae in the spine, with nerve trunks issuing to the right and left between each juncture of the vertebrae, each carrying millions of individual fibers bundled together like a telephone cable and extending to the various parts of the body. This is why any one of the many bodily parts and organs are affected by nerve obstructions and why these effects can be detrimental.

Doctors of Chiropractic are trained to discover displacements of the vertebral segments of the spine. Not only do they rely on their educated fingers discovering displaced vertebrae that reveals noticeable tenderness as the result of irritation, but x-ray is also used to show the position of the vertebrae in relation to one another. Other diagnostic measuring equipment are utilized but the type of devices used vary with doctors preference and are used to provide additional information about the body and the possible underlying dysfunction.

Vertebral displacement, termed “subluxation” by chiropractors is corrected by a chiropractic adjustment. The bone will be felt and usually heard called a “cavitation” as it is moved back into place, where it belongs. Bones move from pain causing positions to the original health inducing positions. Chiropractors are uniquely trained in the biomechanics of all the joints comprising the human body and know exactly which structures are “out-of” their normal position and through various techniques assist the two bones comprising the joint back into its proper position.
In this modern era of catch phrase we have often come to know the resultant cause of a displaced vertebrae as a “pinched nerve”.

You can see, healthy and normal nerve trunks branch forth from normal openings in the spinal column. But you can also see the devastating effect vertebral pinching has on a once healthy and normal nerve trunk.