You didn’t spar with Tyson. No high speed car accident. No parachuting incident. Rather, you woke up with neck pain. It’s got to be a pinched nerve in your neck.
This is another one of those posts I’m going to be very biased about. But only because I’ve been practicing chiropractic for the past 15 years (has it been that long??) and have seen countless cases with my own eyes.
Basically, there are two paths to go down when it comes to neck pain. Chiropractic and not-chiropractic. Sound pretty simple? It is.
But first, we need to clarify something. Just because your neck hurts, and hurts bad, does NOT mean that you have a pinched nerve in your neck. Quite frankly, this entire description is somewhat outdated, as we know that it is not common for a disc bulge in the neck or low back to actually contact the exiting nerve root directly. It seems like everyone thinks that, just because they have pain in their neck, that it has to be due to a pinched nerve somewhere.
Let me ask you this–ever had a muscle cramp up in the middle of the night? Hurts like H-E-double hockey sticks, doesn’t it? No pinched nerve involved there, just pain receptors firing from the muscle contracting too tightly. Why can’t we relate this same phenomena to neck pain?
There are many, many pain generators in the spine. Muscles, ligaments, tendons, the outer edge of the disc, the facet joints, the joint capsule, the enthesis (where the tendon inserts into the bone) and probably ten other tissues I’m forgetting right now. When you have neck pain or low back pain, it could be stemming from any one of these tissues and likely more than one. Whenever patients look at me and demand an exact explanation as to what is causing their pain I usually suggest autopsy.
Because of this, it is very difficult to tell what the exact cause of your pain is . If a provider looks you in the eye and tells you it’s the disc or the facet joint or the muscles, they’re lying to you and themselves.
So if we don’t know the exact cause of your pain, how can surgery be guaranteed to work? It can’t. It is usually a crap shoot, with no way to tell whether you will benefit or be harmed by the procedure.
Clearly, the chiropractic route for a pinched nerve in the neck does not suffer from this need for specificity in tissue treatment. I know that treatment in our office is designed to address as many of the potential pain generators as possible. More of a figurative shotgun approach.
The research clearly shows that seeing a chiropractor first for your neck pain starts you down a distinct path that only rarely leads to expensive imaging, spinal injections and surgery. Contrast that to all other types of providers including primary care doctors, orthopedic surgeons and pain management doctors. And, believe it or not, seeing a physical therapist first for your pain is going to be one of the most expensive options because they rarely are able to handle to case on their own and almost always refer out to another provider (thus increasing the costs).
All of this leads to this particular study. One would think that, given the stones thrown at chiropractic care over the decades about being voodoo and pseudoscience, mainstream medicine has all of their ducks in a row when it comes to something as vitally invasive as cervical spine surgery.
Not quite.
Researchers looked at all the available studies comparing cervical spinal surgery to conservative care up until June 2011. How many did they find that really met the criteria of a good study without a strong bias? Given that the device manufacturers have made billions of dollars on spinal surgery, this number should be in the hundreds at least, right?
Nine measly studies that compared surgery to conservative care. Nine. Only a single study had a low risk of bias (Tweet this).
Knowing this, are you willing to put your neck on the line (literally!) to have surgery?
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