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A Pain in the Neck..?

New bouts of neck pain affect up to 21% of the UK population every year (1), with almost half of people putting their neck pain down to an accident / injury or whiplash incident (4). Others put it down to lack of exercise poor posture and muscular weaknesses brought on by the time pressures of modern life. The prevalence in the population of neck pain increases until you hit 50 (1), at which point there is likely to be a diagnostic label applied. Making neck pain attribution in the over 50’s different to the under 50’s. Nonetheless it is a common problem.

A study(2) carried out in Taiwan looked to see if there were any predictors of an immediate response to manual therapy existed and they found. Predictors for immediate response to cervical spine adjustments all had the following aspects in common:

  • Both sides of the neck hurt
  • Did not have a sedentary job
  • Exercised twice a week or more
  • Movement relieved soreness
  • Extension (looking up) didn’t aggravate their neck
  • Had spondylosis (degeneration evidenced on x-ray) but no radiculopathy (Clinical finding)

These predictors had an 89% sensitivity. Meaning 9 times out of ten if you had the above characteristics then you’d get immediate relief with manual therapy applied to your sore neck. Great news for those who fit the predictors… What if you don’t..? and still have neck pain…?

For almost half of people with neck pain they put it down to a whiplash event ie a bump in the car. This may not come as any surprise to you but what if your jaw was affected in the whiplash and no one ever looked at it? Its unlikely your treatment would have been successful. Below is a jaw check list for reoccurring neck discomfort / pain or stiffness:

  • Bruxism (grinding)
  • Jaw popping (sounds)
  • Headaches on both sides
  • Deviation of jaw when opening or closing
  • Pain around or behind the eyes

These predictors were helpful for those with ‘Jawlash’ in their whiplash incident that was never found. Or for those with persistent neck pain that have not been helped by previous manual therapy efforts. Improved positioning of the jaw has been demonstrated after Chiropractic Care using OPT images (A type of x-ray) (3).

If we take a view that Australian researchers (4) did in 2004, of symptoms from of whiplash being physical and psychological we get a different check list for neck discomfort / pain or stiffness:

 

  • Had a headache within 72 hours of the incident
  • Neck pain / discomfort / stiffness following incident
  • Jaw sounds following incident
  • Compensatory posture
  • Pins and needles

 

 

Not all of the symptoms were physical in a potentially whiplash inducing incident:

  • Flashbacks of the incident
  • Nausea
  • Blurred vision

As we can see the science behind neck pain is variable. I would say that if the above check lists ring any bells with your experience of your neck then book your self an appointment. Avoid leaving your neck to resolve on its own because one can’t tell if we have gotten used to it or we’ve recovered. This is why so many people have reoccurring bouts of neck pain which can be surmised to be because the first incidence of neck pain /discomfort / stiffness was not biomechanically resolved.

 

References:

  1. Prevalence | Background information | Neck pain – acute torticollis | CKS | NICE
  2. Y.Tseng; National Yang-Ming University, Taiwan doi 10.1016/j.math.2005.08.009
  3. Chinappi. A and Getzoff. H (1995) The Dental-Chiropractic co-Treatment of Structural Disorders of the Jaw and Temporomandibular Joint Dysfunction. JMPT 18(7) 476
  4. Sterling M. et al (2004) A proposed new classification system for whiplash associated disorders–implications for assessment and management – PubMed (nih.gov)
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