For the purpose of this discussion, mechanical neck pain will be defined as “spinal segmental joint dysfunction characterized by altered joint alignment, motion, or physiologic function in an intact spinal motion segment.” (2) This mechanical segmental joint dysfunction (SJD) most commonly results in local non-radicular discomfort.
Research suggests two basic origins of SJD, mechanical and reflexive. Mechanical dysfunction arises from an outside force acting on a segment for either; a brief trauma or extended period of overuse. Janda has suggested that the chronic trigger for altered joint mechanics may begin from an imbalance between the associated muscle groups. (3) Upper crossed syndrome is a common example of muscular imbalance or postural strain, that may lead to SJD. Research has shown that the upper crossed-inducing posture associated with prolonged Smartphone use may carry up to a six-fold increased risk of neck pain. (85,93)
SJD might also arise from sustained visceral nociceptive irritation triggering reflexive segmental muscular guarding, resulting in altered joint mechanics. Psychological and emotional factors may contribute.
SJD primarily affects the synovial facet joints. Hypomobility of these joints is thought to produce concurrent increased local nociceptive activity and diminished mechanoreceptive input. (4,5,6,7) SJD may give rise to a self-perpetuating cycle of discomfort in which the negative effects of hypomobility are perpetuated by inflammation, muscular hypertonicity (via Hilton’s Law) and imbalance. SJD is rarely an isolated event as dysfunction in one segment often leads to involvement of other segments and the spine as a whole. (3) Longstanding joint dysfunction is thought to result in premature degenerative change. (30,65)
While it is difficult to estimate the prevalence of Cervical Segmental Joint Dysfunction (C- SJD), the symptom of neck pain is very common. Medical providers see over 10 million visits per year as a result of neck pain. (8) The lifetime prevalence of neck pain is 50% with 13% of the population experiencing symptoms at any given time. (9,10) Neck pain is second only to low back pain as a cause of lost workdays and in some industries the two conditions have similar rates of absenteeism. (11) Neck pain may have greater chronicity than low back pain. (12) Neck pain is more common in women. (13) A specific medical pathology is absent in 50-80% of neck pain patients, lending support to the idea that joint dysfunction and its associated myofascial involvement are the most common causes of this problem. (14)
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What we do in our office to help this condition:
1. Perform a detailed exam, assessing the alignment of the spine. Due to the fact that the nerves exiting the spine in the neck branch off and go to the head, face, neck, shoulders, and arms, improper alignment in any of these areas may be detrimentally affecting the lumbar spine and its surrounding tissues.
2. As indicated, adjust areas of subluxations (misalignments), restoring proper alignment and nerve system function, which facilitates healing.
3. Apply electrical stimulation and heat to the muscles of the upper back and trapezius. Applying an electrical current helps strengthen muscles, block pain signals, and improve blood circulation.
4. If there is degeneration or herniation of the disc that is compressing a nerve, we will recommend sessions on the decompression table. Spinal decompression is a non-invasive form of traction treatment that calls for the use of a special motorized table to relieve pressure, give spacing back to the spinal discs, and promote natural healing. When the pressure on the disc is decreased or relieved, it can often return to its normal position and stop the pain.
5. Prescribe stretches and exercises in conjunction with chiropractic care to strengthen the soft tissues of the low back, core, and lower extremities.