Dr Davis' Back & Wrist Pain Blog

Chiropractic Treatment for Neck Pain

We have been providing treatment for neck pain in San Francisco for over 21 years now. In fact, neck pain is one of the most common conditions we treat. Our chiropractic clinic is located in the SF Financial District so most of our patients spend the majority of their day in front of a computer, mostly in a static position.

This puts tremendous pressure on the structures in the neck such as the cervical spinal joints, muscles, ligaments and tendons. What happens is the head has a tendency to move forward towards the computer screen as we do our work. The neck muscles react and adapt and have to work much harder than they should. This forward head posture (FHP) also puts abnormal stresses on the neck bones predisposing them to Vertebral Subluxations, which is the term chiropractors use to describe what we treat.

Subluxations in the neck are a combination of misalignment of the cervical spine, abnormal or restricted cervical motion, cervical muscle spasms, pressure on the cervical nerve roots, and loss of function. There may or may not be neck pain.

Chiropractors can tell if you have subluxations in your neck by checking your posture, your cervical range of motion, your muscle strength of your upper extremities and grip strength, as they are controlled by the nerves in the neck, the reflexes and sensation in the upper extremities, and any tenderness or swelling around the cervical vertebrae. 

Once a chiropractor determines you have vertebral subluxations, also referred to as "Pinched Nerves", they will make a determination of how long the problem has been there so they can grade it. This can be done by taking an x-ray of the neck to check for spinal degeneration, loss of neck curve, thinning of the disc, and anterior weight bearing of the skull on the spine. X-rays are not always necessary but are a very useful tool if indicated. 

Chiropractic means "done by hand". So most chiropractors will use their hands to correct subluxations and all it's components. This is usually done on a chiropractic table or bench and there are hundreds of variations of this. The object is to re-align the cervical spine, restore neck joint motion, reduce muscle spasm, swelling and inflammation, take the pressure off the spinal nerves, and restore lost function such as lost grip strength.

And yes, of course...if there is neck pain or neck, shoulder, and arm pain or headaches, your chiropractor will want to rid you of this as soon as possible. The good news is...as the cervical subluxation corrects the neck pain subsides.

How long will it take to fix my neck pain?

Well, this depends on how long the problem has been there, your age, your level of spinal degeneration, your adherance to the treatment recommendations, your stress level, your diet, your exercise frequency, your work schedule, etc. Chiropractors take all this into consideration and depending on the chiropractors technique make recommendations that make the most amount of sense for you.

Some chiropractic doctors such as us, incorporate exercises into the treatment process or massage or deep tissue laser...but the main course is always the chiropractic adjustment.

So there you go. Done by hand 100% natural chiropractic for neck pain. It just makes sense. 

To schedule an appontment for neck pain treatment in San Francisco please call 415-392-2225.

Dr. Eben Davis is founder and clinic director of Executive Express Chiropractic.

San Francisco Chiropractor Review: Neck Pain

Our "Patient of the Week" is Temple Terkildsen. Temple came to our clinic with severe and excruciating neck pain that was interfering with her home and work life. After a few days of trying to gut out the pain, she decided to venture to our clinic to have her neck looked at.

The pain was so severe that with each step she took it felt like someone was stabbing her in her lower neck and upper back. After just a few visits with stretching, massage, and chiropractic care she knew she had made the right decision and was on the road to recovery. Temple has now regained almost full function and control of her life again. We are so happy she chose us to help her in her time of need We are SO proud of you Temple!

Chiropractors are able to fix conditions such as severe neck pain in a short period of time by addressing the cause of the problem. In Templ'e case she had a pinched nerve in her neck with was causing muscle spasms, inflammation, pain, and loss of function.

In cases like this pain pills, muscle relaxers, cortisone, or even exercise will not address the cause. Now that Temple is feeling better we have incorporated exercises into her treatment program to strengthen the injured neck muscles and prevent the problem frome reoccurring.

To schedule an appointment with a neck pain doctor in San Francisco call 415-392-2225. Mention this chiropractor review and receive a complimentary ice gel pack (Value $20).

Serving zip code 94111 for over 20 years

San Francisco Chiropractor Review: Neck and Back Pain

The Executive Express Chiropractic "Patient of the Week" is Sarah McCullough. Sarah came to us with sharp pinching pain in her neck and upper back. The pain was so bad she came to the office before we opened hoping someone would be there to help her.

Luckily we were there! Through a series of treatments including chiropractic adjustments, stretching, exercises, and massage, Sarah has experienced significant relief. She sought us in desperation but now returns for convenience. We are located near her work and make it easier for her to receive care.

Sarah now realizes that regular chiropractic adjustments are the perfect antidote for long hours in front of the computer. 

Most of the patients we treat at our Embarcadero Center location work in the Financial District in high stress work environments. It does not take long for stress to build up in the muscles which can pull bones of the spine out of alignment and pinch nerves in the neck and back.

If this condition is left undetected and uncorrected it can lead to spine and disc degeneration, as well as bulging and herniated discs.

Regular chiropractic adjustments can prevent this from happening and allow your body to function at optimum levels.

To find out if you are a candidate for care at our San Francisco Chiropractic Clinic call 415-392-2225. Mention this blog post for an office tour and complimentary consultation.

San Francisco Chiropractor Review: Neck Pain

The Executive Express Chiropractic San Francisco "Patient of the Week" is Melissa Kirby. Melissa presented to our clinic with constant, severe neck and shoulder pain for which she could find no relief. At the recommendation of a friend, Melissa decided to try out our San Francisco Chiropractors and see if we could help. Melissa had never been to a chiropractor and was very apprehensive.

Well, it has been several weeks now and Melissa reports that her neck pain and her shoulder pain are much better. Melissa is able to sleep better at night, concentrate at work, and exercise once again.

Melissa looks forward to her spinal adjustments and is especially fond of the warm-up massage and stretching that is done before hand. Melissa is looking forward to becoming pain free and plans on continuing on with chiropractic as needed for spinal maintenance and overall well being.

To schedule an appointment with one of our chiropractors in San Francisco call 415-392-2225.

Serving zip code 94111 for over 20 years

Neck Pain and Your Pillow

The relationship between neck pain and your pillow is more important than most of us realize! Though we all may have at one time or another slept on a variety of surfaces, and used any number of pillows (flat, medium, bulky) made of different materials (foam, feather, air, water, or memory foam), it’s usually not until neck pain and/or headaches start to become an issue that we start to think, “…how important is my pillow?” Thankfully, the question has been addressed in a randomized peer-reviewed study. So, what did they find out?

            The goal of a pillow is to support the neck more so than the head. In a study headed by Dr. Liselott Persson, MD, of the department of neurosurgery at the University of Lund in Sweden, researchers tested whether specific neck pillows have any effect on neck pain, headache and sleep quality in people suffering with chronic (>3months), non-specific neck pain. They also researched whether there was an optimum or “best” type of pillow that was preferred by their 52 patient group. They used 4 different pillows, 1 “normal” pillow and 3 of which were specially designed, each having a different shape and consistency. Over a 4-10 week time frame, the pillows were randomly distributed to the neck pain group who then graded them according to comfort, the effects on neck pain, sleep quality and headache using a questionnaire, and also described the characteristics of an “ideal pillow.” Researchers and participants concluded the “ideal pillow” (for reducing neck pain and headaches and improving quality of sleep) includes a soft pillow with good support under the neck’s curve (lordosis).

            There are many styles of contoured cervical or neck pillows that vary considerably. This study supports the use of a specially designed style over a normal pillow. So what are some of the things to look for? First, consider your neck’s length and girth.  When you look in a mirror, do you have a neck that is short vs. long or, narrow vs. wide? This will direct you to a pillow that has a larger “hump” for your neck to be cradled in if it’s a long neck and, the height of the hump – taller for the slender neck or, shorter for the wide neck. Some pillows have 2 options of “hump” sizes (located on the long edges of the pillow) – one short and flat and the other side taller and wider. Others recommend lying in the middle of the pillow if you’re a back sleeper vs. lying on the edge of pillow when sleeping on your sides. A measurement taken from the neck to the point of the shoulder determines if the pillow should be a small, medium, or large. Water filled and/or air filled pillows can be varied by the amount of water or air added. The bottom line of which is “best” is based on comfort and support. Regardless of which you choose, it can take several days to get used to the new pillow, so we recommend using the pillow for at least 1 week. By then, you’ll know if you chose the right style. 

            We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

We sell Tempur-Pedic pillows at our San Francisco Chiropractic Clinic. We do this because we believe it is the best all around pillow and offers great value. However, it's not a bad idea to visit a store where they have a variety of cervical pillows so you can try them out and see what feels most comfortable.

In the SF Bay Area we recommend Relax the Back Store.

To schedule an appointment with one of our San Francisco Chiropractors for a complimentary cervical pillow demonstration call 415-392-2225 or just stop by during open hours (9-6 M-F, 9-1 Sat).

Dr. Eben Davis

 

What Causes Neck Pain and What Exercises Help?

Seventy percent of the population will experience severe neck pain at some point in their lives. Many will become chronic, whereby the neck pain persists for over 90 days.

It’s safe to say that if you haven’t had neck and/or shoulder pain, you probably will. Like low back pain, there is a statistical increase in probability that once you’ve had neck pain, the chances of having another episode are significantly increased. A recent study reported that over a 12-month period, 16-18% of the population studied complained of neck and shoulder pain and each year, medical care was obtained by 21-38% of that same group. Moreover, 13-21% lost work time because of their neck and/or shoulder pain. The study reported there was a “…strong episodic nature…” as this condition was found to frequently come and go. Neck pain can arise from a number of structures including muscles, ligaments, bone, joint capsules, and more. Typically, a patient presenting with neck pain is treated for a few weeks and is then quite satisfied with their result… until the next time. Unfortunately, there is usually, “…a next time.” So, the question is, what can we do to prevent neck pain or its re-occurrence?

When considering the many causes of neck pain and the high rate of recurrence, one common finding in those with this popular “come and go” neck/shoulder pain pattern is weakness of the deep flexors muscles located in the front of the neck. One reason for this common finding is that it is very difficult to strengthen the deep, intrinsic muscles of the neck as they are “involuntary.” That means, we cannot consciously “flex” or purposely contract our deep neck flexor muscles. Also, the larger extrinsic muscles tend to be too tight and by reflex, “turn off” or, inhibit the deep neck flexor muscles, compounding the problem.

Therefore, in order to exercise them, we must “trick” the deep muscles into contracting without contracting the larger, extrinsic muscles. This can be accomplished by doing a very specific, controlled exercise with our neck by laying on the back with a partially inflated blood pressure cuff (or, by using a special device purposely made for this test and exercise) placed behind the neck. The inflatable bag is pumped up partially to about 20mmHg and then in a VERY controlled manner, we tuck in our chin and flatten our neck pressing into the bag raising the pressure by 2mmHg and holding that steady for 3-5 seconds. This is repeated in increments by pushing down a little harder until the gauge reads 24mmHg and again, holding that for 3-5 seconds. This pattern is repeated 5x or, until you reach 30mmHg and the process is then reversed releasing the pressure in 2mmHg increments at 3-5 second holds until you reach 20mmHg again. Sound easy? Not quite!!! This exercise requires “fine motor control” to accomplish the task and most of us haven’t specifically addressed these fine moving muscles and end up only exercising the larger extrinsic muscles by doing traditional neck strengthening exercises, which further inhibits the deep neck flexors. 

Note: Most reading this other than doctors and therapists will not have this piece of equipment. You can work the deep neck flexors doing the exercise in the video above on a firm bed, exercise bench, or on the floor. We recommend you ice before and after.

The first time you try this, you’ll be amazed at how challenging and tiring it is. But, after a few days of performing the exercise, you may find you feel much better!  Of course, this depends on the degree of injury one has, but often, once cervical spine stability is improved by strengthening these deep neck flexors, symptoms usually improve. So, the question is, can we achieve good deep neck flexor strength by doing a more practical, upright position exercise rather than requiring a costly apparatus that requires a laying down position?  In a recent study, a standing exercise where a similar movement called, a “neck-lengthening maneuver” was performed producing similar results as the laying down exercise (relaxation of the strong, extrinsic – outside - muscles and strengthening of the deep neck flexors). Simply tuck in the chin and stand tall, “lengthening” your neck!

Chiropractic adjustments, massage, and low tech exercises such as the ones many chiropractors prescribe will help prevent and treat most neck pain.

            We realize that you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

To schedule an appointment for neck pain treatment in San Francisco call 415-392-2225

 

Chronic Neck Pain Treatment and Chiropractic

We have been providing chiropractic treatment for chronic neck pain in San Francisco for over 20 years. 

Over 70% of Americans will experience neck pain at some point in their lives. Many will develop chronic neck pain, which is neck pain that persists for over 90 days. The primary risk factor for developing chronic neck pain, is previous neck pain. This is why it's so important to get the right kind of treatment at the onset of neck pain.

 

Chronic neck pain can have many causes. Here are a few:

• A Bulging or Herniated Disc in the Neck: This can cause pressure on the nerve leading to what we call a "Pinched Nerve". Some patients experience pain down the arm and into the hand.
• Spinal Stenosis: This is a narrowing of the spinal canal from spinal degeneration. Often times the patient will notice that certain positions or activities cause neck, shoulder, or arm pain.
• Degenerative Disc Disease: Often times the neck pain will come on gradually, and get worse over time. Certain events may trigger pain, such as activities that are out of a patients normal baseline. Even stress can trigger pain.
• Osteoarthritis in the Neck Joints: Arthritis in the neck joints can cause pain that is worse in the morning and better in the afternoon or as the day progresses. Exercises often help.
• Vertebral Subluxation: This is what chiropractors call a vertebrae that has lost it's normal relationship with the one above and the one below and is not functioning properly. This can lead to pain and dysfunction and all of the above.

There are other causes of neck pain...and there are many triggers, such as poor posture at work, bad sleeping habits, sports injuries, too much stress, too much computer use, iPad, cell phone, etc. Traveling is also hard on the neck. Heck, working in your yard, playing with your kids, painting, working on your car, in your garden, or doing anything you do don't normally do...can all set the stage for neck pain, that can eventually become chronic.

So what's the solution...What is the best treatment for chronic neck pain?

According to recent research (see news story about chiropractic for neck pain), the best treatment for neck pain is chiropractic and low tech exercises. This is exactly what we do at our San Francisco Chiropractic Clinic...and frankly, it's what the best chiropractors do. 

We prefer to do the exercises at the clinic at the time of the chiropractic adjustment, and at the same time provide the patient with neck exercises and stretches they can do at home and at work. 

We also incorporate soft tissue methods such Active Release Techniques (ART) and Graston Technique to break up scar tissue, muscle spasms, and adhesion's. This in conjunction with chiropractic adjustments and low tech exercises is very powerful.

We are also concerned with educating our patients on proper ergonomics, sleeping position and use of a cervical pillow. It is also important to learn about things like micro-breaks, which are brief resting periods when working...this is a good time to stretch. Proper hydration is important too...this keeps the joints lubricated. Supplementation can help as well. Pharmaceutical Grade Fish Oil can help reduce inflammation in the joints, as can a diet loaded with fruits and vegetables. Everything matters.

If you would like to find out if you are a candidate for neck pain treatment in San Francisco, call 415-392-2225. Mention this article for a complimentary consultation.

Serving zip code 94111 and surrounding areas for 20 years

Neck Pain, Headaches, and Poor Posture

Neck pain is one of the most common complaints for which patients present to our San Francisco chiropractic clinic. Headaches are also another very common problem and often go hand-in-hand with the presence of neck pain. So, the question that is frequently asked is, “…why do headaches and neck pain often travel together?”

            There are many types of headaches, some of which we have discussed previously with migraine and tension-type headaches being the most common. This article will focus on how headaches and the neck are related to each other and what YOU can do about it.

            The relationship between neck pain and headaches is strong! In fact, in some cases, headaches will occur ONLY when the neck hurts. One reason is because the first three nerves that exit out from the top of the cervical spine (C1, 2 and 3) have to travel through the thick group of muscles that insert onto the back/base of the skull along the occipital rim. Because we carry a lot of stress in the neck muscles, when they tighten up, they squeeze or pinch those 3 nerves and pain then radiates into the back of the head and sometimes up and over the vertex to the eyes or behind the eyes. If you take your fingers or thumb and push firmly into those muscles at the very top of the neck or base of the skull, it often feels, “…like a good hurt.” This is because they are usually tight since most of us carry our head too far forwards (forward head posture or FHP) and the muscles have to contract and constantly work to keep the head from gliding even further.

            So, what can YOU do about it? Let’s talk about a few GREAT posture retraining exercises. Tuck in your chin to the point where the voice changes pitch (your voice will start to sound “funny”). At that point, release the chin slightly so the voice clears and stay in position! That is the posture or head position of choice. Initially, it will be very difficult to remember to hold that position very long because your muscles (and brain) aren’t used to it and, you’ll slip back into the old forward head carriage habit or chin poke position. So, be patient with yourself because it takes about 3 months of constant self-reminding to, “…keep that chin tucked,” before this new “habit pattern” is formed in the brain.

We like to have our chiropractic patients perform these posture exercises at the clinic to make sure they do them and are doing them properly. Once learned these exercises can help counteract hours of poor posture at the computer.

            Another great exercise is an “offshoot” of this, where you tuck the chin in as far as you can (making a double or triple chin) holding that position for 3 seconds, and then tip the head back as far as you can without releasing the chin tuck and hold for another 3 seconds. Repeat this 2-3x / “set” and perform this multiple times per day.

            A 3rd great exercise for improving the forward head carriage posture is performed by lying on your back on a bed so that the edge of the bed is at the middle of the neck and head is dangling off the bed. Take a tightly rolled up towel (a hand size towel works well) and place it under the neck so that is resting on the edge of the bed so that your head can fall back towards the floor. Take some deep breaths and concentrate on relaxing all your neck muscles. Periodically, slowly rotate your head left to right, right to left, and “feel” the different muscles stretch as you do this. If you can afford 15 minutes, that’s PERFECT! But, if you only have a few minutes it’s still GREAT!

            Between maintaining a chin tuck upright posture and retraining the curve in your neck with the head hang off the bed exercise, you’ll feel (and look) much better! 

A cervical pillow such as Tempur-Pedic, can also help to restore and maintain the curve in your neck. 

            We realize that you have a choice in where you choose your health-care services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

To schedule a complimentary consultation for headaches and neck pain treatment in San Francisco, call 415-392-2225 and mention this article. 

Related Articles:

How Poor Workstation Posture Causes Neck Pain and Headaches

Chiropractic and Migraine Headaches

How Stress Causes Headaches

The Best Exercise for Forward Head Posture

Serving 94111 zip code and surrounding areas for 20 years

 

How Many Adjustments Do I Need For Neck Pain?

We have been providing neck pain treatment in San Francisco for over 20 years now. During this time we have learned much. The most important thing we have discovered is that everybody is different and needs to be treated as such.

For instance...you may have two 35 year old men present with neck pain from sitting at a desk too long...one of them gets better after a few chiropractic adjustments, the other takes 10. That's just the way it is.

Sure, we make treatment recommendations based on a patients age, exam findings, and cases we have treated that are similar, but still, as we get into the treatment each case responds differently.

Chronic neck pain...which is neck pain that has persisted for 90 or more days complicates things further. Now we are talking about pain that is deep rooted. The nervous system has been re-wired because of the chronic neck pain and other parts of the spine and body are compensating.

Typically, chronic neck pain can take several weeks to many months to fully resolve. Chronic neck pain is usually the result of repetitive stress or injuries that have not healed properly, such as a sports injury or whiplash. Headaches can develope as well as shoulder and arm pain...even low back pain as the body adapts to the neck pain and abnormal motion and function.

So...how many adjustments you need for your neck pain will vary on all the above.

The good news is that chiropractors deal with all these scenarios on a daily basis...it's what we do. And after 20 years we have seen a lot...enough to know what to do and what not do do. When it comes to neck pain it's best to get chiropractic adjustments right when you feel the pain. The last thing you want is for your neck pain to become chronic.

My recommendation...see a chiropractor ASAP after any kind of injury to the neck, such as a whiplash from an auto accident...or a sports injury...or if you sleep funny or work too hard. And get checked for misalignment's to your neck periodically...say once per month.

If you take care of your spine it will take care of you...and nobody needs a pain in the neck!

Dr. Eben Davis is clinic director of Executive Express Chiropractic in downtown San Francisco.

For an appointment with one of our San Francisco Neck Pain Doctors call 415-392-2225

Serving zip code 94111 and surrounding areas since 1992.

 

Is Manipulation Best Treatment For Neck Pain?

We have been providing treatment for neck pain in San Francisco for over 20 years now.

Mechanical neck pain affects an estimated 70% of people at some point in their lives. Many different treatment approaches are available for neck pain, making it very difficult for those suffering from neck pain to know which treatment approach(es) to choose. Research in this topic has revealed some very interesting information that places chiropractic and spinal manipulation in a VERY STRONG POSITION – in fact, at the TOP OF THE HEAP!

            One such study looked at benefits of spinal manipulative therapy (SMT) in patients with acute and subacute neck pain. This study compared three study groups: 1. SMT only, 2. medication only, and 3. Home exercise and advice (HEA). This study randomized 272 neck pain patients suffering from neck pain for 2 to 12 weeks into a 12 week treatment period using 1 of the 3 treatment approaches tracking the results with the participant-rated pain as the primary treatment outcome measure. Secondary outcome data was obtained from other approaches. The results showed that the group treated with SMT, “…had a statistically significant advantage over medication after 8, 12, 26 and 52 weeks. HEA also had a statistical advantage over medication. Lastly, similar benefits were calculated between the SMT and exercise group. The conclusions support SMT and exercise/advise to be the choice over medication for acute and subacute neck pain patients. Regarding exercise, a similar study showed that “high-dosed supervised strengthening exercise” with and without SMT, was superior to a “low dose home mobilization exercise and advice group at 4, 12, 26, and 52 weeks.”

            Regarding chronic neck pain patients (that means pain that has been present for greater than 3 months), this study evaluated the changes that occurred in 191 patients. These patients were randomized to 11 weeks of 1 of 3 treatment groups and evaluated at 3, 6, 12, & 24 months after treatment. The 3 treatment options included: 1. Spinal manipulative therapy (SMT) only, 2. SMT with low-tech neck exercises, or, 3. A form of exercise using a MedX rehab machine. The results support the highest level of patient satisfaction was found in the 2nd group (SMT with low-tech exercise), suggesting that when patients present for treatment, spinal manipulation with low-tech exercises results in the most satisfied patient (this is what we do at Executive Express Chiropractic). These findings are important as this study evaluated the LONG-TERM benefits in patients who have had neck pain for a long time (i.e., “chronic”), where most studies only look at the short-term benefits.

            Similar conclusions were reported from perhaps the largest scale study on neck pain based on research from 1980 to 2006 on the use, effectiveness and safety of noninvasive treatment approaches for neck pain and associated disorders. Their review of over 350 articles supported manual therapy (manipulation and mobilization) and supervised exercise to again, SHINE in their conclusions.

            What is important is that ALL these studies support what chiropractors do: manipulate the neck and give supervised exercises! So, what are you waiting for? SPREAD THE WORD to everyone that you know who has neck pain – CHIROPRACTIC MAY BE THE BEST CHOICE!!!

            We realize that you have a choice in where you choose your health-care services.  If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

To schedule appointment with a San Francisco Neck Pain Doctor, call 415-392-2225. Mention this blog post for a complimentary consultation.

Related articles:

The Neck-Migraine Connection

Neck Pain Study: Chiropractic and Exercise Beats Drugs