Expert: Gerald Anzalone, D.C. - 8/25/2009

Question
I teach many fitness classes and I am in good shape. I have always felt like my range of motion in my neck is not good and sometimes have pain when I tip side to side. I have been having a bit of hip and neck, upper back pain so I decided to visit the chiropractor. I went three years ago and really didn't like it much. Anyhow, I was feeling pretty good, went in for my first visit, was adjusted, felt better that evening and work up at 3:00 in the morning with incredible neck pain and upper back area under my rhomboids. They advised that I come in again for another adjustment, so I did. I am in so much pain it is unbearable. I can't even take a deep breath without discomfort. It is painful to move my neck and I feel like I have an extreme muscle issue in the middle of my back. They want me to return again for an adjustment, but now I feel like my body needs to have a chance to heal. I am worried that I made a bad decision by seeing a chiropractor. I can barely close and open my car door because of the pain. What is going on with my body, specifically my neck and upper back along my spine>

Answer
Hillaree,

Firstly, it is impossible for me to evaluate your clinical condition over the Internet.

In general, minor soreness after spinal manipulation can be a common side effect, which has been reported in the literature, especially in tissues that may already be inflamed, subject to an acute trauma or repetitive stress disorder, or that are chronically "tight" (the more appropriate term is 'hypertonic'). This minor discomfort is usually very short-lived.

However, severe pain after spinal manipulation may be a strong indicator that the technique being used is inappropriate for the individual's particular clinical condition. Pain sources in the spine and extremities may range from disc to muscular to articular (joint), and pre-manipulative evaluation is essential to try to determine the most appropriate approach to initial patient care where manual spinal therapy is concerned.

The problem may not be that you saw a chiropractor, but that perhaps you saw the wrong type of chiropractor, or at least, the technique used may not be appropriate. Chiropractic technique encompasses much more than the traditionally-thought of spinal manipulation which produces the audible release of the joint. A skilled chiropractor is versed in soft tissue manipulation, joint mobilization, and various rehabilitative exercises in addition to traditional joint manipulation.

You have a couple of options. The first would be to discuss your concerns and present symptoms with your chiropractor to determine if other techniques would be more appropriate for your care, or if additional evaluation of your condition (i.e., an MRI scan or other diagnostic imaging modality) may be necessary.

You can also see your primary care physician to discuss the possibility of obtaining a prescription for medication (i.e., anti-inflammatories, pain medication, or muscle relaxers).

Depending on your condition, you might need to see a physical therapist or a massage therapist instead of a chiropractor.

If your chiropractor is unwilling address your concerns and present symptoms to your satisfaction, you might need to find a new chiropractor. Having a negative experience with one practitioner in any field doesn't represent the majority of practitioners, most of whom are usually very good at what they do. By the same token, repeating the same procedures after experiencing an undesirable outcome or side-effect makes no sense, either.

I hope that this helps to answer your question.