If you have ever been to a doctor’s office and had an x-ray performed, you have likely heard about something called spinal degeneration. Spinal degeneration is a condition in which the discs and joints of the spine begin to narrow and often form bone spurs. You may have even been shown a poster with the stages of spinal degeneration on it, and asked to pick which stage you are in.
You compared yourself to one of these images, and identified yourself within one of the various phases of spinal degeneration. Maybe you felt confused. Maybe you felt alarmed, perhaps even a little scared. Either way, you knew that your neck probably didn’t look like the “normal” neck, and that you had work to do.
How Bad is it Really? No one likes to be told that their spine is developing arthritic degeneration. It’s a sign that the days of our youth are fading, and a reminder that our bodies are not going to last forever. Everyone will develop some level of spinal degeneration as we get older. Regardless of whether someone has a lifetime of chiropractic, supplements, positive mental attitude, etc, we cannot stop discs from breaking down or bone spurs from forming. Once people get into their 40’s and 50’s, we expect to see some degree of degeneration in the spine. Are there those in their 70’s without it? Sure. But those are OUTLIERS, and we don’t make predictions based on a handful of outliers. With that being said, here are some quick facts to know about spinal degeneration.
1. Degeneration ≠ Pain – One of the things that really frustrates me is when someone tells a patient that they are going to live with chronic pain because they have spinal degeneration.
While many people with degeneration do have spinal pain, an OVERWHELMING MAJORITY of people with degeneration have no pain what so ever.
While a lot of people with pain have some level of spinal degeneration, that doesn’t mean that spinal degeneration is the CAUSE of their pain. I’ve seen thousands of patients with massive spinal degeneration, and many of them will get better despite the fact that their degeneration has NOT CHANGED. We have to resist being trapped within a diagnosis, especially if that diagnosis has a high degree of inaccuracy.
2. Your Spine Isn’t Going to Fuse (Probably) – some patients have come to me with concerns that a doctor told them that their spine is fusing. This is always something that raises my eyebrows because there are less than a handful of situations where you would expect the segments of the spine to fuse together. I took an x-ray on one of these patients and all that was visible was moderate disc degeneration. A very common finding on x-ray, and nothing to get very alarmed about. They were under the impression that their spine would be fused together within 5 years if they didn’t get this fixed.
This is absurd for a couple of reasons:
1. Vertebra don’t fuse as they degenerate. Discs will get closer together to where there’s minimal space, but regular degeneration WILL NOT turn into a fused vertebra. They are completely different things.
2. We have NO idea what the time table is on degeneration. None. Nada. Zilch.
Except in cases of certain disease processes (i.e. – ankylosing spondylitis), this is nothing but fear mongering.
Degeneration, Not Death Sentence
Degeneration can be a problem for some patients. Loss of hydration in the disc, and lack of movement in the spine can create problems for the brain and nervous system. Time and again, I’ve seen patients who have been told that their problem is related to arthritic knees, hips, and spines, respond really nicely to Structural Correction. Even without seeing any change to the degenerated joint.
If the arthritis were the sole problem, then no one with spinal degeneration would ever get better. Degeneration is a sign of a breakdown process, but it’s not usually the cause. We need to be freed from these self-defeating labels that hold us back from living the active and healthy lifestyle we all deserve. If you’ve been told that your pain or problem is because of arthritis or degeneration, it may be time to get another opinion.
If you would like to have your nerve system checked for its Structural integrity, a consultation to discuss your concerns may be a great place to start. Find out where to go from here by contacting our office at 248-287-8700
you suffering because of age, or might it be something deeper?
“Don’t get old, you end up like this”
“That’s just because of old age”
“See, this is why you shouldn’t get
These are some of the most common
phrases that I hear when people talk about the pain they’re having. Most of the
time, they’re being said by someone in their early 40’s; which is just more than
half of an American’s lifespan (78 years of age: 2012). It’s spoken as if
Father Time had a magic shot that make a person start experiencing pain and
arthritis completely out of the blue when they hit nature’s halfway point.
Let’s take a look at it for a
second. When most people talk about the pain of getting old, they’re usually
referring to a cascade of problems that’s lumped into the name Arthritis.
We’re talking about the joint shrinking version known as osteoarthritis, and
not the hot and burning inflammatory arthritis. Osteoarthritis is usually used
to describe any one of these problems: degenerative joint disease, degenerative
disc disease, spondylosis, bone spurs, and spinal canal stenosis.
Let’s take a look at one example:
This is the x-ray of a spine from a
side view. This is a person in their late 50’s or early 60’s with neck pain and arm pain for the past year. The
yellow arrows are pointing to areas that have severe degenerative disc disease,
estimated 40-50 years of breakdown. When these badly degenerated discs were
pointed out to them, guess what was said?
“Oh, those are just due to old age”
Now, of course there will be wear
and tear on the spine of a 60 year old person. There’s no question about that.
But the extent of damage to the area of the spine is substantial. Now the
interesting thing is this, how old is the healthy disc of the spine?
That’s a trick question of course,
because all of the discs are the same age. If this problem was strictly a
matter of aging, wouldn’t you expect every single disc to have similar levels
the truth, this person did not have a problem of age; they had an aging
There are definitive problems with
the structure of this person’s spine. When a structural problem happens into
the spine, 2 things can happen:
The biomechanics of the spine become distorted and
accelerate the wear and tear of the joints. Think about what happens to
your car when the tires are improperly aligned. Would you expect the
steering wheel to pull to one side? Would you expect one tire to wear out
on one side faster than the other? Would you expect the ability for the
tire to hold air to be different from side to side? The same thing happens
to the joints of the spine too!
The structural shift will distort the signals going in
and out of the brain. As the spine shifts, the spinal cord and spinal
nerves will misfire into the brain. This misfiring causes the muscles of
the spine to tighten and spasm, and create dysfunction to anywhere where
those nerves travel.
Those are the facts. Here’s where
things get tricky. This person had a problem in their spine for upwards of 50+
years. However, they did not show any signs of pain until the past year. What
Problems in the spine can be left
undiagnosed and unidentified for several years. Research shows that many of us
have herniated discs in the spine, and out of
those people 60% of you will feel no symptoms. Thus, a problem
that should be of primary concern can be wreaking havoc on the body
without us knowing it.
With that said, these problems are
almost always preventable. With proper exercise and proper postural awareness,
you can save years of wear and tear on the spine, and maintain full function of
the delicate nervous system. As with anything else, it’s always important that
you protect the parts of your body that you hold most dear through routine checkups.
We always find time to check our
blood pressure, cholesterol, eyes, and of course your teeth.
When was the last time the structure
of your spine was checked?
people are familiar with the image on the top. An image of a lowly
iceberg. It looks so simple to simply steer around and bypass it on
the way to smoother seas.
if our past was a good teacher, then we know that by only paying
attention to the surface, we can miss a dangerous obstacle
in the depths.
bodies are equipped with an incredible array of signals to let
us know that something is wrong. Sometimes it comes in the form of a
pain in the back, draining
or chest pain. The purpose of these signals is to tell us that
something is wrong, but it’s up to us to look within to identify
long as we continue to exist in a healthcare system that only seeks
to reduce symptoms, then we will continue to get the same results as
those who only saw the tip of the iceberg.
we look towards the body’s healing capacity, and why it’s not
operating at 100% full function, then we are missing the boat on the
health challenges of millions of people. And there’s no amount of
drugs, natural medicine, surgery, or insurance money that can save
that ship from sinking.
What’s a Normal Headache?
This is truly one of the more frustrating things that I hear is when someone tells me about their “normal headache”.
From a physiology standpoint, it would seem silly for the human body to make head pain a normal part of body’s day to day functions.
How do you know what type of headache you have? What type of treatments are best for each headache? We’ll break all of that down today.
These are the most common headaches, and what most people classify as a “Normal Headache”. This type is known for having a band like compression around the temples, forehead, or back of the head. Many people call this a stress headache because it is exacerbated by a person’s response to stressful situations. These headaches are typically mechanical in nature (tight muscles, associated with neck pain)
There is a lot of variation in the duration and intensity of this type of headache. Even though the pain can become severe (as high as a 8 or 9/10 on the pain scale), the lack of neurological symptoms imply that the nature of the headache has a different origin.
Most people control these headaches with massage, over the counter medications, and conventional chiropractic to provide short-term relief. Things like Yoga and stress management techniques are also popular treatments.
A severe headache is NOT the same as a migraine. It’s important to recognize this because the nature of a migraine headache goes beyond mechanical dysfunction. Migraines are characterized by abnormalities in blood flow to the brain, which creates some distinct neurological symptoms. Most migraines feature:
Sensitivity to light
Aura and other visual disturbances
Pins and needle sensation
Post headache hangover
Treatments usually go beyond over the counter medications.
Of course there are several other types of headaches. Things like cluster headaches, sinus headaches, and trigeminal nerve pain fall into the spectrum of common headaches. Another emerging class of headache include those that come from chronic use of pain medication, which has led to a search for new drugs or non-drug therapies to try to manage this common debilitating problem.
The truth is, because headaches are experienced differently by so many people, it might be best to figure out where headaches have a commonality.
The Craniocervical Junction and the Trigeminal Nucleus
The craniocervical junction is a fancy term for where the head meets the neck. A tremendous amount of research is going on in this part of the body because of how big a role it plays on the brain and overall neurology. One of the things that they have found is that this part of the body has a big influence on a part of the spinal cord called the trigeminal nucleus.
The trigeminal nucleus is where the nerve cells exist that provide innervation for head, neck, face, jaw, the brain’s outer covering, and the blood vessels of the brain. Here’s a surprising fact:
The brain itself does not feel pain
When you feel pain in your head, it is coming from brain’s outer covering called the meninges, and the blood vessels. All of these structures feed into the trigeminal nucleus and this piece of anatomy tells our brain what it should feel.
In the world of Chiropractic we find that symmetry of the cervical spine matters. When you lose your normal structural symmetry of the spine, then the trigeminal nucleus is less likely to work properly. That’s why headache patients usually respond so quickly to this unique type of care.
Of course it may not help every person with headaches. The truth is that headaches can be affected by tumors, chemicals, and even food for some select cases. However, a gross majority of the population’s headaches are likely secondary to a structural shift of the head and neck.
Pain after a car accident can be very strange and confusing. Take a look at
these examples and tell me if this reminds you of a situation that you or
someone you know.
Person A: Healthy and fit 37-year-old man in a car and
gets hit at 45 mph+. The impact drives his car into the car in front
causing extensive damage.
Person B: Healthy and fit 29-year old woman. Sitting in
line in a parking lot when another car runs into the back of her at 10 mph or
less. Minimal damage to the car and wore a seat belt.
Which one do you think had a worse whiplash injury and had pain immediately
and which do you think just had soreness that they wanted to get checked
Both had substantial biomechanical changes on their x-ray and MRI, but only
one had a significant amount of pain immediately after the incident.
If you guessed that Person B with the parking lot bumper tap had the most
pain, then you win! Congratulations!
The Deceptive Nature of Pain
Pain is one of medicine’s greatest tricksters. To this day, researchers and
scientists don’t have a strong grasp on the nature pain disorders.
Why is it tricky? Because the pain someone feels isn’t
necessarily related to the amount of damage in the body. Patients
with fibromyalgia have crippling pain despite not having any visible damage to
Pain is the most important factor to a patient, but it can be the most
deceptive factor to a clinician. When it comes to taking care of people after
an accident, we have to measure a patient’s function
regardless of their pain status.
Happens to the Neck After an Accident?
Insurance companies will only
consider it an accident-related whiplash injury if you see a doctor within
14 days of the accident. So if you have no pain after the accident or the pain
wasn’t bad enough to drive you to a physician until day 15, then you didn’t
have a whiplash (I know how silly it sounds).
But going back to the previous
example, we know that both Patients A and B had biomechanical flaws as a result
from trauma to the spine. Despite the fact that there were 2 very different
accidents and 2 different pain statuses, there are similarities in what can
happen to the neck even after the smallest collisions. Take a look at the video
below which simulates an accident less than 10 mph.
Happens to the Neck in an Accident?
After watching the video, you can
get the impression that a collision at just 5-7 mph causes rapid movement of
the head and neck.
Despite the fact that your body is
encased by a 2 ton metal box, it’s easy to see that even though the vehicle
stops moving, there is still a transfer of energy into the body. When you’re
wearing your seat belt, it causes a rapid deceleration of your body, but your
head will continue to move forward and backward very rapidly.
In fact, a large enough force to the
neck can actually produce a concussion even if there’s not direct contact to
the head! These accidents would need somewhere around 90 G’s of force to the
While that would cease to be a small
accident, the smaller 10 mph accidents can produce 3-5 G’s of force which is
enough to damage the tissues of the neck. The way your head accelerates and
decelerates can put 3-6 G’s of force into the cervical spine. This force gets
transferred into the ligaments, muscles, discs, and joints of the neck more
than any other piece of anatomy.
While the body can tolerate large
amounts of force in brief periods, a large amount of force applied to a small
region of anatomy as seen in a car accident can damage the tissues of the neck.
Ligaments are like the rubber bands
of the spine. They can be stretched, but once they stretch too far, they can’t
go back to normal again. As ligaments are damaged, scar tissue is used as a
patch, but it’s not as functional as the stuff you were built with.
Just like when you sprained your
ankle as a kid and that ankle never worked the same, damage to ligaments of
your neck can happen the same way. Fortunately, true sprains of the neck take a
lot of force and don’t happen with most accidents.
When muscle works beyond its
capacity, or gets stretched beyond its end range, it forms small tears within
the muscle belly. That’s why there’s no consensus as to whether you’re better
off knowing about a coming accident and bracing, or if you’re better off being
Either way, damage to the muscle
tissue can happen depending on the nature of the collision.
Muscle strains can be painful, but
they can and do heal with time. Strain to muscle tissue is one of the most
common sources of pain from whiplash injuries and resolve well with
chiropractic and exercise.
Accidents are one of the most common
ways that people under 30 can suffer herniated discs in the spine. When the
force of an accident overcomes the resistance of the disc material, small tears
in the disc can result in the inner fluid spilling into the spinal canal.
Sometimes this results in a pinched
nerve, but most of the time it does not. A disc problem doesn’t have to be a
big problem. Many people have disc damage and have no idea because it’s not
The muscles, ligaments, discs, and
nerves of the neck help dictate the Structural Positioning of the spine. The
force of an accident can deform one or all of these tissues leading to abnormal
positioning of the head and neck.
This leads to abnormal neurological
input to the brain and what manifests as poor posture (slouching, head tilt, antalgic
lean). While poor posture is not the problem that needs to be treated, it’s an
objective sign of a nervous system is operating at less than its full capacity.
That It’s Not About Pain
Remember at the beginning of the
article we talked about how pain can be deceptive. The reason I wanted to point
that out is because you can experience damage to all of the above structures
and not feel an immediate onset of pain. Pain is just tricky like that.
Whether you feel immediate pain or
not, your neck should always be evaluated even after minor accidents because it
gives the earliest and best opportunity to correct a silent problem.
1. Significant injuries occur at low-speeds.
2. Women suffer greater injuries than men because they have less strength in their neck muscles.
3. Early mobilization is critical. Use of a cervical collar actually gives worse results than no treatment at all. Immobilization following injury causes muscle wasting and loss of strength that significantly delays recovery. Corticosteroids damage articular cartilage & decrease collagen strength & repair. Early mobilization improves healing & repair of bone, cartilage, ligaments, & tendons. It also improves joint proprioception, which helps to prevent early joint degeneration.
4. Most whiplash injuries are occult and cannot be identified on conventional imaging such as x-ray, MRI, or CT scans.
5. The peak inflammation associated with whiplash is located around the C2 vertebra and is the most common origination of headache symptoms. The C2/C3 facet joint in particular is the cause of cervicogenic headache 53% of the time.
6. The severity of vehicle damage is not predictive of injury or outcome. Stiffer vehicles actually increase the probability of long-term consequences because the forces get focused on the head & neck. A more accurate predictor of outcome is if the injured person experiences acute neck pain within the same day of injury. These people are 3x more likely to report chronic neck pain 7 years later. Also of note, younger people generally have a better prognosis & require less treatment.
7. Upper Cervical spine is most injured when head & neck are in flexed & rotated position at time of impact (e.g. looking at cell phone or child in back seat).
8. Whiplash patients are 5x more likely to suffer from chronic neck pain compared to control population.
9. Whiplash patients are at a significantly increased risk for premature disc degeneration. Most common site of disc injury is C5/C6.
10. Cervical range of motion is the most important indicator of physical impairment. It has proven to be 90% accurate in diagnosing people with whiplash symptoms. Flexion and extension are usually the most impaired movements.
11. Over 90% of whiplash patients under chiropractic care showed notable improvement over a 6 month period of care. Chiropractic treatment has been shown to be 5x more effective than Celebrex or Vioxx within 9 weeks of treatment. Chiropractic care has also been shown to have a 2x greater success rate than standard medical care, and a significantly higher success rate than Physical Therapy. Some measured markers include less work absences and less reliance on pain medications. Passive joint motion is superior to active exercise therapy.
12. In order to get the best therapeutic outcome, treatment must be initiated within the first 3 months following whiplash injury. Recommended guidelines for acute or sub-acute recovery with treatment ranges from 2 months to 2 years, with a mean of 7 months. An appropriate initial treatment frequency is 2-3 x per week for the initial 10 weeks of care.
Migraine headaches are among the most debilitating and dreadful neurological problems that exist. They may not be fatal, but the effect on someone’s quality of life can be dramatic. Imagine having days where the sight of light cripples you. Imagine having terrible nausea, and a constant pounding in your head so bad that you wish that someone would just cut the darn thing off your neck. Imagine that pain lasting for hours or even days at a time.
You probably already know that feeling, and you’ve almost certainly been in the same room as someone going through a migraine attack. Fortunately, most people experience a migraine on rare occasion. However, there are those among us that experience these terrible headaches several times a month, and others even experience them on a DAILY basis.
This is the typical life of a chronic migraine patient in my office. Many times these patients have seen several headache specialists. They’ve seen the best neurologists that the Mayo Clinic and Cleveland Clinic have to offer, and have been through every MRI and brain scan available. They’ve tried several different medication regiments, altered their diets, and spend their lives in fear of triggers like meat, wine, and sometimes caffeine.
Many have even tried alternative therapies like acupuncture and conventional chiropractic with no change.
When they finally sit down and speak with me, they’ve been suffering for years, and almost numb to the fact that they have constant pain in the head. Some look a little pale, others need the lights off in the office, and some even come in wearing sun glasses. All of them are a little doubtful and skeptical that their condition can be cured.
Less Focus on Cure, More Focus on Cause
When most people walk into a doctor’s office with an ailment, what they are most often searching for is a cure. Though migraines are terribly common, and have been around for centuries, a cure has been elusive for the millions of patients suffering on a daily basis. Over the counter migraine medications are usually a first line of treatment, followed by prescription medications. There is also a focus on removing triggers from a person’s life like chocolate, caffeine, and certain scents/perfumes.
The truth is that headaches (especially migraines) cannot be treated as a simplistic disease that is the same in all people. Headaches are a dynamic entity with causes that are multi-factorial. Instead of looking at a migraine as a disease entity, it should be seen as a symptom of a neurophysiological process gone haywire.
The Trigeminocervical Complex: The Pain Gate Keeper of the Head/Neck
Don’t get hung up on the terminology, the name is not important for the casual reader. It is important to understand that near the top part of your spinal cord. In the area surrounded by your top 3 neck vertebra is a very important bundle of nerve cells. These specific nerve cells filter incoming signals from the outer covering of the brain known as meninges. They also filter incoming signals from the blood vessels of the brain, as well as signals that come from the neck.
You see, the brain does not have any receptors that trigger pain. It’s kind of crazy to think about, but it’s true. However, the outer protective covering of the brain, and the blood vessels are very pain sensitive. When the receptors from these structures get set off, then a cascade of events can take place leading to the blood vessels in the brain opening up and becoming inflamed.
It’s important that we have ‘filters’ like the trigeminocervical complex around to make sure that not every pain signal gets to the brain. In that way, it acts like a gatekeeper. If it let every pain signal through, you would be in a state of pain without end.
So what went wrong with the built-in gate keeper of pain to the brain?
The normal alignment and movement of the head and neck serve as a buffer to pain signals that go into the gate keeper. When you lose the normal alignment, several things can happen.
Blood flow in and out of the brain is compromised
Inflammatory molecules stay in the brain’s blood supply longer
Muscles and ligaments of the neck misfire
Low grade inflammation persists in the joints of the neck
Small muscles in the neck may pull against the brain’s outer covering
When this happens, you have an environment where the trigeminocervical nucleus can get overloaded with pain signals without the buffer of signals from normal head and neck movement. All of a sudden, a seemingly harmless trigger can send someone with a tendency towards migraines can be sent in a downward spiral of a pounding headache.
Correction not Cure
Our focus is on correcting the Structural positioning rather than curing migraine headaches. The truth is that Structural Correction has benefits that go beyond treating or curing a specific illness or disease. Correction of Spinal Displacement does one thing, and only one thing:
It mobilizes the self-healing, self-restoring potential within your own body.
If we believe that our bodies were meant to be healthy, pain-free, and vibrant, then we must only find what is inhibiting the body’s self-healing potential.
“Doc, I know that you can help me get better, but what can I do on my own to keep this problem from coming back again?”
Almost everyone who comes to my office want to know what they can do to protect their neck from shifting into a bad position again, and one of the most important things someone can do to protect their neck is to create an optimal position for sleep.
Why is sleep important? Aside from the obvious benefits it has on mood, energy, healing, and overall longevity, the way we sleep also impacts the structural integrity of the spine. Just think about it, most of us spend almost 1/3 of our lives sleeping, and that time is often spent in one of a few postures.
In fact, I’ve seen numerous patients tell me that their problem began upon waking, or that they think that their problem began because they slept funny. The fact is that a prolonged period in a structurally poor position can affect the neck and affect the neurovascular tissues that travel through the neck. This can lead to Secondary Conditions like torticollis, neck pain, headaches, and back problems.
So how do we protect our neck and the nerves that pass through it? These tips should get you off on the right foot.
There are 3 primary positions, and sub variations around that.
Stomach Sleeping – Avoid it:
If you haven’t been told already, stomach sleeping without a specialized pillow can put your neck in too much twist in your neck.
Just try this. Turn your head to your right. Now keep it there for an hour.
I bet that sounds pretty terrible. Now think about how that must feel to have your neck sitting like that for 6-8 hours by the time you wake up.
Stomach sleeping also puts the spine in a hyper-extended position which can also lead to back pain on rising.
Side sleeping is a position where almost anyone can get their spine into a neutral position. It allows thelumbar, thoracic, and cervical spine to line up in one plane when the correct pillows are used.
A pillow between bent knees helps keep the pelvis neutral, while a head pillow should be high enough to support the neck, but not be so high that it pushes the neck upwards like you see on the right.
Side sleeping can cause shoulder pain on the side of the low shoulder. This can be corrected by laying on the shoulder blade rather than the arm itself.
Sleeping on your back is probably the easiest way to protect your neck. However, it is associated with higher incidences of snoring and sleep apnea. Back sleeping can also be excruciating for someone suffering from acute low back pain. If this is the case for you, then a side sleeper may be your best resort.
What Pillow Do I use?
EVERYONE wants to know about pillows. It’s almost like they’re looking to justify buying $100 pillow as long as it’s approved by their doctor.
What’s the best brand? Does it need to have contours? What should it be made of? Water? Foam? Feathers?
While I do make specific recommendations for my patients in the office, the truth is that the brand and material matter far less than what the pillow is looking to accomplish.
Pillows should comfortably support the structure of your spine. If your head feels jammed or you feel too extended, then you are not getting the necessary support.
Any conversation about investing in a pillow should involve measurements of your head and neck so that your pillow fits your specific anatomy (it keeps your spine inline when lying down). The material should be hypoallergenic and supportive for long term use. That will usually leave feather based pillows out of the conversation, which they are shown to increase discomfort in pain patients.
Side sleepers – Side sleeping puts your shoulder distance between the head and the bed. Alarger pillow with firmer material is best to support the head and reduce cervical strain.
Back sleepers – Sleeping on your back puts a small distance between the head and the bed. A thinner pillow is usually helpful here. However, if you have severe Anterior Head Syndrome, than a flat pillow may be very uncomfortable and force too much hyperextension. Measurement is key to address your pillow concerns here, but correcting the anterior head syndrome will require a chiropractic approach.
While this may not solve all of your sleep dilemmas. It’s a fast and easy way to start getting better sleep today.
I’m sure you see it almost everyday. Whether it’s the fidgety co-worker who likes to hear all of his joints pop, or the guy on the plane that’s been rubbing his neck all day.
It’s the serial neck popper. They look straight out of the warm up scene of a martial arts movie, sound effects and all. While most will cringe and bite their tongue when they see it, the serial neck popper looks more focused and at ease. In fact, if their joints were capable of it, these people might pop it more often. It might even be you.
“It feels so good, how bad can it be?”
Some of the people who come into my office for care used to be serial neck poppers. Emphasis on the words “used to be”. One recommendation for people when they get their first adjustment is to avoid popping or cracking their neck. There’s usually a look of defeat on their face when the recommendation is given. The truth is that one of their greatest sources of relief from neck discomfort was actually the very thing that was making their problem a chronic issue.
The loose ligaments, and uncontrolled forces from self-manipulation prevent this neck from staying in place.
The x-ray on the right is an example of someone who spends a lot of time popping their own neck. He had no history of a car accident, sports injury, fall, or trauma. However, he has been popping his neck aka, self-manipulating multiple times per day for years.
The green line represents the center point where a person’s head and neck should line up. The red line represents how the patient’s head and neck currently line up in their “normal” seated position.
The level of displacement is not hard to see. In fact, most of you would probably notice someone like this who always holds their neck off to the side.
Though he always feels his neck is very tight, the neck tends to be very floppy without a strong degree of stability. Even after several corrections, his neck will continue to have a tendency to slip towards the side until the ligaments tighten up and heal.
So what exactly happens when you self-manipulate?
Despite popular belief, there is nothing insidious about the popping sound made by joints. The classic crunching sound that you hear, and is stereotyped with chiropractic has nothing to do with broken bones, or rubbing bones against each other. The sound comes from tiny gas bubbles within the fluid that lubricates your joints. When the joint opens up rapidly, these bubbles get released and pop causing those sounds.
It’s more like opening a can of soda than the crunching of a bone. If your neck or back cracks here and there with normal movement, it’s not a cause for concern most of the time.
The sound is ultimately not the problem. What truly is a problem is the way the thrust affects the spine.
In recent years, there have been videos, articles, and books that teach people how to adjust themselves. Now bear in mind, the neck is one of the most sensitive and important pieces of anatomy in the human body. So people are being taught to manipulate their neck without regard for the following factors:
1. Risk factors – Does your neck have disc bulges or protrusions? Are there plaques or anatomical malformations? Some of these risk factors are susceptible to rotation/twisting forces in the neck. Many of these problems can be identified and planned for with a proper examination, but without one, how do you know?
2. What is the current structure of the spine? – How is the spine currently aligned? Do you know which direction puts you into a better position? Are you moving the right vertebra? Are you pushing the vertebra into a worse position than it already is?
Our office uses x-rays to identify these malpositions. Can your own hands measure precise alignment in your neck?
3. Constant Manipulation = Loose ligaments = Poor Stability – Every time you manipulate your spine, you are causing ligaments in the spine to stretch like a rubber band. When you stretch a rubber band enough times, it eventually loses it’s shape and becomes less stable. Your ligaments work the same way. If you keep pounding on your neck with self-manipulation, your neck eventually becomes a sloppy mess like the x-ray above.
When people have ligament instability, it leads them down the road where they depend on manipulation to keep feeling good. Not a good situation, and a big reason chiropractors get a bad rap for getting people “addicted to adjustments”.
So what now?
When choosing a chiropractor, it’s important that they are actually measuring what they are doing to the spine. Almost any chiropractor is able to make someone feel better with manipulation. Manipulation sends a rush of feel good signals into the brain. However, a Structural Chiropractic approach is more than about feeling better in the moment.
It’s about restoring your spine and your nervous system to a state of Normal. A normally functioning spine has the ability to heal and maintain itself without relying on constant manipulation.
That’s why the procedures we perform in our office is truly about fixing the problem and getting it to stay fixed. Many times, these corrections can be performed without any rotation or twisting of the spine. It’s very gentle, and very effective.
Self-manipulation, while a temporary rush and feel good sensation can create hyper-mobility and long term structural problems in the neck. Additionally, it’s easy to become addicted to that feeling, and make your body dependent on constant manipulation to feel normal. In our world, we call that getting “hooked on the crack”. There are just too many questions about what can happen when you self-manipulate. It just doesn’t make sense to do something likely harmful for a few minutes of temporary relief.
of the most common and troublesome problems is a condition known as
Temporomandibular joint dysfuction, or TMD for short. In fact, many
of you may have heard someone talk about their TMJ or having TMD, but
didn’t quite know what it was.
involves the joint that connects your jaw to your head. Proper
movement of this joint is critical to proper function. It has a
profound affect on people because dysfunction of that joint can cause
a variety of problems including:
to open the jaw properly
has rapidly become one of the more common reasons for visits to a
neurologist and pain clinics, because of the dramatic impact that
this sensitive piece of anatomy has on a person’s quality of life.
Many times, this condition is treated with medications. In some
cases, muscle relaxers or injections to the joint.
does this have to do with the neck?
search of PubMed will show numerous references for increased
incidence of TMD in conjunction with a whiplash injury, or head/neck
trauma. A systematic review of
these papers show that people with whiplash/head injury actually have
more severe pain and more pronounced dysfunction of the joint.
Another review showed
that just treating the TMJ in these whiplash related cases poor
outcomes suggesting that the cause of the problem may be outside the
joint itself. The whiplash associated cases showed just a 48%
improvement compared to the non-whiplash cases which improved 75% of
the time. That leaves a huge amount of people who are still in pain
and suffering because the primary insult to the body was not
usually comes in 2 varieties:
Muscular dysfunction – the muscles of the jaw (pterygoids,
masseter, temporalis) become hypertonic and dysfunctional creating
painful musculature and sloppy movement.
Articular dysfunction – the joint itself can have problems.
Dislodging of the disc, arthritic degeneration, and inflammation can
irritate the very sensitive nerve endings that cover the joint.
much can be done about arthritic breakdown of a joint. However, this
is a less common cause of TMD. The most common causes of TMJ problems
stem from muscular imbalance and dislodging of the articular disc. In
a way, these two problems are intimately related. When you have bad
jaw muscles moving the jaw abnormally, then it leaves more room for
the articular disc to shift out of place.
what can make these jaw muscles dysfunctional? To know that, we have
to know what controls the muscle. Every muscle in your body is
controlled by a nerve. Whether it be a big bulky bicep, an achy sore
back muscle, the blood pumping heart muscle, and the food digesting
the jaw muscles, a special nerve called the Trigeminal Nerve emanates
from the skull and provides innervation for the face, jaw muscles,
teeth, brain, and other important structures. (as seen in the above image)
trigeminal nerve is one of twelve specialized nerves called Cranial
Nerves. The unique thing about Cranial Nerves is that they do not
exit out of the spine. They actually begin come out of the brain and
the brainstem, and exit out of the skull. Therefore, a problem with
one of the cranial nerves is usually indicative of a problem at the
Cervical Displacement, Whiplash, and the Brain Stem
of the reasons that our office gets referrals is because of how Cervical Displacement impacts
the health and function of the brain stem. While the top of the neck
doesn’t apply direct pressure to the brain stem, the movement and
function of the neck has large implications for this important piece
someone has an episode of whiplash, there can be substantial damage
and injury to the neck, but the more concerning portion is what
happens to the nervous system. A phenomenon known as Central
Sensitization occurs. This problem happens when the brain stem fires
inappropriately to the limbic system (controls the basic emotions (fear, pleasure, anger) and drives (hunger, sex, dominance, care of offspring)) and reticular activating system
(the places where pain is interpreted in the brain). When this
happens, even the slightest touch or movement can trigger a pain
sensation in the brain.
is why many doctors can find no physical damage to the body, but
people will suffer with chronic pain issues like fibromyalgia. People recognize this quickly when the pain is stemming from the
neck, shoulders or back, but the reality is that this same thing is
happening in the jaw muscles.
get to the root of someone’s problems, we have to evaluate this
critical, but under studied part of the nervous system.
Structural Chiropractic address this?
1. Restore healthy biomechanics to the spine –
create a state of Normal Structure in the neck so that the proper
signals get to the brain.
2. Increase circulation through the brain –
proper alignment ensures that blood to and from the brain stem
properly. Proper blood flow means better nerve firing.
3. Restore health biomechanics to the jaw –
Once the neck alignment is restored, most of the time the jaw will
reset on it’s own. However, sometimes gentle jaw adjustments may be