Are Invasive Procedures the Only Hope for Managing Neck Pain?
In a recent article published in a journal for neurosurgeons reported “successful” treatment of neck pain was only obtained after utilizing an “MBB.” MBB, meaning medial branch block, is a procedure where medication is injected into the spine next to branches of spinal nerves to deaden them. Interestingly enough, the procedure is only temporary and was used after a typical regime of medications of varying combinations, which included: Tylenol, tramadol (muscle relaxer) and codeine. If various combinations of the drug were unsuccessful, the patients were subjected to the more invasive nerve block procedure.
The authors of the study made “discovery” after taking x-rays. There was a relationship between loss of cervical curve and severity of pain.
“Dysfunctional cervical intervertebral discs, cervical facet joints, atlanto-axial and atlanto-occipital joints, ligaments, fascia, muscles, and nerve root dura have been shown to induce pain in the cervical spine with the resulting sequelae of neck pain, upper extremity pain, and head- ache.”
It is EXACTLY this analysis which we have been using at our office for the past 15 years to not only determine the cause of neck pain, headaches and radiating arm pain but also to create a solution. The methods used in the study cited above can only manage symptoms. Our process of spinal remodeling solves these problems. Loss of normal cervical curvature and alignment will cause problems if present; it’s only a matter of time. Only consistent, perpetual use of these drugs will diminish symptoms and make you feel better. Unfortunately, the use of pharmacological interventions will stop pain AND allow the degenerative processes, which are causing the pain and symptoms to continue. The long-term effect is people will think their problem has been solved instead of realizing it has only been “managed.” They will no longer look for a solution because they think once the pain has gone; their problem has been solved. It’s actually the exact opposite. The abnormal position of your spine, which has lead to your symptoms, continues to create accelerated degenerative changes. You can think of the opportunity to solve your neck pain as one with an expiration date. The longer you wait to actually solve the problem, the harder it will be to achieve a successful outcome.
The spine is a complex system of joints, ligaments, tendons, muscles and nerves. All of these units work in together to create our neutral and active postures. Our posture is just an external expression of what’s happening internally. The reason posture is one of the many tools our office uses to develop treatment plans for patients is because it allows us a quick and easy method to establish a baseline prior to treatment. We tend to think that posture and movement are separate entities when, actually, they are tied together on a spectrum of active movement versus static balance. The spine forms the structure to which the muscles are attached. If the underlying structure is out of position, our muscles will have to work harder to control movement. Static balance is a very active process, the brain is using your nervous system to detect slight movements and activate your muscles to keep your body balanced. Muscles that have to work harder due to poor internal structure (and poor posture) fatigue more quickly, have a harder time maintaining balance (equilibrium) and lead to increase loading on the joints. The increased loading (force) on your joints will inevitably lead to breakdown and degeneration of both the hard and soft tissues in your body.
Good posture isn’t as simple as just “sitting or standing up straight.” Your body and the ligaments responsible for posture have remodeled and changed shape over time.
Your muscles aren’t strong enough to last against ligaments. Ligaments act exactly like gigantic rubber bands and are responsible for helping create your posture in conjunction with the action of your muscles. These rubber bands can deform over time, looking down at cellphones, laptops or working at a desk, can all create changes in the shape of your ligaments. Car accidents, falls off a bike or a slip on ice can create immediate changes to the shape of your ligaments. The soreness your feel after a car accident or a fall are a sign your muscle and ligaments have been damaged. Even though the pain may go away, the damage remains and will lead to progressive degenerative changes over time. It’s not a question of “if” your spine will degenerate when it has lost its normal position; it’s a question of “when” and “how bad.”
In “The cell biology of intervertebral disc aging and degeneration” written by Zhao, et al and published in the journal, “Ageing Research Reviews” is very clear that abnormal position is responsible for accelerate aging and breakdown of our bodies:
“Intervertebral disc degeneration, which mimics disc aging but occurs at an accelerated rate, is considered to be related to neck or low back pain and disc herniation.”
The relationship of pain to the presence of accelerated degenerative changes is clear. The only remaining factor is answering the question: does abnormal position cause increased loading and stress? You can probably guess since I’m asking the question, someone has already found the answer. In an article titled, “Straightened cervical lordosis causes stress concentration: a finite element model study,” the authors used a very sophisticated system of analysis to compare spinal position and loading within the spine. In this instance, spinal position and posture can be considered to mean the same thing. “The result demonstrated that the active movement range of straightened cervical spine decreased by 24–33 %, but the stress increased by 5–95 %.”
The short version? Abnormal position leads to LESS MOTION and MORE STRESS. The same article tells us these results may be useful in the treatment of cervical spondylosis (arthritic changes). The obvious statement they missed is that abnormal position CAUSES these changes. In the absence of abnormal spinal position (posture), the presence of degeneration is very rare.
Our office chooses to correct the CAUSE of these problems. Using the most advanced spinal analysis software available, your spine is compared to a normal spine and used to build a prescription for corrective care which will help your body remodel the spine into a more normal position. Our goal is NOT to manage your pain, it’s to SOLVE your problem! If you have persistent back or neck pain, it’s a safe bet abnormal spinal position is the cause because true muscular complaints resolve within 4-6 weeks. We help people get a new perspective on their pain and help them eradicate symptoms and get back to doing what they enjoy with whom they enjoy doing it.