When it comes to neck pain the best medicine is no medicine at all according to a new study published in the Annals of Internal Medicine.

The study, funded by the National Institutes of Health, tracked 272 patients with recent-onset neck pain who were treated using three different methods:

• Medication
• Exercise
• A Chiropractor

After 12 weeks the patients who used a chiropractor or exercised were more than twice as likely to be pain free compared to those who relied on medicine.

The patients treated by a chiropractor experienced the highest rate of success with 32 percent saying they were pain free, compared to 30 percent of those who exercised. Only 13 percent of patients treated with medication said they no longer experienced pain.

“Doesn’t surprise me a bit,” Dr. Lee Green, professor of family medicine at the University of Michigan told ABC News. “Neck pain is a mechanical problem, and it makes sense that mechanical treatment works better than a chemical one.”

Dr. John Messmer who specializes in family medicine at Penn State College of Medicine agrees.

“I always prescribe exercises and/or physical therapy for neck pain,” he wrote. “I also tell patients that the exercises are the treatment and the drugs are for the symptoms.”

Dr. Stephanie Maj has a thriving family practice in the heart of Chicago. Her clinic is located at 1442 W. Belmont Ave., 1E, Chicago, IL 60657. 773.528.8485. www.communitychiropractic.net

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Forward Head Posture, Cervicogenic Headache, and Anatomical Connection Found Between the Rectus Capitis Posterior Major and the Dura Mater by Dr. Stephanie Maj

 

A new study, just published in Spine Journal, reports on an investigation of the muscles of the suboccipital triangle and their relationship to cervicogenic headaches (headaches that are caused by subluxations in the neck.)

 

This got me thinking of a problem I see in over 75% of patients that come to my office:  Forward head posture.  This position (see picture) puts the neck in an extended position which puts pressure on the nerves that go to the muscles in the back of neck, right under the skull (the rectus capitus muscle group).

This study reports that those muscles connect to the dura mater. The dura mater is the outermost, toughest, and most fibrous of the three membranes, or meninges, covering the brain and spinal cord.

During the anatomic study of thirteen cadaver specimens, it was discovered that eleven of the 13 specimens had a connection between the rectus capitis posterior major muscle (at C2) and the spinal dura mater. [1]  A previous report by Hack (Spine 1995) [2] discussed a connection found between the rectus capitis posterior minor and the dura mater and its relationship to cervicogenic headache.

What is most interesting in this new study is that manual traction of the rectus capitis posterior major resulted in gross movement of the dural sheath from the spinal root level at C2, all the way down to the T1 nerve root.  Hack previously suggested that:

“It has been speculated that the function of the muscle dural bridge may be to prevent folding of the dura mater during hyperextension of the neck. Also, clinical evidence suggests that the muscle dural bridge may play an important role the pathogenesis of the cervicogenic headaches.”

The authors of the current study concluded that “various clinical manifestations may be linked to this anatomical relationship.”  This is where Chiropractic comes in and the stress put on these upper neck structures from forward head posture becomes an important thing to evaluate.

According to Kapandji (Physiology of the Joints, Volume III), for every inch your head moves forwards, it gains 10 pounds in weight, as far as the muscles in your upper back and neck are concerned. That’s because because they have to work that much harder to keep the head (chin) from crashing onto your chest. This abnormal positioning also forces the suboccipital muscles (the ones that raise the chin) to remain in constant contraction, putting pressure on the 3 suboccipital nerves.

This nerve compression may cause headaches at the base of the skull. Pressure on the suboccipital nerves can also mimic sinus (frontal) headaches. It is these nerves and muscles that have the relationship with the dura mater and therefore the brain and headaches.

If you are suffering from headaches of any kind, take a look at how far your head is in front of your shoulders (they should line up ear over top of shoulder.)  Chiropractic has great success correcting this postural abnormality and when corrected, can lead to less pressure on upper neck and significant reduction of headaches.

REFERENCES:

1. Anatomical Connection Between the Rectus Capitis Posterior Major and the Dura Mater

Spine (Phila Pa 1976). 2011 (Jan 27)

2. Anatomic Relation Between the Rectus Capitis Posterior Minor Muscle and the Dura Mater

Spine 1995 (Dec); 20 (23): 2484-2486

 

Dr. Stephanie Maj has a thriving family practice in the heart of Chicago. Her clinic is located at 1442 W. Belmont Ave., 1E, Chicago, IL 60657. 773.528.8485. www.communitychiropractic.net

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Proper posture simply refers to maintaining the body in a position which protects against excessive stresses which cause injury, while requiring a minimal amount of muscular effort to maintain. In other words, a comfortable position which will not irritate your spinal tissues.

Posture plays a significant role in the development of chronic conditions such as chronic back and neck pain. Poor posture is responsible for overstretching ligaments and other supportive spinal structures as well as exhausting spinal musculature, all of which quickly leads to the development of chronic spinal pain.

Learning and practicing proper postural habits will help reduce the likelihood of acquiring back and neck injuries, reduce spinal degeneration, and help keep your spine and body happy and healthy.

Proper Seated Posture

Prolonged sitting is a frequent cause of back and neck pain. And while extended periods of sitting are best avoided, for many, it’s a fact of life.

When sitting, it’s important to keep the back straight, knees bent, and head centered over the shoulders. Slouching forward may be comfortable and allow the spinal muscles to relax but gradually overstretches spinal ligaments, leading to back and neck pain among other problems. We always encourage patients to maintain a “neutral spine” position at all time is ideal.

Seat Backrest – The proper chair has a backrest which slightly inclines backwards. This has the effect of relaxing the spinal musculature and decreasing spinal discal pressure.

Armrests – Armrests provide support for the arms which helps to reduce the work load and stress on the trapezius and shoulder muscles. The armrest height should allow the forearms to comfortably rest while being low enough to go underneath tables or desks in the work area.

Lumbar Support – Having a lumbar support either built into the chair or inserting a portable lumbar support helps to maintain your natural lower back curve. These small supports are quite handy, effective and relatively inexpensive.

Seat Bottom Angle - The seat angle relative to the floor is more of a personal preference than an exact science, as long as a neutral spine can be maintained in comfort. In general, the more the seat bottom tilts forward the more extension of your lower back will occur to keep you in a neutral position.

Seat Height – The height of the seat should be so that it allows you to sit all the way back in the seat while your feet are still able to reach the floor. If they can’t and you’re stuck with the chair, use a footrest to remedy the problem.

In addition to the suggestions provided above, it’s important to:

• be aware of your posture throughout the day and be sure to maintain a neutral spine -no slouching
• take mini breaks on a regular basis when in a prolonged position and remember to stretch
• have the right equipment and tools for working in a prolonged position, use ergonomically designed furniture and keep a lumbar support in your car for “chair crises”

Proper Standing Posture

Although standing is something we do everyday most of us have never really given “the art of proper standing” a second thought. Many people are actually unaware that their standing habits can contribute to their back and neck problems.

If you’re one of those people, the following “general standing guidelines” should help you out.

General Rules For Standing

• maintain a straight spine rather than slouching to the side
• avoid slouching forward or hyper-extending
• keep the chin up with the head centered over the shoulders
• keep the feet slightly less than shoulder width apart
• keep the knees slightly bent
• wear comfortable shoes and leave the heels at home
• avoid standing still for long periods of time, rather, sit down or move around

Proper Lying Posture

Approximately 1/3 of our life is spent lying in bed, on the couch, and on the floor. Like other positions, there is a right way and a wrong way to lie. For individuals suffering from pain, modifications may be necessary to obtain a “pain-free” position or a position which does not aggravate the pain.

Lying  On Your Stomach

Extended periods of “stomach lying” should be avoided. This is because excessive stress is placed on the joints of the low back and because excessive rotation must take place in the neck. Neck pain, back pain, headaches, dizziness, as well as arm paresthesias are commonly experienced when in this position for an extended period of time. If you must lie in this position to relieve pain or for some other reason, keep one leg bent with the same side arm raised with approximately 90 degrees of flexion at the shoulder and elbow joints.

Lying On Your Back

Most people find lying on their back to be a relatively comfortable position. For individuals suffering from back problems, placing a folded pillow underneath the knees will help reduce tension in the lower back and make this position more tolerable. Some individuals may also find placing a small pillow or towel under their lower back to be helpful. This will help to maintain the natural curve of the lumbar spine.

Lying On Your Side

Lying on your side is a favored position by many individuals. It may also be a comfortable position that provides relief for individuals with back problems. It’s important while in this position to have adequate support for the head and neck. A pillow which fills the gap between the head/neck and the bed should be used to keep the head and neck in line with the rest of the spine. Additionally, placing a pillow between the knees will help reduce lumbar and pelvic torsion. Women with larger hip and small waists will find a small pillow under the waist will prevent lateral bending of the spine while lying on the side.

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The British Chiropractic Association has been in the news recently with a study they did on men with back pain and man bags. Apparently 60% of men polled use a man bag and 66% of the men polled also have had back pain. The man bags they wore had an average weight of 6.2 kgs (13.7 lbs) with a laptop usually making up the most weight in a bag.

Man Bags and Back Pain

Do you use a “man bag“? I wonder does a laptop bag count as a man bag?

For many, a man bag can be cool or not so cool from a style point of view. It also depends when do you use a man bag. If you carry lots of goods like laptop, tablet PC ( ipad, galaxy tab etc…), papers or files, I can understand the need for a daily man bag.

You can see below the contents of one guys man bag (reading book, mobile phone, camera, wallet, mp3 player, pens and pencils, note books). No notebook, netbook or tablet PC here.

According to the poll taken it would seem quite a few men in the UK use a man bag. Also quite a few men get back pain who use man bags. Most back pain studies say the population in general does experience back pain so that is no surprise. I do wonder if there are that many man bag UK men out there, maybe London.

I do believe that heavy man bags, hand bags, ruck sacks, school bags etc… repetitivley carried only on one shoulder can contribute to a back pain episode.

I guess also if you don’t have a car and want to do gym after or before work you would need a bag to carry all your gym things in. That might be quite different from the trendy man bags being used by football stars and celebs like David Beckham. What would David carry in his man bag?

How To Carry a Man Bag to Avoid Back Pain

So with all the talk on man bags how should you carry a man bag in a back friendly way.

Man bag back friendly tips according to the British Chiropractic Association article would be:

• Alternate the shoulder used to carry the man bag
• If using a single strap style man bag carry it across your body with strap on one shoulder and the bag on the other hip
• If there are two straps use them and have the back close to your back not near your bum like a school boy
• Decrease the weight of the bag by not carrying things you don’t need for that day
• Try not stay in one position long with the man bag like standing on the train. Try move around or the man bags position

At the end of the day a man bag can contribute to a back pain episode because you are carrying a weight and it can be asymmetrical weight on your body forcing only certain muscle to work. If you repeat this daily then this could be a problem for you in the future or currently just like always carrying your wallet in the same back pocket causing a “wallet sciatica.”

If carrying your man bag is unavoidable, use the tips above AND see your chiropractor so that the stress on your spine and nerve system can be removed with gentle, specific chiropractic adjustments. Just like a brick layer cannot stop lifting bricks for a living, carrying a heavy bag might just be a necessary evil. Use Chiropractic to alleviate any added stress so that you can perform at optimal!

Dr. Stephanie Maj has a thriving family practice in the heart of Chicago. Her clinic is located at 1442 W. Belmont Ave., 1E, Chicago, IL 60657. 773.528.8485. www.communitychiropractic.net

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Imagine thirty or forty years ago, if I told you that dentistry would be painless, that doctors would watch television to perform surgeries, that brain surgery for tumors could be done with a laser, that fetuses could be operated on within the uterus, that knife-less surgery could be performed, you would not have believed me. By the same token, would you believe me if I told you that chiropractic adjustments could be done painlessly without any popping or cracking sounds, and no jerking or to make an adjustment of your spine is an amount equivalent to tapping your fingers on a table.

The latest of these Chiropractic technologies is the ProAdjuster. This state-of-the-art machine uses NASA-developed computer and engineering technologies to both locate and gently correct spinal problems, analyzing and treating the human body at a level that was never before possible.

Let’s test this out. Put your hand flat on a table or even your leg. Now tap your fingers as though you were listening to music that you really enjoyed. Now tap as hard as you can. That is about the amount of pressure you will feel with a ProAdjuster adjustment. Do you think you can handle that? Of course you can. Even small children are adjusted with the Pro-Adjuster. The amount of pressure can be completely controlled and adjusted for the patient’s comfort, safety and effectiveness.

Pro-Adjuster: A Breakthrough in Healing

How can anything so gentle with such little force involved move my vertebrae and change my spine? The ProAdjuster utilizes a precise oscillating force with uninterrupted motion. It is able to increase the mobility of the spinal vertebrae by reducing or eliminating the fixations. In other words, the ProAdjuster is “unsticking” the joint.

Have you ever seen a woodpecker tapping in an oscillating fashion on a tree? It is hard to believe, but you can watch them bore right through the hardest wood! The ProAdjuster taps in much the same way but uses soft tips that are comfortable to the human body and don’t create damage.

Not only is the ProAdjuster great for the patient, it is great for the doctors as well. It is a valuable tool providing vital information about your spinal health, ultimately resulting in a higher level of care. What is it that every doctor wants for their patient and what every patient wants from their doctor? The answer is one word…RESULTS!

Check out this study showing how great the treatment of the Cervical Spine is with the ProAdjuster.  In this double‐blind, randomized, placebo‐controlled trial, the conclusion of the researchers was that treatment with the ProAdjuster, using the Oscillating Percussion Technique, is effective in improving range of motion and reducing pain. (1)

Check out the ProAdjuster, it is a safe, effective, drug-free solution to many spinal issues.

Dr. Stephanie Maj has a thriving family practice in the heart of Chicago. Her clinic is located at 1442 W. Belmont Ave., 1E, Chicago, IL 60657. 773.528.8485. www.communitychiropractic.net

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