Ask the Chiropractor: What caused my neck pain?

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“What caused me to have this neck pain?”  “How long is it going to take to get better?” These two questions are very commonly asked in my Chiropractic practise. If you are curious about what may be causing your neck pain and what factors you need to control to speed up your recovery then this is the post for you.

As a Chiropractor, my job isn’t simply about adjusting joints and making people’s spines crack. I need to look beyond  the patients’ pain and their muscles, joints, and nerves.   I must look at other factors which may explain the cause of their problem, which influence the prognosis of their neck injury, and the risk factors which may result in long term chronic pain/disability. 

Neck pain is a common occurrence. I often see it in those who sit for long periods of time, in athletes and in those who have been in car accidents.  Some people get better quickly while others never seem to recover.

Here are some of the risk factors that increase your chance of experiencing neck pain.

  • Highly repetitive activities
  • High force activities
  • High job demands
  • Neck flexion – head forward posture
  • Arm force
  • Arm posture
  • Duration of sitting
  • Twisting or bending of the trunk
  • Hand-arm vibration
  • Workplace design.
  • Previous neck/shoulder injury
  • Reduced health/quality of life

For the most part, these factors can be controlled by you. It is understandable though, that these factors may not be completely in your control because of your professional duties.  If possible, contact your employer to look into changing your office ergonomics or changing your equipment. 

The length of your treatment depends on a number of factors.  These same factors may also be reason for the people developing chronic neck pain. So what factors lengthen your recovery or lead to chronic pain?

  • Greater initial pain
  • More initial symptoms
  • Greater initial disability
  • Little influence on your work situation
  • Passive coping style
  • Catatrophizing
  • Depressive mood
  • Fear – avoidance behavior
  • Blue collar worker
  • Prior sick leave

 You can control some of these factors but for such factors, such as, passive coping, depression, catatrophizing and fear-avoidance behavior seeking out the appropriate professional will be beneficial.

I hope this has helped you further understand the factors that influence your neck pain and the factors that may be slowing your recovery.

Until next time,  enjoy your day

Dr Notley
The only dual credentialed Chiropractor and Athletic Therapist in Winnipeg

P.S. Scroll down and check out some of the research on neck pain

We found 226 articles related to course and prognostic factors in neck pain and its associated disorders. After a critical review, 70 (31%) were accepted on scientific merit; 47 of these studies related to course and prognostic factors in WAD. The evidence suggests that approximately 50% of those with WAD will report neck pain symptoms 1 year after their injuries. Greater initial pain, more symptoms, and greater initial disability predicted slower recovery. Few factors related to the collision itself (for example, direction of the collision, headrest type) were prognostic; however, postinjury psychological factors such as passive coping style, depressed mood, and fear of movement were prognostic for slower or less complete recovery. There is also preliminary evidence that the prevailing compensation system is prognostic for recovery in WAD.

Results. The prevalence of neck/shoulder pain with pressure tenderness was 7.0% among participants performing repetitive work and 3.8% among the referents. We found an association with high repetitiveness (prevalence ratio 1.8, 95% confidence interval 1.1–2.9), high force (2.0, 1.2–3.3), and high repetitiveness and high force (2.3, 1.4–4.0). The strongest work-related psychosocial risk was high job demands (1.8, 1.2–2.7). Increased risk was also associated with neck/shoulder injury (2.6, 1.6–4.1), female gender (1.8, 1.2–2.8), and low pressure pain threshold (1.6, 1.1–2.3). Neck/shoulder pain was strongly associated with reduced health-related quality of life.
Conclusions. Work-related physical and psychosocial factors, as well as several individual risk factors, are important in the understanding of neck/shoulder pain. The findings suggest that neck/shoulder pain has a multifactorial nature. Reduced health-related quality of life is associated with subjective pain and clinical signs from the neck and shoulders. The physical workplace factors were highly intercorrelated, and so the effect of individual physical exposures could only be disentangled to a minor degree.
We found 226 articles related to course and prognostic factors in neck pain and its associated disorders. After a critical review, 70 (31%) were accepted on scientific merit; 14 of these studies related to course and prognostic factors in working populations. Between 60% and 80% of workers with neck pain reported neck pain 1 year later. Few workplace or physical job demands were identified as being linked to recovery from neck pain. However, workers with little influence on their own work situation had a slightly poorer prognosis, and white-collar workers had a better prognosis than blue-collar workers. General exercise was associated with better prognosis; prior neck pain and prior sick leave were associated with poorer prognosis.

Physical risk factors for neck pain 
To identify physical risk factors for neck pain, a systematic review of the literature was carried out. Based on
methodological quality and study design, 4 levels of evidence were defined to establish the strength of evidence for the relationship between risk factors and neck pain. Altogether, 22 cross-sectional studies, 2 prospective cohort studies, and 1 case-referent study were eligible for determining the level of evidence. The results showed some evidence for a positive relationship between neck pain and the duration of sitting and twisting or bending of the trunk. A sensitivity analysis was carried out excluding 3 items of the quality list, the importance of which seemed doubtful. On the basis of this sensitivity analysis, it was concluded that there is some evidence for a positive relationship between neck pain and the following work-related risk factors: neck flexion, arm force, arm posture, duration of sitting, twisting or bending of the trunk, hand-arm vibration, and workplace design.
Results. The analysis included 977 patients. Altogether, 141 workers (14.4%) reported that they had experienced neck pain at least once during the 3-year follow-up period. The relation of neck pain to high quantitative job demands (relative risk [RR], 2.14; 95% confidence interval [CI], 1.28–3.58) and low coworker support (RR, 2.43; 95% CI, 1.11–5.29) was statistically significant. An increased risk was found for low decision authority in relation to neck pain (RR, 1.60; 95% CI, 0.74–3.45), but this relation was not statistically significant.
Conclusions. High quantitative job demands and low coworker support are independent risk factors for neck pain. There are indications that another risk factor for neck pain is low decision authority.

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