The three main questions a person asks when presenting for care are:
- What is wrong?
- How do we fix it?
- How much will it cost?
What is wrong
Neck pain is a common symptom reported by patients presenting for chiropractic care. When a patient presents for care for neck pain, the following questions are relevent:
When did the neck pain start?
How intense is the pain? ( example: 3 out of 10 with 10 being the worst)
What does it feel like? (sharp, dull, burning, pins and needles)
How often does it hurt? ( constantly, every other day, a few times a week)
Does it radiate? ( does it go into your arm, to your hands,to specific fingers)
Do you also get headaches?
What movements make it worse? (turning the head, looking down)
What activities make the pain worse or provide some relief? (laying down decreases the discomfort, driving increases the pain)
Has the pain limited any activities? ( you can not sleep as long, you don't read as much because of the pain)
Is it worse at any particular time of the day? ( it hurts more when you first wake up but decreases as the day goes on)
After identifying the current state of the complaint, it is important to consider the health history of not only the neck but other structures that are related to the neck and which may also be affected by cervical dysfunction:
Have you had similar complaints in the past?
Is there a history of trauma?
Is there a history of circulatory problems, cancer, other issues?
Have you been previously diagnosed with a straight neck, disc herniations, stenosis or arthritis?
Additionally, it is important to determine what factors may be contributing to the neck dysfunction:
Do you feel stressed?
Does your work require you to remain in a position which require your head down for a long period, to reach overhead frequently or to lift heavy objects?
Do you have bad posture?
After the history is taken, an examination will be performed in order to determine which structures are affected and how bad. What we are looking for is:
Is the dysfunction affecting the nerves exiting the neck ( increased pain down the arm with certain movements, increased/decreased reflexes, decreased strength, increased/decreased sensations)
Is the dysfunction related to a muscle strain. a sprain or a spasm ( does it hurt more when you move away from the pain, does turning towards the pain make it better or worse)
Is the dysfunction affecting the joints of the spine ( is it worse when you look up, better when you look down, is it best when looking down and tilting away from the discomfort?
Is it a combination of nerve, joint and or muscle dysfunction?
An acute complaint is one which began within three months while a chronic complaint began greater than three months ago. Many acute flare ups are the result of an underlying chronic condition.
Examples of acute neck conditions:
sprain / strain
muscle spasm
facet irritation
nerve irritation
Examples of chronic conditions that lead to discomfort:
arthritis
adhesion ( scar formation)
disc herniation
straight neck
fibromyalgia
With all neck pain—no matter what the cause—the pain itself tells us that there is some kind of problem and if the source of the pain is not identified and corrected, the condition causing it is likely to worsen.