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Neck pain and its treatment

Neck pain is a serious condition for many people. It can cause headaches, arm and upper back pain, even depression.

Dr. Scott Haldeman, clinical professor of neurology, University of California-Irvine, found in his study of neck pain that it is a widespread experience that is a persistent and recurrent condition for the majority of sufferers. Neck pain disables approximately 2 out of 20 people, which affects their ability to carry on with daily activities.

The study recommends that neck pain (including whiplash related pain) be classified and treated in a common 4-grade system:

  1. neck pain with little or no inference with daily activities
  2. neck pain that limits daily activities
  3. neck pain accompanied by radiculopathy (“pinched nerve” — pain weakness and/or numbness in the arm)
  4. neck pain with serious pathology, such as tumor, fracture, infection, or systemic disease.

Haldeman and his task force found that most neck pain falls into grades 1 or 2.

The task force also studied the association between chiropractic care of the neck and stroke. They found that patients who visit a chiropractor are no more likely to experience a stroke than are patients who visit a family physician. The type of stroke associated with chiropractic manipulation can be caused by ordinary neck movements like checking when backing up a car or by looking up at the sky.

The minority of those who experience grade 3 neck pain found that corticosteroid injections may provide temporary relief.

Surgery is a last resort and should be considered only if accompanied by arm pain that is persistent or if the person is experiencing grade 4 pain due to serious injury or systemic disease–according to researchers.

The researchers recommend:

  • Stay as active as you can, exercise and reduce mental stress.
  • Don’t expect to find a single “cause” for your neck pain.
  • Be cautious of treatments that make “big” claims for relief of neck pain.
  • Trying a variety of therapies or combinations of therapies may be needed to find relief.
  • Once you have experienced neck pain, it may come back or remain persistent.
  • Lengthy treatment is not associated with greater improvements; you should see improvement after 2-4 weeks, if the treatment is the right one for you.
  • There is relatively little research on what does or does not prevent neck pain; ergonomics, cervical pillows, postural improvements etc. may or may not help.
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