Health Update: Neck Pain

How Can I Get Rid of This Neck Pain?

“I’ve been having this pain in my neck for a long time and it just won’t go away!  It’s getting to a point where I have to do something and I’m not sure which route to go.  Some of my friends have suggested chiropractic but I’m just not sure.  Can you give me any advice?”

Neck pain is a very common complaint that chiropractors treat on a regular basis.  Most people will experience neck pain during their lifetime requiring professional care and the choice between chiropractic or some other form of health care certainly exists.  Chiropractic is a non-drug, non-surgical option many find appealing because of the many side effects of medications and no one wants to consider surgery unless it’s absolutely necessary and everything else has been tried first.

The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders published some good, sound statements about neck pain of which a few include:

In most cases, don't expect anyone to find a single "cause" for your neck pain. 
Stay as active as you can; simple exercises and reducing mental stress can help. 
A combination of therapies, including chiropractic care, may be needed. 


First, trying to identify the “cause” of your neck pain is often tricky and sometimes impossible to trace.  Don’t worry, that’s “normal” as most patients cannot trace it to one specific cause because it’s multifactorial or, caused by more than one event, often over a period of time.

Second, staying active and performing exercises can greatly help to reduce and sometimes prevent neck pain.  One particular exercise that can be done multiple times per day and even in public places, as it’s not too conspicuous, is called chin tucks. Let’s try it together!  While sitting, look straight ahead and tuck your chin towards your chest or, glide your head backwards.  Hold the tucked position until you feel fatigue, which usually takes 5-15 seconds, and then slowly release the head poking your chin forwards in the opposite direction. Looking at this from the side, it sort of looks like a chicken when they walk!

 Repeat this exercise and emphasize the slow release, as if you’re in “slow motion,” gliding forwards and backwards holding the endpoints for 5-15 seconds per repetition.  Start with 5 reps and over time, gradually increase the reps to 10 and repeat this several times each day.  As a postural retraining process, when you’re sitting in your car, at your desk, watching TV, or in meetings, partially tuck in your chin so that the weight of your head (which is approximately 15 pounds) is centered back over your upper back and not poking forwards.  This will GREATLY reduce the amount of muscle tension that commonly builds up during the day due to the increased muscle activity that is required to hold the weight of the head when it’s too far forward and away from the center of the body.  Constantly remind yourself by maintaining a partial “chin tuck” during the day and perform the gliding exercises periodically, at least 3 times a day.  Be patient as it takes about 3 months for this “new” posture to become automatic and your new “normal” habit.

If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service.  We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and we look forward in serving you and your family presently and in the future.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR NECK PAIN!  

FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597.

Health Update: Whiplash

Whiplash – What Can I Do To Help?

Whiplash occurs when the neck is suddenly and forcefully jerked, and is typically associated with car crashes.  The speed at which the neck is forced upon impact is faster than we can contract our muscles in attempt to stop the forceful movement.  This results in muscle, tendon, and/or ligament over-stretching, even tearing.  Symptoms include stiff and painful neck movements, weakness or, the head “feels heavy” making it challenging to “hold up” as well as headache, and sometimes dizziness, ear noises, TMJ or jaw pain, and “mental fog.” What should be done if a whiplash injury occurs?

The amount or degree of damage to the soft tissues – that is, the muscles, tendons, ligaments, and disks of the neck -- will be the deciding factors as to how much rest vs. activity should be initially performed.  If there are no fractures, dislocations or other injuries resulting in an unstable cervical spine (neck), studies have shown rest and a soft collar is actually harmful when compared to early return to activity and exercises.  Chiropractic treatment, which essentially exercises the joints of the neck, has been shown to speed recovery when performed sooner rather than later after a whiplash injury.

A handy way to classify the injury includes four categories: 

1) Pain with no significant abnormal clinical findings
2) Pain with mild clinical findings and range of motion loss
3) Pain with neurological injury (resulting in radiating arm pain)
4) Pain associated with fracture and/or dislocation

Those suffering with category 1 or 2 injuries should minimize rest, collar use, proceed with life’s activities and not be afraid to do desired activities.  More aggressive exercise and, utilizing chiropractic adjustments as soon as possible is very effective in the first two categories of injury.  Category 4 (fractures and dislocations) injuries require the use of a rigid collar usually for 4-6 weeks as rest/protection is imperative. Category 3 demands careful monitoring by your chiropractor as neurological problems like arm pain and numbness, muscle strength weakness, must be watched during the healing process.  The use of ice is helpful with all four categories of injury and exercise training is important and can be started sooner in the first two categories of injury.

What can you do if you sustain a whiplash injury?  The first order of self-help is the use of ice.  This is a much better choice over the use of heat as ice reduces swelling and pain while heat can increase swelling because it brings in more blood flow into an already swollen area.  The heat may feel good during its use but most patients report the pain either returns shortly thereafter or feels worse.  Ice and heat can be alternated but ice should be emphasized by using ice for 10 minutes, heat 5 minutes, and repeat the ice / heat / ice approach starting and ending with ice. One session usually equals 40 minutes (ice/heat/ice/heat/ice for 10+5+10+5+10, respectively, = 40 min.), and several sessions can be repeated each day.  The old adage of “ice for 24 hours followed by heat” does NOT apply here as ice or “contrast therapy” of ice/heat/ice/heat/ice can be performed for as long as there is pain or, for several weeks or longer.

The good news is that you will never hurt yourself by using ice but, you can make it hurt worse by using heat too soon so, when in doubt, use ice!  The next, very important, recommendation is to utilize exercises to stretch and strengthen the neck and upper back region. The “general rule” of exercise is slow repetitions staying within “reasonable” boundaries of pain.  That is, a good, stretch type of pain is encouraged while avoiding sharp pain.  We have discussed several very practical neck stretches and strengthening exercises previously and we will again address this in the future. Posture correction of chin tucks, keeping your head back over your shoulders is very helpful as well. We realize that you have a choice in where you choose for your healthcare services.  If you, a friend or family member requires care for whiplash, chiropractic care is a logical first choice and we would be honored to offer our services to you.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 
732-984-9597 OR VISIT US AT ADVANCED-WELLNESS.NET

Health Update: Neck Pain

What Is This Pain in My Neck!

“When I woke up this morning, I couldn’t move my neck!  Every time I try to move it, I feel sharp pain on the left side of the neck shooting down into the shoulder blade.  It just came out of nowhere!”

Chances are, you are suffering from a common condition called torticollis, which literally means, “twisted neck” after the Latin terms of “torti” (twisted) and “collis” (neck).  The common name for this is “wry neck,” and it’s basically a painful muscle spasm, like a “Charlie-horse” but located in the neck muscles.  Usually, a person wakes up in the morning with this and the cause is often related to sleeping with the window being open or a fan or air conditioner blowing on you.  It can also relate to a “cold settling in the muscle” after a cold or flu virus.  Trauma such as falling or a car accident can also cause torticollis. However, most of the time, patients with torticollis are not sure what caused the abrupt onset of symptoms.

Usually, torticollis will gradually improve over a 2 week time frame. However, it only takes a few days to a week (at the most) if you receive chiropractic adjustments.  Most importantly, without treatments, the sharp pain can last a week and can severely limit your activity, often prohibiting work as well as your desired “fun” activities.  Hence, most people prefer having this treated as opposed to “waiting it out.” In some cases, it can last longer than a month and in rare cases even longer, so getting this treated is highly recommended.  Also, try to get in for a treatment immediately before the muscle spasm really sets up.  We find this to be the most effective approach.

Here are a list of symptoms and treatment suggestions for torticollis:

Acute Torticollis Symptoms
Muscle spasms
Neck and shoulder pain 
Neck and spine contortion (neck twisted to right or left side of body)
Pain Relief Treatments for Acute Torticollis
Chiropractic neck and spinal adjustments
Analgesics
Heat packs
Muscle relaxants
Rubs and ointments (Icy Hot, BioFreeze)
Massage with essential oils
Acupuncture
Sleep / Relax
Supportive cervical collar


If you, a family member or a friend require care, we sincerely appreciate the trust and confidence shown by choosing our service.  We are proud that our conservative care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and we look forward in serving you and your family presently and in the future.

FOR A FREE NO-OBLIGATION CONSULTATION CALL
732-984-9597 OR VISIT US AT ADVANCED-WELLNESS.NET

Health Update: Whiplash – Can This Affect My Memory?

Whiplash – Can This Affect My Memory?

"Doctor, is it normal for people after a whiplash injury to notice problems with memory. I can’t seem to remember things I just recently did since my car accident?”

This is a common complaint occurring as a result of a whiplash injury, but it’s not commonly known, leaving those who are suffering wondering, “…what’s wrong with me?” Whiplash is an injury that classically occurs as a result of a car crash at any speed, even at low speed! This is because at low speed, there is little to no damage to the car, and the forces from the crash are not absorbed by the crushing metal. As a result, those forces are transferred to the contents inside the car – that is, the passengers. This sometimes results in a significantly greater injury compared to crashes that occur at twice the speed because the latter results in crushing metal. The actual injury that occurs in whiplash is caused by the sudden, rapid movement of the head resulting in varying degrees of injury to the neck, as well as to the contents inside the skull – that is, the brain. The brain literally “bangs” into the inside walls of the skull when the head is rapidly accelerated during a car crash. The resulting injury is a concussion. What’s interesting is that most patients injured in a car crash often don’t mention a concussion nor is it usually asked about at the doctor’s office as other, more obvious injuries are dwelt with. The condition is usually referred to by one of two names: post-concussive syndrome or mild traumatic brain injury (MTBI).

"Doctor, when I’m reading a book or magazine, sometimes I have to re-read the passage several times before it sinks in. It’s as though I lose my concentration and I can’t focus on what I just read. The other day, I was talking to a group of co-workers and I lost my place in the middle of the discussion and had to ask, ‘…now where was I?’ I notice this is happening a lot since the car accident.”

This can be very embarrassing, frustrating, and scary for patients suffering with MTBI. Other symptoms associated with this include difficulty in focusing (blurred vision), headaches, having difficulty in pronouncing certain words (“tongue twisted”), having difficulty in understanding what was said, difficulty remembering numbers or groups of numbers like phone numbers, addresses, birthdates, and so on. These symptoms can range from mild to severe and can be very disruptive, making work and everyday tasks challenging.

How long does it last? MTBI can completely clear up in 2 to 6 months without problems or, it can hang on for 2 years or longer, and may even become a permanent residual from the car crash. In one study, continued problems after a 2 year time frame were reported in close to 20% of those injured 2 years earlier. This study suggests that about 1 out of 5 may continue to suffer with MTBI and the associated brain-related problems for at least 2 years following a car crash. However, another study reported the long term “higher cognitive function” (such as the ability to communicate through written or spoken language) is usually not affected by whiplash injuries. However, they preface that with by reporting that a more commonly injured group with more mild brain problems was found.

As chiropractors, we are trained to do a thorough history, orthopedic and neurological examination, and ask specific questions about mild traumatic brain injury. It is important to discuss this information with those suffering from whiplash injuries as frequently, MTBI patients think something is “…seriously wrong” and harbor unnecessary anxiety.

We realize that you have a choice in where you choose for your healthcare services. If you, a friend or family member requires care for whiplash, chiropractic care is a logical first choice and we would be honored to offer our services to you.

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR WHIPLASH

FOR A FREE NO-OBLIGATION CONSULTATION CALL 732-984-9597

Health Update: Whiplash Part 2

Whiplash – What Is It?

Whiplash is a slang term for an injury to the neck that occurs as a result of a sudden jolt, classically occurring in a car accident though a slip and fall injury can sometimes result in a similar condition.  In a classic rear-end collision, the car is struck from behind and accelerated forward at speed that even if the person knew the impending collision was about to take place, bracing the body prior to impact would not prevent injury.  In fact, muscles can only be voluntarily contracted at around 800-1000 msec. and in a rear end collision, the head is “whipped” within a 300-400 msec. time frame.  Add to that, the muscles in the front of neck are initially stretched with the car is propelled forward leaving the head in a relatively extended backwards position.  Most of the headrests in cars are not properly positioned so the head often goes back much farther than the limits of our muscles, ligaments and joints may allow resulting in stretching and tearing of these tissues.  When the tissues in the front of the neck are over stretched, the “rubber band” effect propels the head forward - overstretching the muscles, ligaments, and joints in the back of the spine.  This “crack the whip” phenomenon occurs within 400-500 msec., far quicker than what we are capable of when voluntarily contracting our muscles. Here is a breakdown of what happens in a 5 mph rear-end collision:

0 msec.: At the moment of impact, the car seat just begins to move and the occupant has not yet been accelerated forward.
50 msec.:  As the back of the car seat pushes the torso forward, the spine moves forward, resulting in a straightening of the thoracic and cervical spine. About 2-3 G’s of force are exerted on the torso.
75 msec.:  This difference in motion between the neck and torso results in an S-shaped curve, where nearly all of the bending in the cervical spine takes place in the lower cervical spine.  This rapid bending in just a few joints can result in ligament damage in the lower spine.
150 msec.: Here, the torso has pulled so far forward on the lower neck that the head is forced backwards often over the head restraint.  Depending on the position of the headrest, the angle of the seat back, and “spring” effect of the seatback, the ligaments in the front portion of the spine are often injured during this phase of the collision.  About 3-4 G’s are exerted on the shoulders.
200 msec.:  Finally, the force of the car seat throws the head and torso forward. Here, 5 G’s are exerted on the head and neck as it whips forwards.  All of this is completed in less than 500 msec.

One of the reasons this occurs has to do with the ability of the car – particularly the back bumper to not deform so that the force of impact is transferred directly to the contents within the vehicle (ie., the passengers).  At higher speeds, the crushing metal absorbs some of the impact and the contents are actually less jostled and thrown about.  This helps explain how a no damage rear end collision can result in greater injury than a higher speed collision.

If you, a loved one, or a friend is struggling with whiplash residuals from a motor vehicle collision, you can depend on receiving a multi-dimensional chiropractic assessment and therapeutic approach at this Advanced Wellness in Marlboro.

Dr. Cilea is president of Advanced Wellness, an integrated practice that offers chiropractic care, physical therapy, pain management, acupuncture and massage therapy.  To find out if you are a candidate for their customized treatment approach call 732-719-8148 or visit www.advanced-wellness.net.

Health Update: Whiplash Part 1

What is the Best Type of Treatment for Whiplash?


Whiplash usually occurs when the head is suddenly whipped or snapped due to a sudden jolt, usually involving a motor vehicle collision. However, it can also occur from a slip and fall injury.  So the question on deck is, which of the health care services best addresses the injured whiplash patient?

This question was investigated in a published study titled, A symptomatic classification of whiplash injury and the implications for treatment (Journal of Orthopaedic Medicine 1999;21(1):22-25).  The authors state conventional medical treatment utilized in whiplash care, "is disappointing."  The authors’ reference a study that demonstrated chiropractic treatment benefited 26 of 28 patients with chronic whiplash syndrome.  The objective of their study was to determine which type of chronic whiplash patient would benefit the most from chiropractic treatment.

They separated patients into one of 3 groups:

Group 1: patients with "neck pain radiating in a 'coat hanger' distribution, associated with restricted range of neck movement but with no neurological deficit."

Group 2: patients with "neurological symptoms, signs or both in association with neck pain and a restricted range of neck movement."

Group 3: patients who described "severe neck pain but all of whom had a full range of motion and no neurological symptoms or signs distributed over specific myotomes or dermatomes." These patients also "described an unusual complex of symptoms," including "blackouts, visual disturbances, nausea, vomiting and chest pain, along with a nondermatomal distribution of pain."

The patients underwent an average of 19.3 adjustments over the course of 4.1 months (mean).
The patients were then surveyed and their improvement was reported:

Group 1                                                                                                          
  
38% Asymptomatic
43% Improved by Two Symptom Grades
13% Improved by One Symptom Grade
6% No Improvement

Group 2
24% Asymptomatic
24% Improved by Two Symptom Grades
24% Improved by One Symptom Grade
28% No Improvement

Group 3
0% Asymptomatic
9% Improved by Two Symptom Grades
18% Improved by One Symptom Grade
64% No Improvement
9% Got Worse

These findings show the best chiropractic treatment results occur in patients with mechanical neck pain (group 1) and/or those with neurological losses (group 2).  The exaggerated group (group 3) was the most challenging and, the only group where a small percentage worsened.  The good news is, the number of cases that responded well to chiropractic treatment (groups 1 & 2) far out number those that don’t (group 3).  Hence, most patients with whiplash injuries should consider chiropractic as their first choice of health care provision.

If you, a loved one, or a friend is struggling with whiplash residuals from a motor vehicle collision, you can depend on receiving a multi-dimensional chiropractic assessment and therapeutic approach at Advanced Wellness Marlboro, New Jersey.

New Headache Study Shows the Benefits of Chiropractic Care by Dr. Joseph Cilea


Headaches are a common complaint in patients presenting for professional care, including chiropractic management. Patients with headaches seek chiropractic care because they find manipulation or adjustments applied to the cervical spine and upper back region are highly effective in reducing the intensity, frequency and duration of the headache pain. This is because the cervical spine / neck, is often the origin of the headache as the three nerves in the upper neck (C1, 2 and 3) pass through the thick, overly taught neck muscles in route to the scalp / head. When the muscles of the neck are in spasm, the nerves get “pinched” or squeezed by the overly tight muscles resulting in headache pain. Each nerve runs to a different part of the head and therefore, pain may be described as “…radiating over the top of head (sometimes into the forehead and eyes),” or, into the head and over the ear, sometimes reaching the temple. Also, an area located in the back and side of the head is the area where the C1 nerve innervates, so pain may also be reported in that location. When more than one of the C1-3 nerves is pinched, the whole side to the top of the head may be involved.

In the October 2009 issue of The Spine Journal, Western States Chiropractic College, Center for Outcomes Studies, reported benefits are obtained with the utilization of spinal manipulation in the treatment of chronic cervicogenic headaches. The word “chronic” means at least 3 months of headache pain has been present. This new study compared 2 different doses of therapy using several outcome measures including the pain grade, the number of headaches in the last 4 weeks and the amount of medication utilized. Data was collected every 4 weeks for a 24 week period and patients were treated 1-2 times/week and separated into either an 8 or a 16 treatment session with half the group receiving either spinal manipulative therapy or a minimal light massage (LM) control group.

The results of the study revealed the spinal manipulation group obtained better results than the control group at all time intervals. There was a small benefit in the group that received the greater number of treatments with the mean number of cervicogenic headaches reduced by 50% in both pain intensity and headache frequency.

The importance of this study is significant as there are many side effects to medications frequently utilized in the treatment of headaches. Many patients prefer not taking medications for this reason and spinal manipulation therapy (SMT) offers a perfect remedy for these patients. Couple SMT with dietary management, lifestyle modifications, stress management, and a natural, vitamin/herbal anti-inflammatory (such as ginger, turmeric, boswellia) when needed, a natural, holistic approach to the management of chronic headaches is accomplished.

We are proud that chiropractic care has consistently scored the highest level of satisfaction when compared to other forms of health care provision and look forward in serving you and your family presently and in the future.

Call Now 732-431-2155