Here at the Pierce Clinic of Chiropractic we see hundreds of patients a week who suffer from various forms of neck pain.  Often, the onset of pain began a few years ago after getting rear ended in a car accident or after a concussion playing sports.  Other times it mysteriously developed out of nowhere. When the pain first began, it was minor and manageable and you coped through stretching, heat treatments, and massage therapy. However, as the years progressed, for some reason this minor pain in the neck began to worsen beyond your ability to self manage it.

Eventually these patients find themselves seeking pain management through the use of medications, Cortisone injections, and surgical procedures, as a primary solution.  However these interventions are really more of a mask then a fix.  Before heading down this path it is critical to ask, “What is actually causing the pain in my neck?”

Let’s take a look at the research:

Nikolai Bogduk’s, one of the most important spinal researchers, gives detailed insight into cervical spine structure and its ailments in his article, “The Anatomy and Pathophysiology of Neck Pain”.

“By definition, neck pain is pain perceived as arising in a region bounded superiorly by the superior nuchal line, laterally by the lateral margins of the neck, and inferiorly by an imaginary transverse line through the T1 spinous process.”

This definition does not imply the cause of pain lies within this area, it defines neck pain on the basis of where the patient feels the pain.

Find the Cause of Pain, Implement a Plan to Stop It

The objective of clinical practice is to determine exactly the source, and cause of pain, and then implement measures to stop it. The first, and most important part of being a doctor is to find the underlying cause of the disease.

Nerves exit the spinal cord and travel to all the muscles, tendons, ligaments, and discs of the cervical spine. Anatomically, there are a tremendous amount of nerves coming out of the top 2 bones known as the atlas and the axis. These nerves connect heavily to the joints surrounding C1, C2, and the skull. This is important because there is very important vestibular or balance information going from these two joints up into the brain.

According to Bogduk, numerous scientific studies report that when joints in the neck are agitated with injections, they produce pain patterns marking them as important sources of neck pain. However, there is little data showing muscle and tendons actually cause pain.

“Other tissues, such as the posterior neck muscles, the cervical dura mater, the median atlanto-axial joint and its ligaments, and the vertebral artery, are potential sources of neck pain, because they are all innervated, but they have not been subjected to study either in normal volunteers or in patients. That they could be sources of pain is a credible proposition, but formal evidence is lacking.”  

Bogduk’s paper goes on to show the research of many ailments that have been commonly labeled as causes of neck pain. He lists through artery tears and other vascular problems.  These are possible, however rare and usually caught early with signs of intense headache. Systemic joint pain, like rheumatoid and fibromyalgia, can be causes of neck pain, but they’re rarely present without accompanying symptoms. Tendinitis of the longus coli, an important neck flexor, along with fractures can cause pain, but they are also extremely rare and can’t account for the high incidence of neck pain in the general population.

Arthritis is the most common diagnosis for neck pain. Often times, it’s the first diagnosis given to a patient. However, asymptomatic individuals may have terrible arthritis while other times symptomatic patients may have no arthritis.  When Dr. Bogduk reviews the research regarding arthritis as a common cause of neck pain, he finds that evidence is weak and inconsistent.  This makes it an unlikely cause of neck pain despite everything we’ve been told.

Conclusion

Bogduk leaves us with this powerful statement,

“A sober review of the purported causes of neck pain reveals that the most readily diagnosed and serious conditions are rare and do not account for most cases. Meanwhile, the most commonly applied diagnoses lack validity. They have either been disproved by epidemiologic studies or have defied testing. Other entities are descriptive terms but are not proper diagnoses. There are no data on the cause of common, uncomplicated neck pain.”  

Coming from a professor who is well known in the field for managing pain, you can understand why this statement is powerful. This is what makes the Pierce Clinic of Chiropractic unique. Through 120 years of clinical practice, chiropractors have found that misalignments in the upper cervical spine are often the misdiagnosed root of the problem. Using revolutionary technology with the Advanced Orthogonal Technique, we have been able to help thousands of patients by gently and specifically aligning the atlas and axis with the skull.

As the alignment begins to hold, the joints start healing, they stop generating pain, and that pain in the neck gradually turns into a memory. More information about this procedure can be found at AdvancedOrthogonal.com.

Our main page for all neck-related issues is here.

Bogduk, N. (2003). The anatomy and pathophysiology of neck pain. Physical Medicine and Rehabilitation Clinics of North America, 14(3), 455-472. doi:10.1016/s1047-9651(03)00041-x