Hello Davidson Chiropractic patients! It’s that time of week to discuss a new topic. This topic was brought to me by one of my patients. So, here it is! “Doc, how do I know if I need an adjustment to my neck or just a massage?” […]
I love this question, as it makes me revisit some Anatomy and Physiology. Here is the attempt to give you the “cliff note” version to explain. In the neck, humans have seven vertebra and six intervertebral discs. We also, have 2 facet joints on each side, then of course layers of muscles that physically move those joints through contraction.
When I assess a patient, besides checking reflexes, muscle strength and orthopedic tests, I check both Active range of motion and passive range of motion. Active is what the patient can do on their own, while passive is me moving the head without their help. For example, if a client is seated on the table and I ask them to turn their head far right and then far left, then note their active range of motion is 45 degrees on the left and 85 degrees on the left. I document they lost close to 50% of normal left rotation. So, what is the problem, the muscle or the joint? Well, we don’t know yet. Now we lie the patient on their back, removing gravity, and I take them through the same motions with no help from them or their muscles. Here is the key, if I still can’t get the patient past 45 degrees of left rotation, then it tells me we have a joint problem as a result of poor mechanics, arthritis/degeneration, or adhesions in the neck. Therefore, this patient may benefit from spinal manipulation to improve range of motion and reduce pain. No amount of stretching will change the reduction of motion, unless the joint complex is addressed.
Usually there are components of both muscle and joint involvement, so most likely the patient would benefit from some form of manual muscle therapy, joint manipulation, and strengthening rehabilitation to prevent future occurrences.
I hope this helps in the understanding of our complex human bodies. Here is to eliminating your pain, restoring your livelihood, and instilling your confidence.
Thanks so much,
Marc J. Fondino, DC