Your neck, also called the cervical spine, begins at thebase of the skull and contains seven small vertebrae.Incredibly, the cervical spine supports the full weight ofyour head, which is on average about 12 pounds. Whilethe cervical spine can move your head in nearly everydirection, this flexibility makes the neck very susceptibleto pain and injury.

The neck’s susceptibility to injury is due in part to bio-mechanics. Activities and events that affect cervical bio-mechanics include extended sitting, repetitive move-ment, accidents, falls and blows to the body or head,normal aging, and everyday wear and tear. Neck paincan be very bothersome, and it can have a variety ofcauses.

Here are some of the most typical causes of neck pain:

Injury and Accidents: A sudden forced movement ofthe head or neck in any direction and the resulting“rebound” in the opposite direction is known aswhiplash. The sudden “whipping” motion injures thesurrounding and supporting tissues of the neck andhead. Muscles react by tightening and contracting, cre-ating muscle fatigue, which can result in pain and stiff-ness. Severe whiplash can also be associated withinjury to the intervertebral joints, discs, ligaments, mus-cles, and nerve roots. Car accidents are the most com-mon cause of whiplash.

Growing Older: Degenerative disorders such asosteoarthritis, spinal stenosis, and degenerative discdisease directly affect the spine.• Osteoarthritis, a common joint disorder, causes pro-gressive deterioration of cartilage. The body reacts byforming bone spurs that affect joint motion.• Spinal stenosis causes the small nerve passagewaysin the vertebrae to narrow, compressing and trappingnerve roots. Stenosis may cause neck, shoulder, andarm pain, as well as numbness, when these nerves areunable to function normally. • Degenerative disc disease can cause reduction in theelasticity and height of intervertebral discs. Over time, adisc may bulge or herniate, causing tingling, numbness,and pain that runs into the arm.

Daily Life: Poor posture, obesity, and weak abdominalmuscles often disrupt spinal balance, causing the neckto bend forward to compensate. Stress and emotionaltension can cause muscles to tighten and contract,resulting in pain and stiffness. Postural stress can con-tribute to chronic neck pain with symptoms extendinginto the upper back and the arms.

Chiropractic Care of Neck PainDuring your visit, your doctor of chiropractic will performexams to locate the source of your pain and will ask youquestions about your current symptoms and remediesyou may have already tried. For example:• When did the pain start? • What have you done for your neck pain? • Does the pain radiate or travel to other parts of yourbody?• Does anything reduce the pain or make it worse?

Healthy LivingPatient Information from the American Chiropractic Association

Conservative Care of Neck Pain

Healthy LivingConservative Care of Neck Pain

Your doctor of chiropractic will also do physical andneurological exams. In the physical exam, your doctorwill observe your posture, range of motion, and physicalcondition, noting movement that causes pain. Your doc-tor will feel your spine, note its curvature and alignment,and feel for muscle spasm. A check of your shoulderarea is also in order. During the neurological exam, yourdoctor will test your reflexes, muscle strength, othernerve changes, and pain spread.

In some instances, your chiropractor might order teststo help diagnose your condition. An x-ray can show nar-rowed disc space, fractures, bone spurs, or arthritis. Acomputerized axial tomography scan (a CT or CAT scan)or a magnetic resonance imaging test (an MRI) canshow bulging discs and herniations. If nerve damage issuspected, your doctor may order a special test calledelectromyography (an EMG) to measure how quicklyyour nerves respond.

Chiropractors are conservative care doctors; theirscope of practice does not include the use of drugs orsurgery. If your chiropractor diagnoses a condition out-side of this conservative scope, such as a neck fractureor an indication of an organic disease, he or she willrefer you to the appropriate medical physician or spe-cialist. He or she may also ask for permission to informyour family physician of the care you are receiving toensure that your chiropractic care and medical care areproperly coordinated.

Neck AdjustmentsA neck adjustment (also known as a cervical manipula-tion) is a precise procedure applied to the joints of theneck, usually by hand. A neck adjustment works toimprove the mobility of the spine and to restore range ofmotion; it can also increase movement of the adjoiningmuscles. Patients typically notice an improved ability toturn and tilt the head, and a reduction of pain, soreness,and stiffness.

Of course, your chiropractor will develop a program ofcare that may combine more than one type of treat-ment, depending on your personal needs. In additionto manipulation, the treatment plan may include mobi-lization, massage or rehabilitative exercises, or some-thing else.

Research SupportingChiropractic Care

One of the most recent reviews of scientificliterature found evidence that patients withchronic neck pain enrolled in clinical trialsreported significant improvement followingchiropractic spinal manipulation.

As part of the literature review, published inthe March/April 2007 issue of the Journal ofManipulative and Physiological Therapeu-tics, the researchers reviewed nine previ-ously published trials and found “high-quali-ty evidence” that patients with chronic neckpain showed significant pain-level improve-ments following spinal manipulation. No trialgroup was reported as having remainedunchanged, and all groups showed positivechanges up to 12 weeks post-treatment.

For more information on preventionand wellness, or to find a doctor ofchiropractic near you, visit ACA’s web-site at www.acatoday.org/patients.

This patient information page is a public service of the Journal of the American Chiropractic Association. The infor-mation and recommendations appearing on this page are appropriate in most instances, but they are not a substi-tute for a diagnosis by a specialist. For specific information concerning your health condition, consult your doctorof chiropractic. This page may be reproduced noncommercially by doctors of chiropractic and other healthcareprofessionals to educate patients. Any other reproduction is subject to ACA approval.

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