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How do I cure my neck pain?
Cincinnati Neck Pain
If you experience neck pain you are not alone. Neck pain is quickly becoming one of the most common reasons for visiting the doctors office. Anyone who suffers with neck pain knows that the condition can dramatically interfere with our daily lives, often making driving, sleeping, exercising, and even concentrating very difficult. As if that wasn’t enough, neck pain is often recurrent, with the same problem occurring over and over again. To make matters worse, many common neck conditions are often slow to respond to traditional types of care, often providing only temporary relief.
WHY DOES THE NECK BECOME INJURED?
When talking about the neck, we are actually talking about the upper portion of the spinal column- the cervical spine. The cervical spine consists of 7 small bones called “vertebrae” stacked on top of each other, each of which is connected through a series of joints. These joints allow the neck to turn and bend, which is important for all of our everyday movements. By themselves the joints of the cervical spine are not very stable, so to protect the region, a complex system of muscles surrounds the spinal column to control movement and protect the area from injury. These muscles are arranged in several layers. The deepest layers consist of very small muscles that attach into each individual vertebrae and control and protect each individual joint. The middles layers span across several joints, and the outer layer consists of the larger, more powerful muscles that run the entire length of the neck, all the way from head to the shoulders.
Not only do these muscles need to move and protect the cervical spine, but they also must control the weight of the head. The head and neck have a unique anatomical relationship in that the larger, heavier head, which weighs about 10 pounds, sits atop the thinner neck. This essentially represents an inverted pendulum where the natural tendency is for the heavier head, which represents the top of the inverted pendulum, to topple over. This places a high demand on the neck muscles to both support and control the weight of the head, while at the same time ensuring adequate movement and stability of joints of the cervical spine. This complex process requires each muscle to be adequately strong, flexible, and coordinated, and as long as this is the case the neck remains protected and healthy.
HOW DOES INJURY OCCUR?
The health of the neck depends on a complex interaction of muscular of muscular contractions to move and stabilize each joint in our cervical spine, and properly move and postion the head. If any of the muscles that surround the cervical spine become tight, weak or uncoordinated, it will place excessive strain on the other surrounding muscles and on the spinal column itself. Over time, if imbalance in the muscles and resulting abnormal head and neck abnormal head and neck motion is allowed to continue, it can eventually develop into more sever neck conditions.
There are a variety of situations that can cause tightness, weakness, and abnormal function of the neck muscles. For example, poor or prolonged postural strain that occurs wit computer use and desk jobs, repetitive use with with certain sports, muscle imbalances, lack of stretching or strengthening, or previous injury such as car accidents (even monor accidents with little or no injuries that occurred at the time), can all affect the normal function of the neck and surrounding muscles resulting in excessive strain to the area.
Over time this strain can develop into what is known as micro-trauma. Simply stated, micro-trauma is very small scale muscle damage that occurs in muscles and ligaments in response to small levels of strain. Initially this micro-trauma is not painful, but may be perceived as mild ache or tightness in the muscles, or at the medial or lateral epicondyles. Although it is only small, this damage still needs to be repaired. The body responds to micro-trauma by laying down small amounts of scar tissue to repair the injured tissue. Unfortunately over time this scar tissue will build-up and accumulate into what we call adhesions. As these adhesions form they start to affect the normal health and function of the muscles and related joints. In fact, they will often lead to pain, tightness, lack of flexibility, muscle weakness, compromised muscle endurance, restricted joint motion, and altered biomechanics, and diminished blood flow. This places even further strain on the neck muscles, which, in turn, leads to even more micro-trauma. Essentially a repetitive strain injury cycle is set-up, causing continued adhesion formation and progressive cervical spine dysfunction. At this point, pain and tightness will often start to become noticeable.
As the repetitive strain injury cycle continues the ability of the neck muscles to meet the demands placed on them diminishes. At this point, it is not uncommon for the muscles to give way and a more severe and debilitating pain occurs. In fact, many patients come into our office explaining how they have neck pain but they did not really have any major type of injury occur. When further questioned these patients almost always describe some mild pain or tightness in their neck that has been building over time. As you can see from the explanation of the repetitive injury cycle, these types of conditions build up over time until they eventually develop into larger scale injuries.
How Can These Neck Injuries be Fixed?
The most common approach to treating neck pain is medication to reduce inflammation, block pain, or relax muscles that may be causing headache symptoms. In the case of chronic or recurrent pain, sometimes doctors will prescribe stronger prescription medications to help fight the symptoms. In some cases, even more invasive measures such as joint blocks are used, whereby an agent is injected into the joint to block the referred pain and other symptoms.
The main reason that medications fail to provide long-term resolution for neck pain is that they fail to address any underlying problems of the muscles, nerves or joints of the neck that are causing recurrent pain. Instead, they address the symptoms of the pain and simply cover up the underlying issues in the neck, that if not addressed will continue to cause problems. As a result, many people become reliant on medication to accomplish relief of their neck pain. This is not only a temporary fix that is only covering up the problem, but it also increases risk of side-effects and dependency on the medication.
Unfortunately, muscle tightness and imbalance, scar tissue adhesions, nerve entrapment, and abnormal joint movement cannot be seen on an x-ray or advanced imaging. These problems in the muscles, joints, nerves and ligaments can however, be felt or tested with the hands of a properly skilled and experienced practitioner. A thorough history and clinical examination is usually sufficient to give the clinician enough information to diagnose the problem.
The Traditional Approach
In an attempt to relieve elbow pain, a variety of treatment methods are used, either on their own, or in combination with other methods. Some of the more common approaches include muscle relaxants, anti-inflammatory medication, rest, ice, ultrasound (US), muscle stimulation (E-Stim), massage, acupuncture, stretching, and strengthening exercise. Unfortunately most of these traditional techniques generally require a long period of time before they provide only temporary relief from symptoms instead of fixing the underlying cause of the problem.
The main reason that these approaches are often ineffective is that they fail to address the underlying scar tissue adhesions that develop within the muscles and surrounding soft tissues. It is these adhesions that are binding the tissues together, restricting the normal movements, and interfering with the normal flexibility and contraction of the muscles in and around the spine.
Passive approaches such as medications, rest, ice, and steroid injections all focus on symptomatic relief and do nothing to address the muscle restrictions and dysfunction. More active approaches such as stretching and exercises are often needed for full rehabilitation of the condition and to restore full strength and function of the muscles, however, they themselves do not treat the underlying adhesions. In fact, without first addressing the scar tissue adhesions, stretches and exercises are often less effective and much slower to produce relief or recovery from neck pain.
Our Approach: ART® – A Better Solution
ART® stands for Active Release Techniques®. It is a new and highly successful hands-on treatment method to address problems in the soft tissues of the body, including the muscles, ligaments, fascia, and nerves. ART® treatment is highly successful in dealing with elbow conditions because it is specifically designed to locate and treat scar tissue adhesions that accumulate in the muscles and surrounding soft tissue. By locating and treating the soft-tissue adhesions with ART®, it allows the practitioner to, 1)Breakup restrictive adhesions, 2) reinstate normal tissue flexibility and movement, and 3) more completely restore flexibility, balance, and stability, to the injured area and to the entire kinetic chain.
You can think of an ART® treatment as a type of active massage. The practitioner will first shorten the muscle, tendon or ligament, and then apply a very specific pressure with their hands as you actively stretch and lengthen the tissues. As the tissue lengthens the practitioner is able to assess the texture, and tension of the muscle to determine if the tissue is healthy or contains scar tissue that needs further treatment. When scar tissue adhesions are felt the amount and direction of tension can be modified to treat the problematic area. In this sense, each treatment is also an assessment of the health of the area as we are able to feel specifically when the problem is occurring.
An additional benefit of ART® is it allows us to further assess and correct problems not only at the site of pain itself, but also in other areas of the kinetic chain, which are associated with movement compensations and are often contributing factors to the problem. This ensures that all the soft tissues that have become dysfunctional and are contributing to the specific injury are addressed, even if they have not yet all developed pain.
One of the best things about ART® is how fast it can get results. In our experience, the majority of elbow injuries respond very well to ART treatment, especially when combined with the appropriate home stretching and strengthening exercises. Although each case is unique and there are several factors that will determine the length of time required to fully resolve each condition, we usually find a significant improvement can be gained in just 4-6 treatments. These results are the main reason many elite athletes and professional sports teams have ART® practitioners on staff, and why ART® is an integral part of the Ironman triathlon series.
To book an appointment to see if ART® will be able to help with your elbow injury, simply call our office at 513-531-2277 The Traditional Approach