Most people suffering from chronic spinal pain and arthritis-in-neck discomfort have heard the terms disc degeneration, joint degeneration, or spinal arthritis.

Even though it sounds scary, terms like "joint degeneration" and "spinal arthritis" really do not tell us much besides the fact that the spine is deteriorating. The number one question is why is it degenerating, and can that process be stopped? Joint degeneration or arthritis is a natural process the body endures as we age. However, we want to slow that process down as much as possible.

There are a few situations that will advance the degenerative process of arthritis in neck and spine at an increased rate. One is obviously trauma. Any acute trauma to the spine will speed up the joint degeneration process if the spinal segment affected is not properly treated and normal joint motion is not regained. Another is repetitive stress or repetitive micro trauma. Any joint that is chronically stressed beyond normal functions will naturally degenerate at a faster rate than normal. Finally, the number one cause of joint or disc degeneration is abnormal joint motion. Like I mentioned before, abnormal joint motion is similar to the front end of your car being out of alignment and the tires wearing abnormally. The same thing happens in a joint with abnormal motion or alignment. The joint will wear abnormally and become arthritic.

The key to determining if joint or disc arthritis is due to age or external factors, is best determined by radiographic examination. Basically, if every joint is in the same phase of degeneration or arthritis, then it is considered an aging process. If only a select few joints or discs are degenerated when compared to the entire structure, such as the experience of arthritis in neck not evident lower in the spine, then those degenerated segments are a result of something other than age.

Therefore, in order to prevent disc or joint degeneration, the spinal arthritis must first be correctly examined. Once the cause of degeneration is determined, it must be properly corrected to prevent further degeneration, and possibly future surgical correction.

Neck pain is a common problem in society today.

Stiff Neck Pain

More often than not, stiff neck pain is a result of posture. With over 70% of occupations being “desk” jobs, the steady rise of stiff neck pain cases is expected. Obviously, cervical spine conditions lead to or contribute to other conditions such as; headaches, carpal tunnel like symptoms, etc. However, I am going to focus on neck pain only. Even though these cases sound simple, there is a substantial level of complexity to properly diagnose neck pain.

Lets start with the basics; pain is always the result of a pain generator, so it is essential to determine the sources that cause neck pain. Research has revealed that inflammation is the number one pain generator by a long shot. Therefore, the primary focus to treating neck pain is to determine the source of inflammation. Once the source is determined, the proper treatment can be administered. Inflammation can be a result of multiple conditions including the following:

• Discogenic syndromes, which involve damage to the intervertebral discs located between each vertebrae.
• Joint imbrication, which involves compression or jamming of the joints between the vertebrae, and neuritis, which is nerve root irritation at the spinal level.

Things That Cause Neck Pain

Some other sources that cause neck pain include:

• muscle contracture
• arthritic degeneration
• chronic stress
• vitamin deficiency
• acute injury

Once the inflammatory cause is discovered, then and only then can the symptoms/condition be treated properly at the source.

By treating the source of stiff neck pain or severe neck pain, patients will receive long term benefits rather than periodic medical symptom treatment. In the majority of these cases, chiropractic manipulation, along with other therapies, is the most conservative treatment.

Severe Neck Pain

However, the severity of each condition could possibly warrant a more invasive treatment. In order to prevent more invasive treatment for severe neck pain, cervical spine pain cases must be addressed and treated without procrastination. If these conditions are not addressed as soon as possible, they will progressively deteriorate leading to a more extensive and costly solution.

In the last entry I discussed the anatomy of a herniated cervical disc, so here I will not go into much detail on that specifically, but focus instead on what is involved in bulging disc treatment.  Disc injuries can be very complex in nature, and need to be appropriately diagnosed at a back pain clinic to determine the correct treatment.  The most important concern with these cases is nerve, nerve root, or spinal cord contact or compression.  If an MRI reveals compression of one of these structures and the correlating symptomatology is present then surgical intervention must be considered as long as all conservative resources have been exhausted.  However, surgical correction should be a last resort.  Some conservative treatments to consider are spinal rehabilitation, chiropractic, spinal decompression/traction, and exercise (core strengthening).  

By far, the best treatment for a herniated cervical disc or disc injury is to diagnose it at an early stage so that the cause of the herniation can be corrected.  This will prevent further disc damage that eventually leads to more aggressive bulging disc treatment like surgical intervention.  

Research has proven that a healthy spinal segment (two vertebrae and disc in between) will not alter or damage unless excessive external force is applied.  Basically, what that means is that a healthy spinal disc should not herniate with any force or movement applied by the individual.  The majority of the time, however, you will hear of an individual that twists, sneezes, coughs, lifts an object, or performs some other routine action,  and it resulted in a disc injury.  But with the above research, it is also proven that these injuries are not normal, and signifies that the spinal joint segment is weak.  This weakness is what enables herniated cervical disc injury.  

Here is a common example I had a patient today in his mid 40’s that bent over to pick up his newspaper and could not stand back up, compelling him to find a back pain clinic and his subsequent trip to my office.  An examination and MRI proved his lumbar spine disc bulge.  Now, the disc certainly did not bulge because the newspaper was too heavy. His herniated cervical disc was a result of a weakness or instability at that spinal level.  The instability made him more prone to injury.  

Even a monkey could diagnose a herniated disc, but it is a more complicated matter to discern the cause for it and to know the correct bulging disc treatment to apply.  The best treatment approach is to further determine what caused the herniated disc, and if that causation  is correctable.  If the case is correctable, this will prevent further damage to the disc and prevent the case to becoming a surgical case in the future.

So if you have a bulging disc that needs treatment, go to a back pain clinic, like Village Chiropractic, that can diagnose and address the source of the problem. Bulging disc treatment is more involved than merely focusing on the bulging disc.

Cervical disc herniation is a common spinal problem with today’s society.  The condition itself has about as many different names as the number of people it affects.  Some of the common ones are disc bulge, slipped disc, disc protrusion, sequestered disc, disc prolapse, disc tear, etc.  In addition to the many different terms used to describe a cervical disc herniation, there are a variety of treatments available.  The treatments, however, are case-specific.  They vary depending on the severity of the disc injury, symptoms associated with it, and the effect on the peripheral or central nervous system.  

To determine what is the best treatment option, it is important that you understand the biomechanics associated with a spinal disc, and the process of a disc injury.  

First, let’s start off with the basics.  A spinal disc is located between two vertebral bodies.  It acts as a shock absorber between the vertebra above it and the vertebra below it.  The disc is circular with a viscous fluid center called the nucleus pulposus and an outer ring-shaped portion called the annular fibrosus, which is similar to the consistency of cartilage.  Envision that a disc’s inside is like jelly, and the outside is like a hard rubber.  

Now that you understand the anatomy of a disc, let’s talk about the disc injury.  Disc bulge happens when the outside “hard rubber” portion “bulges” out.  This bulge alters the normal shape of the disc from primarily circular, to circular with an additional semi-circular portion at a particular location.  As long as the outside “hard rubber” ring does not tear, the “jelly” material will stay contained within the disc.  However, if it does tear, it leads to a cervical disc herniation.  This is where the “jelly” actually leaks out slightly from the disc tear.  If the “jelly” leaks out and separates from the inner disc contents, then it is called a sequestered disc.  

Let’s review: there are three different primary disc injuries.  A disc bulge, a disc herniation, and a sequestered disc.  Each of them have varying degrees of complexity.  The primary reason is because the disc is located in close proximity to the central nervous system (i.e. spinal cord) and peripheral nervous system (i.e. nerve roots exiting the spinal column, sciatic nerve roots, etc.).  Because of the sensitivity of the surrounding nervous system, a disc injury can cause anything ranging from pain to actual muscle atrophy.  If the injured disc contacts or irritates a part of the nervous system, it must be addressed properly to determine the appropriate treatment.    

Headaches affect 99% of people at some point in their life, and chronic, debilitating headaches affect 62% of people.  Therefore, headaches everyday are a common complaint in our clinic. In order to properly diagnose and treat a headache, it is obviously important to understand the mechanism of a headache.  

Essentially, the pain noted with a headache is due to swelling, expanding, or dilation of a blood vessel in the brain.  When the vessels expand, they irritate nerves surrounding the vessels, which are transmitted and interpreted by the brain as pain.  However, the cause of vessel expansion is the most important variable that must be discovered to treat a headache.  

First of all, there is one very important thing to remember.  The majority of headaches have at least two triggers, if not more.  Triggers that directly or indirectly lead to the dilation of the vessels in the brain.  The more common triggers include; allergic response, spinal tension, hormone fluctuation, nutrition, temperature, and blood flow and viscosity.  Like I stated earlier, the majority of headaches have at least two triggers.  For example, a female may be experiencing cervical spine tension, and not have a headache.  However, once her hormones begin the increase due to her monthly cycle, hormonal headaches are triggered.  Another example would be if a person is having an allergic response to pollen, but has no headache until they become dehydrated and the viscosity of the blood increases, causing an allergy headache.  

The most common contributing factor to headaches is spinal tension.  I am not saying that most people with spinal tension will have headaches.  I am just saying that the majority of people with headaches have spinal tension as a contributing factor.  I have noticed through my experience that by removing one or more of the contributing factors, the frequency and intensity of headaches can be drastically reduced.  Since most headaches have spinal tension as a contributing factor, if this spinal tension can be resolved, the headache symptoms will decrease, even if there is another contributing factor like hormones or allergic response.  

Therefore, to properly treat headache symptoms, the triggers or contributing factors must be determined, and at least one of them eliminated. Headaches everyday, whether they be hormonal headaches, an allergy headache, or a headache caused by any number of other reasons, require getting to the root of the cause, and treating it.