IS THE KINK IN MY NECK A PINCHED NERVE?

Is the Kink in My Neck a Pinched Nerve?

By Dr. Troy Vander Molen, PT, DPT

By far the most common type of neck pain that people experience, especially among those of you who are younger, is described as a “kink” or “crick” in the neck. Often times, that localized area of pain makes it difficult to turn your neck one way or the other. It is, quite literally, a pain in the neck!

neck_pain

Over the years, I’ve had many people consult with me reporting that they have a pinched nerve in the neck, and then they proceed to describe the typical kink in the neck that makes neck movement difficult and painful. While those symptoms are not pleasant, this common type of neck pain is not a pinched nerve.

To be sure, there are nerves that travel through small openings that exist between each vertebral body in the cervical spine (and each set of spine segments traveling down the back). However, if you have a condition that compresses one of those nerve roots, you will likely have distinct symptoms that are different from a kink in the neck.

What causes a kink in the neck?

Most medical providers suggest that a painful kink in the neck is the result of muscle spasms. A leading expert in this type of pain, Dr. Robert Maigne, a French medical doctor, described common neck pain as “painful intervertebral dysfunction.” The intervertebral joint consists of several structures: the disk, the vertebral bones above and below the disk, ligaments that provide structural stability, and the facet joints, which are located both on the left and the right where one vertebral bone connects to the neighboring vertebral bone. Irritation of any of these structures can cause a painful kink and possibly headache pain.Neck-pain-2

In my many years of experience as a physical therapist, I’ve found that the facet joint is often the primary culprit. When a facet joint gets irritated, which can happen from time to time if you move wrong, posture yourself awkwardly, or have some arthritic changes in the neck, a signal is sent to the brain, and the brain will unconsciously respond by telling the muscles around the joint to spasm. This unconscious response is a natural protective mechanism for the irritated joint.

It is important to know that a kink in the neck, though painful, is not dangerous. Most people can relieve the discomfort by modifying the aggravating postures, movement, or activities and applying ice and/or heat. If the pain lasts for more than a few days, consider seeing a physical therapist trained in evaluating and treating neck dysfunction. Early intervention usually results in a short course of care, and you will feel better very quickly in most cases.

What kind of distinct symptoms are present with a pinched nerve?

Our nerves carry critical information between the brain and the body. Some of this information is sensory, which travels from the body to the brain and includes our senses of pain, numbness, tingling, burning, temperature discernment, and pressure sensitivity, among others.

Some of the information carried via the nervous system is motor, which travels from the brain to the body and helps us create voluntary and involuntary muscle actions.

Nerves can potentially be compressed both centrally as they exit from the spine and peripherally by structures like tight muscles that exist external to the spine. Spine-related issues that can put pressure on a nerve as it exits the spine (i.e. central causes) include herniated disks and other arthritis-related changes like narrowing of the disk space, disk degeneration, and bone spurring.

 Interestingly, if you are experiencing a pinched nerve, you may not even experience neck pain at all. Some do; others don’t. What you most definitely will be feeling, however, is pain, numbness, and/or tingling that extends into your arms and even your hands. Sensory changes in the arm are typically the earliest symptoms you will notice with a pinched nerve in the neck.

 Like a kink in the neck, a pinched nerve is not necessarily serious. Most pinched nerves result in sensory changes only and can be easily managed conservatively. I would recommend you seek professional consultation if you experience these types of symptoms. A well-trained physical therapist can help determine the source of the nerve compression and determine a plan of care that will help you eliminate the symptom and restore your function.

If you experience changes in muscle function in your arm and/or hand, like a loss of pinch or grip force or other signs of muscle weakness, the compressive forces on the nerve(s) are more substantial and potentially need more advanced care. Our physical therapists typically refer people with these advanced symptoms to a physician or spine specialist for diagnostic testing to determine the extent of the problem.

If you are experiencing any arm symptoms or simply have a kink in the neck, I encourage you to take advantage of one of our free injury screens. A brief and complimentary 20-minute consultation with one of Kinetic Edge’s movement experts can yield a bounty of solid advice that will put your problem to rest. Please call 866-588-0230 today to claim one of our few open slots.

FREE PAIN & INJURY SCREEN DAY ON OCTOBER 23

Free Screen Day on October 23 graphic

2018 marks our 20th year in business! We’ve been doing all sorts of things to celebrate all year long! In April, we offered our first ever free screen day and people loved it! So since October is National Physical Therapy Month, we’d thought we’d offer one last day of free screens this year to thank you, our valued clients, and continue our 20th year celebration. These free screens are for:

  • All past clients who have not been seen in physical therapy in more than three months
  • All present clients who have another problem currently not being treated
  • All loved ones, family, friends, neighbors and co-workers of our past and present clients.

The day of free screens will be on Tuesday, October 23, 2018 from 7 AM – 6 PM.

Call 866-588-0230 to schedule your free screen.

Your free screen consists of a 20-minute one-on-one appointment with one of our movement experts! That expert will ask you about the history of your problem and then test your strength and how well you move.  After a thorough screening, they will give you a written copy of:

  1. The cause of your pain or problem.
  2. A plan for successful treatment.

The appointments are free but limited as each clinic only has 33 spots available.  Call 866-588-0230 now to schedule your free screen.

This free screen is ideal for people suffering with:

  • Lower back pain
  • Arthritis
  • Sciatica
  • Neck pain
  • Headaches
  • Shoulder pain
  • Knee pain
  • Problems walking
  • Balance
  • Hand pain
  • Wrist pain

If you are having pain or problems with day to day activities such as walking, standing, sitting for long periods, going up or down steps, getting in and out of the car, sleeping or driving, then this is an excellent opportunity to see one of our expert therapists and find out the cause of your problem.

Call 866-588-0230 to schedule your free screen for October 23.

PS – As a special bonus, all people attending a free screen on October 23 will receive a free report: “The Three Culprits that Cause Lower Back Pain”.

PPS – In honor of our 20th anniversary, we’ll also be giving away five free CamelBak water bottles.  These are going to the first 5 people to schedule a free screen for October 23.

IS IT SAFE TO CRACK YOUR NECK?

Is cracking your neck all it’s cracked up to be?

by Troy Vander Molen, PT, DPT

Cracking the neckIf you grew up in my day and age, you might associate “snap, crackle, pop” with the breakfast cereal Rice Krispies. Now, being the age that I am, I’m also beginning to associate that phrase with the sound I make when I move!

Since the dawn of creation, our bodies’ biggest enemies have been time and gravity. As a result of a generation of technological advancements, humans today are being impacted by time and gravity in new and different (and more substantial) ways. Think of the postures encouraged by hours at computer workstations and on our smartphones.

As a physical therapist, I’ve had many clients say that they feel like something needs to be cracked to loosen it up. Usually, my clients are referring to a pain and stiffness somewhere in their spine. The release that occurs with spinal manipulation can be perceived by certain individuals as bringing instant pain relief.

The medical term for the noise you hear when a joint pops is joint cavitation. Within each joint, there is fluid that acts as a cushion for the joint. When movement occurs at the joint, a vacuum is created, and the joint pops as fluid rushes back into the joint cavity. This phenomenon can occur either spontaneously by an individual or intentionally by a licensed medical professional like a physical therapist or chiropractor.

In my experience as a physical therapist, it is most common for people with a stiff neck to seek a quick answer to their problem, but is a “snap, crackle, pop” of the neck a safe and effective thing to do? Will it cause arthritis? Could it be potentially hazardous? Is cracking your neck all it’s cracked up to be?

First, let’s discuss the impact of joint popping on arthritis or joint damage. A 2011 study by deWeber et al published in the Journal of the American Board of Family Medicine found no correlation between knuckle cracking and osteoarthritis. That does not mean that there are no effects from cracking a joint. Dr. Pedro Beredjiklian, Chief of Hand and Wrist Surgery at the Rothman Institute in Philadelphia, PA, indicates that cracking a joint loosens “both its capsule and the surrounding ligaments. And the looser those components become, the more easily your joint will pop.” In other words, the more you crack your neck, the more you’ll feel the need to crack your neck.

Neck PainSometimes you’ll hear horror stories of possible major concerns with spinal manipulation of the neck (i.e. cervical spine). For example, from time to time you’ll hear about a person experiencing a stroke after receiving joint manipulation of the upper neck. While a stroke is a very bad outcome, studies indicate one will occur in as little as one in 6 million upper cervical manipulations. So not only is it a highly unlikely occurrence as a side effect, but also in most cases, it’s entirely preventable when well-trained health care professionals do the appropriate testing before cervical manipulation.

There are people who respond very favorably to cervical manipulation. Dr. Jeff Moore, DPT, a physical therapist and educator in manual therapy techniques, describes that there is a major relay station in the neck that consists of nerves that travel between the head and neck. If you experience one-sided headache pain with neck pain or stiffness, and your symptoms tend to get worse in an upright posture, you are likely to respond well to a manipulation of that region.

Why is that benefit experienced? A review article by JG Pickar in a 2002 edition of the Spine Journal explains the positive effects of spinal manipulation. Techniques that result in “cracking” of the neck create a stimulation can dampen the experience of pain through something known as the gate control theory.

Think of it this way. Imagine you stubbed your toe, a minor but definitely painful experience. Now imagine that you experience another more significant injury, like a broken arm. For a while, you may totally forget about your stubbed toe because the new and more substantial stimulus overrides the original less significant problem. In a similar way, the neurological response to spinal manipulation can momentarily override the pain signals and reduce the pain experience.

At Kinetic Edge Physical Therapy, we believe that spinal manipulation can be a beneficial treatment option for some people, because the current evidence supports its use in specific situations. In fact, the most recent research has shown that exercise and manual therapy together is better at reducing pain and enhancing function than exercise or manual therapy alone. In other words, spinal manipulation can effectively treat a symptom, but it doesn’t solve the root problem.

It is also important to note that spinal manipulation is just one of many types of manual treatment options. To get long-term benefit, the manual treatment doesn’t need to be a manipulation, and it must be combined with a more comprehensive assessment that helps you understand why this area of your spine feels tight.

The best benefits of manual therapy come when the treatment is specifically applied. Each joint has a particular design, so the degree and direction of movement matters. That’s why treatment from a trained professional is much more effective (and safe) than self-treatment.

Inefficient postures can contribute to neck painSo, is it OK if you pop your own neck? If done infrequently, it is probably harmless, but if you find yourself needing to do it more and more, seek professional help from a physical therapist trained in manual treatment techniques. It is likely a symptom caused by inefficient posture, which can accumulate into a more significant problem over time, and a thorough assessment will take into account all the factors that contribute to the pain.

If it hurts to pop your neck, don’t do it! In most cases, no pain occurs when you produce a sound, which means that the tissue involved is most likely to be a soft tissue. However, noises accompanied by pain may indicate joint surface damage, and further assessment by a medical professional is warranted.

If you’ve experienced periodic neck pain and would like to “test drive” our well-trained physical therapists, just call 866-588-0230 to schedule a free screen. For no cost and with no obligation, you might just get the answer you need to solve the root problem once and for all, and you can say good-bye to your personal Rice Krispies!

THE HIDDEN CULPRIT BEHIND YOUR PAIN IN THE NECK

by Dr. Troy Vander Molen, PT, DPT

Pain in the Neck How many times have you woken up in the morning with a kink in your neck? Isn’t it frustrating when you can’t turn your head because of your pain in the neck?

There are many reasons people experience pain in the neck, but irritation and movement limitation at a neck joint (called a facet joint) are very common findings when you have a kink in your neck. Sometimes these pains are short-lived. Other times they can linger. Often, they are recurrent. Usually people experience more frequent, more intense, and longer duration episodes as time goes on unless they find and fix the root of the problem.

If you’ve read our blog before, you won’t be surprised to hear that, like most musculoskeletal issues, this is another situation where the area with the pain is not really the primary problem. The things that hurt are usually simply the areas that experience more physical stress due to another neighboring area failing to do well what it is designed to do.

Figure 1
Figure 1

A commonly overlooked and undertreated area that can contribute to lots of aches and pains – including pain in the neck – is the thoracic spine (Figure 1). Unlike the cervical spine (neck) above and the lumbar spine (lower back) below, the thoracic spine is profoundly different. It has 12 segments and is surrounded by the rib cage which connects to the thoracic spine segments. This cage provides stability and support, as well as protection to vital organs beneath.

The thoracic spine is not designed to move a lot, but the little movements that the thoracic spine can make – and its appropriate posture and position – are critical to the long-term health of neighboring regions like the shoulder and neck above and the lower back below.

One of the body’s biggest enemies is gravity, and the thoracic spine is constantly fighting this tremendous and consistent force. If we don’t maintain our bodies well, the end result of this incessant battle against gravity is that the thoracic spine begins to flex slightly into a rounded curve. This flexion movement is usually coupled with a forward head and a forward shoulder position, which increases tissue loading on the facet joints of the neck, among many other things (Figure 2).

figure 2
Figure 2

So, if you’re currently dealing with neck pain or have experienced it in the past, you could eliminate the real problem and achieve real progress by making sure the thoracic spine is fighting well against gravity and has the necessary mobility to reduce stresses at the neighboring tissues.

So, this month, we are saving some time for those of you that suffer with pain in the neck. We’d love to give you 20 minutes of our time to figure out if your thoracic spine is the real reason for your pain. Unfortunately, we don’t have enough time for all of you. We did, however, save 10 slots in our schedule. Email us or call 866-588-0230 now to claim one before they are all taken up.

HOW TO SOLVE THAT KINK IN YOUR NECK

by Troy Vander Molen, PT, DPT 

As a physical therapist, it’s common for me to work with a person experiencing neck pain. In fact, studies have shown that in one year, between 10-20% of the population will experience neck problems. Research also tells us that only 7% of people with musculoskeletal issues see a physical therapist each year. So, I can easily deduce that there are a lot of people reading this that have experienced neck pain but have never sought the counsel of a physical therapist.

neck-pain-womanI know it is a little daunting making the decision to see a physical therapist, so let me share some key principles that will help you understand your neck and how to care for it.

The neck – formally known as the cervical spine – is made up of seven vertebral segments. The alignment and orientation of the joints that connect each segment (known as facet joints) allows for a lot of rotation movement, which is very important if you are merging into traffic, for example. Overall though, the neck is quite mobile in all three dimensions of movement – rotation, side bending, and flexion/extension.

At times, our necks experience a localized area of pain and soreness. Most of us know what it feels like to have a “kink” in our neck – localized pain on one side that makes turning the head difficult. Why does this occur? Most often it is because one of the joints between cervical segments that guide and control movement has become irritated.

If this occurs to you, here are three great ideas to get rid of that pain:

  1. Push Through the Pressure
figure-2-acupressure-to-the-neck-muscles
Figure 1. Acupressure to the neck muscles

With this type of issue, there are often associated muscle tightness issues, sometimes even trigger points. Use your thumb or fingers of the hand opposite the side of pain and push directly in the middle of the tight muscle (Figure 1). Hold it for about 45 seconds, and follow up with a stretch in the opposite direction. Repeat this 2-3 times to reduce muscle tension and pain.

  1. Monitor Your Posture

Kinks in the neck are usually an indication that your posture is suboptimal. A slouched posture results in upper back flexion, and the neck compensates by falling forward and extending at the upper cervical segments (Figure 2A). Repeat correct posture by sitting tall and performing a chin tuck (Figure 2B), which reverses the faulty posture.

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Figure 2. Chin tuck

 

  1. Use the Blessing of Movement

An often forgotten strategy is using movement to reduce pain and muscle tightness. It is a natural reaction to splint the neck when a kink occurs. Unfortunately, a lack of movement reduces nutrition to the neck joints, and the problem is typically prolonged. Instead, you should move the neck, but be sure to emphasize movement away from the sharp pain. For example, if it hurts to rotate to the right, you should repeatedly rotate the neck to the left to help it loosen up. You can use the same strategy for side bending and flexion/extension. Motion helps drive nutrition to the joint, which helps resolve the problem.

 

If you’ve read any of my articles in the past, you know that I always talk about the neighbors to the area of pain. The neck is no different. Treating your neck pain is different than treating the neck problem. So, if you get some benefit from the aforementioned exercises, it’s because you’ve used strategies to reduce the pain, but you haven’t necessarily eliminated the problem.

 

If you go to a health care practitioner and medications, injections, a chiropractor, taping procedures, ultrasound, surgery, or another treatment that focus on the area of pain, you will likely feel better… at least for awhile. You are also likely to have the issue return because you haven’t found and fixed the root problem.

 

Last month I told you that a majority of the people I’ve helped with shoulder issues have had limited thoracic spine and hip mobility. (Check out that article here.) You might be surprised to find that nearly all of the people I’ve treated over the years with neck pain have a root problem at the thoracic spine.

 

If you’ve experienced recurrent neck pain, I’d encourage you to act now. This month, we’re offering free neck screens, but this offer is limited to only 5 clients at each of our five locations. Email us or call us today at 866-588-0230 to get a complimentary, brief (15 minute), no strings attached assessment with one of our physical therapists to help you understand if your neck needs a little help from its friend, the thoracic spine.

FREE NECK PAIN AND HEADACHE SCREENS

WHEN: June 21, 2018 from 12:00-5:00 PM

WHERE: Kinetic Edge in Des Moines – 516 3rd Street, Suite 100

 Kinetic Edge in Ames – 4700 Mortensen Road, Suite 101

WHY: To get YOU back to pain free living!

Headache1Do you find yourself constantly rubbing your neck? Are you popping pills every day to get rid of your headaches? Do you turn your head with caution as to not disrupt anything in your neck?

Headaches are one of the most common of all physical complaints and can be one of the most frustrating to manage. Tension-type headaches (also called muscle-spasm headaches) are the most common types of headaches in adults. They may be the result of a neck or jaw problem, poor posture, fatigue, or stress.

A problem in the neck, head, or jaw – such as an injury or arthritis – can lead to tension in the muscles at the back of the head and to increased pressure on the nerves to the face and head. Poor posture can cause these muscles to become overworked, which can trigger a headache.

If you are living with neck pain or suffering from headaches on a regular basis, our free neck pain and headache screens are the perfect opportunity for you to get our friendly and knowledgeable movement expert’s insight on how to get rid of your pain permanently! To claim your free 20 minute screen, email us or call 515-309-4706.

 

Pain in the neck: A one-minute test and how to fix it

Neck pain 2Do you find yourself massaging your neck throughout the day? Do you try to move your neck as little as possible as not to bother it? At Kinetic Edge Physical Therapy, we help many people with pain in the neck. In some instances, the pain may travel into the shoulder, elbow, hand, chest, or shoulder blade.  For successful treatment and successful pain relief to occur, we must first find out what is causing the problem.

It is common for physical therapists to first look at how well a person with pain in the neck can move. If you suffer from pain in the neck, take this one-minute test at home to see how well you can move.

PicMonkey Collage 2One-minute test for neck pain: 

  1. Sit up with your back straight in a chair.
  2. Move your head up as far as you can.
  3. Move your head down as far as you can.
  4. Turn your head to the left as far as you can.
  5. Turn your head to the right as far as you can.
  6. Raise your right arm straight up as high as you can.
  7. Raise your left arm straight up as high as you can.

Most people with neck pain will feel limitation or restriction with one of these six movements.  For example, when looking down, many people will feel a tightness at the base of their neck or between their shoulder blades.  When turning the head side to side, it may be much easier to turn one direction than the other. If this happens, this usually means there is hope for successful outcomes with the right physical therapy treatment.

If you felt pain during the one minute test, your next goal is to reduce the pain.  If the pain is reproducible (meaning a movement brings on the symptoms), then there is usually hope.  Good treatment first restores the movement, and good physical therapists use various forms of hands-on treatment to achieve this. For instance, we’ve seen many who have trouble turning their head to the left.  We do a hands-on treatment at their first visit to help restore normal movement and then ask the person to try to turn their head to the left again.  After just one visit, most people will notice better movement and less pain. If we have done this, we have helped address the source of the problem.

So now what?

Perform the one minute test at home.  Note any tightness, pain, tingling or limited motion you have. If you have limited motion and would like to find out how to reduce your pain, please call us to schedule a free Kinetic Screen to see if physical therapy is right for you.

  • Pella: 641-621-0230
  • Des Moines: 515-309-4706
  • Oskaloosa: 641-676-3535
  • Newton: 641-791-9675
  • Ames: 515-337-1037

If you had discomfort or difficulty moving with any of the tests from above and want to learn some simple exercises for neck pain, simply email us telling where you experienced the problem. We’ll send you a simple home exercise that is specifically designed to help you move better, feel better, and function better.