Doctor… I Have a Pain in the Neck - What can I Do?
May 10th, 2008 Subscribe To Our Feed
Tip! The problem is that many front line health care practitioners do not know how to properly diagnose or treat this condition. In fact, the subluxation complex, which simply means a spinal bone or vertebrae has fallen out of alignment, is almost always overlooked when a patient is first examined by their physician for neck pain.
Neck pain is a common and costly medical ailment. Few studies of really effective medical treatments exist compared with those, say, for low back pain.
Many drugs used in clinical practice have been tried. Among those are nonsteroidal anti-inflammatory drugs (NSAIDs), tricyclic antidepressants, neuroleptic agents, and opioid analgesics.
While uncontrolled studies show benefit, controlled studies are lacking. So what has been shown to work so far? According to a recent study, there are only two medicines that have been proven to be effective. The first is intravenous methylprednisolone for acute whiplash used within eight hours for whiplash and the second is intramuscular lidocaine for chronic mechanical neck disorders. (Peloso PM, Gross AR, Haines TA, et al. Medicinal and injection therapies for mechanical neck disorders: a Cochrane systemic Review. J Rheum 2006; 33:957-967).
What is disheartening is that the usual treatments such as anti-inflammatory drugs and acetaminophen have been largely ineffective- at least according to this one large study.
Even epidural injections were classified as showing “limited evidence of benefit.”
A number of interventions in this large study were ineffective. These include:
� Oral psychotropic agents
� Oral anti-inflammatory agents and oral analgesics
� Intramuscular injections of multivitamins.
� Nerve-block injections
Tip! For severe acute neck pain resulting from an accident or injury, doctors recommend bed rest, a neck brace or collar, and cold treatment (such as an ice pack) for neck pain relief. Heat (such as that from a heating pad) and physical therapy are usually recommended for treating chronic neck pain.
In addition, several interventions were judged to have shown “moderate evidence of no benefit.” These included intramuscular injections of botulinum toxin (Botox A), intracutaneous injections of sterile water, subcutaneous injection of carbon dioxide and melatonin.
So what can you do if you’re a patient?
First of all, remember that these studies that are published in the literature have flaws. They do not report the data from private practices. Also, many of the studies that are reported as being “negative” are done in large medical centers where there is already a built in bias that these treatments don’t work. It’s sad but true. A lot of academic doctors really don’t believe in treatment. They’d rather write negative papers.
Second, make sure you see a skilled rheumatologist… one who is skilled in the management of osteoarthritis and neck problems.
The things that might afford some relief in addition to the two described above are also- at least in my 25 years of experience are:
� Physical therapy for chronic problems
� Chiropractic for acute problems
� A neck support pillow
� Ice/ moist heat
� Gentle traction
� Exercises done under the supervision of a skilled therapist
� A soft cervical collar worn temporarily
� Epidural, nerve block, and soft tissue injections (despite what they say, I think they work)
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Dr. Wei (pronounced “way”) is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians. For more information on arthritis and related conditions, go to: http://www.arthritis-treatment-and-relief.com Tip! More recently some TENs machines are now available with an electrical probe which can be used to stimulate acupuncture points to bring pain relief. While almost all TENs machines have cautions about placing the electrode pads on the head and neck these �accu TENs� machines will permit users to stimulate the accu points or channels elsewhere on the body to bring relief to head or neck pain. |
Technorati Tags: back pain, neck pain, pain relief, stress relief
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A Fresh Start Plan for People With Neck Pain!
May 2nd, 2008 Subscribe To Our Feed
Tip! A recent European study divided patients into three groups for treatment. The group that received traditional Chinese acupuncture reported the most significant neck pain relief in the short term and over time, compared with those that underwent massage therapy or laser treatment.
“If you have to deal with chronic neck pain, it can be a real struggle. I know� because I’ve had to do it myself,” states Dr. Nathan Wei, a board-certified rheumatologist and Clinical Director of The Arthritis and Osteoporosis Center of Maryland.
How arthritis causes neck pain…
The neck is an interesting structure. It’s made up of 7 bones stacked on top of each other. Each is separated from each other in the front by fibrous cushions called discs, and from each other in the back by special joints called facet joints. “The maximum movement of the neck occurs between the 4th and 6th cervical vertebrae…and this is where the most wear and tear in arthritis is seen,” says Dr. Wei
Pain can come from anywhere!
Dr Wei adds, “� anything in the rear part of the brain can cause referred pain to the neck�.This includes aneurysms, infections, and tumors�.
Also, neck pain can be referred from the shoulder, the upper chest, or even the heart! �Problems in the soft tissues of the neck such as growths or tumors affecting the thyroid gland, esophagus (food pipe) or trachea (wind pipe) can also lead to neck pain
Tip! Pain management doctors are specialists at diagnosing the reasons for your pain as well as treating the pain itself. Arthritis, back and neck pain, cancer pain, nerve pain, migraine headaches, shingles, and phantom limb pain for amputees are among the most common pain problems they usually manage.
Injury to the muscles and ligaments (example= whiplash auto accident) can cause neck pain. Dr. Wei declares, “This is the type of problem I have had for many years. I’ve been rear-ended a few times and I have degenerative arthritis in the neck at the C5-6 level. Patients I have talked with agree with me when I report popping or grinding in the neck with movement. Other patients say it “feels like sand back there” when they move their head�”
Pain from whiplash can radiate up the back of the head and cause headache. It may also radiate into the shoulders or between the shoulder blades.
Tip! Several factors can contribute to neck pain. Symptoms may be the result of bad posture at a computer in the workplace, or a neck trauma.
Dr. Wei also adds, “Some types of neck pain are dangerous. When neck problems are associated with pressure on the spinal cord, this is called myelopathy and is a neurosurgical emergency!”
What are the most effective treatments?
Treatment obviously depends on making the correct diagnosis. According to Dr. Wei, the goals of treatment are to relieve pain, improve range of motion, prevent weakening of muscles, and restore function. Among the common treatments are non-steroidal-anti-inflammatory medicines or NSAIDS, topical agents such as Myorx, soft neck collars, neck support pillows, and exercises. Dr. Wei firmly reminds us, “� evidence of instability or cord compression is a ticket to see the neurosurgeon stat�”
Dr. Wei (pronounced “way”) is a board-certified rheumatologist and Clinical Director of the nationally respected Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and has served as a consultant to the Arthritis Branch of the National Institutes of Health. He is a Fellow of the American College of Rheumatology and the American College of Physicians.
For more information on arthritis and related conditions, go to:
http://www.arthritis-treatment-and-relief.com
Technorati Tags: back pain, neck pain, pain relief, stress relief
Related Tags: back pain, neck pain, pain relief, TMJ
Chronic Head, Facial, Or Neck Pain That Won’t Go Away - Could It Be TMJ?
April 28th, 2008 Subscribe To Our Feed
Tip! The problem is that many front line health care practitioners do not know how to properly diagnose or treat this condition. In fact, the subluxation complex, which simply means a spinal bone or vertebrae has fallen out of alignment, is almost always overlooked when a patient is first examined by their physician for neck pain.
I stumbled across TMJ when I needed treat a literal pain in the neck that would not go away. It seemed that the pain in my neck came from my jaws. “TMJ” refers to disorders of the jaw muscles and of the temporomandibular joint, the hinge at the side of the head that joins the lower jaw, mandible, to the temporal bone of the skull. TMJ expert John Taddey, D.D.S. states that one the most common symptoms of TMJ is a dull, aching pain around the ears which can radiate to the neck, shoulders, and back of the head. These symptoms may be coupled with tenderness of the jaw muscles and a headache.
While the causes of TMJ are many, the condition is usually the result of a collective malfunctioning of the chewing muscles, the teeth, and the temporomandibular joint. The face and jaw muscles may go into spasm or cramp and lead to tissue damage, pain and tenderness. The level of damage and pain varies.
Tip! Along with a high mesencephalic output, the neck pain patient may present with a decreased output of the cerebellum. The cerebellum is in the back part of the brain.
Diaganosing TMJ can be elusive. Recognizing TMJ requires a thorough understanding of the two-inch area just in front of the ears that houses the temporomandibular joint, sinuses, glands, the middle and inner ears, throat tissues, brain tissue, muscles, ligaments, nerves blood vessels, lymphatic tissues, bones and teeth. TMJ can mask itself with a “referred pain”. This occurs when pain felt in one area of the body originated from another source. For example, you may visit your doctor with an earache and find your ear is healthy, while a decayed tooth or TMJ is the root cause of the earache.
TMJ can arise form trauma, whiplash, stress, teeth-grinding and clenching, misaligned teeth, missing or sore teeth, muscle abuse, infection, diseases of the joints such as arthritis, and cancer.
Your family dentist should be able to recognize TMJ. Depending on your condition, she may treat the TMJ herself or refer you to a physician, orthodontist, chiropractor, psychologist or oral surgeon for more specialized treatment.
For more information on identifying and treating TMJ yourself, read TMJ Self-Help Program: How to recognize a TMJ problem: What to do to relieve pain and restore health: When to seek professional help by John Taddely, D.D.S. with Constance Schrader and James Dillon.
Health author and Noixia campaigner Naweko San-Joyz lovingly writes from her home in San Diego. Her works include “Acne Messages: Crack the code of your zits and say goodbye to acne” (ISBN: 0974912204) and the upcoming work “Skinny Fat Chicks, Why we’re still not getting this dieting thing” (ISBN: 0974912212) for release in June of 2005.
For useful acne self-help articles visit http://www.Noixia.com
Technorati Tags: back pain, neck pain, pain relief, stress relief, TMJ
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