Expert: Dr. Victor Dolan, DC, DACBSP - 8/13/2009

Question
Hi Dr. Dolan.  I've written you more than once before and appreciate your expertise.  In Jan. I had a herniation of C6, C7 and have had regular chiropractic and massage since then.  Currently I get chiropractic twice a week and massage before one of those treatments.  However, deep at the base of my neck on both side, I've developed stiffness that keeps coming back.  I keep finding myself sleeping on my side at night but it seems as if my neck is supported enough and I'm not in pain.  I seem to do better sleeping on my back but am growing tired of that for so many months.  What will relieve this stiffness? The massage seems deep enough.  Should I have chiropractic daily for a few days?  Thanks for any advice.  I've received your handouts on herniations and inflammation before and am doing supplements along with diet changes and McKenzie exercises.  I'm a 44 yo female.  Thanks.  Joni in DE

Answer
stiff neck, acute spastic torticollis, wryneck, whiplash, staten island stiff neck, staten island whiplash, reversed cervical curve, military neck, loss of cervical curve, herniated disc, staten island herniated disc, staten island chiropractic,






Hello  Joni,

I am sorry to hear of your continuing problems.

".....I've written you more than once before and appreciate your expertise......"; thank you for the kind words, I hope I WAS helpful,  I hope this IS helpful.

This may be quite repetitive, and I am sorry if it is, but I do not recall your question/ my answer from previous- - - - but you can check that I am consistent !!!

"....I've developed stiffness that keeps coming back. ....", is this something new?, something different?, a new development, a new 'twist'?   If this is a 'new' development, please take a look at any changes that have coincided with this new change.  Did the stiffness come after a new mattress?, new pillow?, a new exercise routine?, a change in job?, change in exercise routine?, even a change in diet?

This stiffness that keeps coming back,  look back, what changed when this changed?
If you have an answer---- you might have THE answer.

"....Currently I get chiropractic twice a week and massage before one of those treatments.....", this sounds very fair, very efficient.  Coupling the soft tissue work (massage) and the adjustment (joint, nerve) should really help your problem.  Massage AND chiropractic both have many many different techniques and approaches.  You have written me here--- have you communicated these same concerns to your LMT (licensed massage therapist) and DC (doctor of chiropractic)?-  please, talk to them, perhaps altering a technique could be helpful.  In the chiropractic office, perhaps a change in therapy- from ultrasound to electrical muscle stimulation, or vice-versa could be helpful.

I really like partnering the massage and chiropractic adjustment.  In New York, most (translate just about all) insurances do NOT pay for massage and chiropractic on the same day- this to me is actually stupid, as they are complementary.  That is one of the reasons I perform many stretches and mild (thumper) massage to most of my patients either pre- , post- adjustment or both.

(percussion = thumping like a drum;  http://www.massage-tools.com/thumper-sport-percussion-massager.html ,  http://www.mysimon.com/find/thumper+massager )

If you get good results with standard chiropractic care, but the condition returns, perhaps you should speak with your doctor of chiropractic about MUA (spinal manipulation under anesthesia).
(spinal manipulation under anesthesia, spinal manipulation with sedation: http://www.youtube.com/watch?v=IddzP39milA  ,  http://www.youtube.com/watch?v=MJOflSjyfU0 )

"....I keep finding myself sleeping on my side at night but it seems as if my neck is supported enough and I'm not in pain.....";  NEVER on your stomach, side is okay- arms down, back is best for sleeping posture.  When you sleep on your side, keep your elbows below shoulder level = hug a pillow, hug your honey. Whenever you sleep; use an orthopedic cervical support pillow
( http://www.amazon.com/Tri-Core-Orthopedic-Standard-Support-Pillow/dp/B000ET9TXQ = support the NECK and head, not just the head ).

".....I seem to do better sleeping on my back but am growing tired of that for so many months.....";  > 'I seem to do better on my back' (see above), so sleeping on your back gives you LESS stiffness and you feel BETTER,,, but  '(I) am growing tired of that ';  you are growing tired of feeling better?, oh- you are tired of sleeping on your back,,,, sorry to say, sleeping on your back is best, sleeping on your side is okay (keep arms down), and sleeping on your stomach is a no- no.  If you do not like this, then you will have to negotiate with Mother Nature; it just IS.  
(((((( http://www.midweek.com/content/columns/onthemove_article/sleep_posture/ , http://www.youtube.com/watch?v=CSd2WJud5WE = notice the cervical support pillow , http://www.youtube.com/watch?v=10GIGt1hslQ  ,  http://www.spine-health.com/wellness/ergonomics/guidelines-improve-posture ,  WOW -  THIS MEDICAL SITE SOUNDS LIKE A CHIROPRACTIC DOCTOR : http://my.clevelandclinic.org/healthy_living/Back_health/hic_Posture_for_a_Healt...  
  Proper posture:
Keeps bones and joints in the correct alignment so that muscles are being used properly.
Helps decrease the abnormal wearing of joint surfaces that could result in arthritis.
Decreases the stress on the ligaments holding the joints of the spine together.
Prevents the spine from becoming fixed in abnormal positions.
Prevents fatigue because muscles are being used more efficiently, allowing the body to use less energy.
Prevents strain or overuse problems.
Prevents backache and muscular pain.
Contributes to a good appearance. ))))))))

"....What will relieve this stiffness? .....";  no ONE thing will 'cure' you.  Please take into account ALL of this answer to your question, place in as many ( all ? ) of the components; talk with your massage therapist and Chiropractic Doctor; and you should be able to defeat the stiffness.

"....Should I have chiropractic daily for a few days?...."- this might be helpful to get you back 'over the edge' towards good health, discuss it with your Doctor; but I do think if you are being consistent at 2X per week, you are doing a good job already.

".....I've received your handouts on herniations and inflammation before and am doing supplements along with diet changes and McKenzie exercises....",  I hope the handouts have been helpful.  Here comes the repetitive part.  In my Staten Island Chiropractic office  I hand out the following printouts which may be helpful to you:







PAIN     


Pain  is a  ‘red light on the dashboard’.
 
Pain is your body telling you that something is wrong.

That RED LIGHT on the dashboard of your car-
-- do you ignore it until the car breaks down,
or do you get it checked and correct the problem?  

Pain,
pain in your body-
-- do you ignore it until your body breaks down,
or do you get it checked and correct the problem?   

Pain,  
do you cover up the pain by taking a painkiller?  
Take a painkiller,
mask the pain,
and allow a problem to progress in your body?

    

NOTICE  ON  PAIN  RELIEVERS:
 
Label changes ORDERED by FDA;  the FDA announced proposed label changes for OTC over-the-counter pain relievers to include the potential for stomach bleeding and liver damage (FDA news  206- 207;  12-9-06) ;

The  American Heart Association issued a scientific statement recommending medical doctors change the way they prescribe OTC pain relievers from a first choice to an alternate of recommending non-pharmacologic treatment (AHA statement  2-26-07).

NSAID Acceleration of ARTHRITIS; an important side effect of Aspirin and other NSAIDS is that it will inhibit cartilage repair and accelerate cartilage  destruction ( Journal of Rheumatology, 1982; 9: 3- 5 ). Many times people take NSAIDS for the pain of Arthritis, not realizing these drugs may make the underlying condition worse.  These medications cover up the pain, and cause the problem to worsen.


Pain  can  often  be  the  result  of  the  Vertebral  Subluxation  Complex.

Vertebral  Subluxation           (  ‘VSC’ ,    ‘subluxation’   )
Vertebral Subluxation  is  actually  a  quite  common  condition.   Doctors of Chiropractic look for pathological conditions which may require referral to other specialties,   and also look for ‘Subluxation’. Other disciplines look for pathology, but overlook the importance of alignment and movement in the spine which affects our nervous system  (the master control system- ALL health disciplines learn this).  VSC- ‘Subluxation’ – can be the cause of many symptoms and conditions.

Only  a  Doctor of Chiropractic  will  evaluate  and  treat  for  VSC,   as  well  as  other  pathology.

The course of VSC is highly variable.   Some patients with VSC literally cannot walk, yet other patients with similar test findings may be able to run marathons or lift heavy weights.    Some patients immediately develop symptoms related to the VSC,  some patients take years to develop symptoms.  Some people suffer for only a few days with pain and symptoms, some people suffer for months.  Some people recover in days, some take months or years, depending upon severity of the condition.

A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.  When subluxated, joints are in a stressed, vulnerable, compromised condition.  Subluxation may cause Arthritis, Disk Herniation, or aggravate such conditions.
       Vertebral  Subluxation   cannot   be corrected through chemicals (medicine), stretching,  yoga,  vitamins  or  physical  therapy  alone.       Subluxation- a neuro/skeletal/muscular-    mechanical-    problem  requires  a    mechanical correction-  -  -    a manipulation,         best  performed  with  the  chiropractic  adjustment.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine

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My Staten Island Stiff Neck patients also get:

“Stiff   Neck”   

( Also Known As-  wryneck, torticollis, neck muscle spasm )

-can be caused by big bad things: cancers, tumors, fractures, even heart attacks- only history/ examination/ evaluation by an appropriate health professional can differentiate these problems/ conditions.  

USUALLY  these  complaints  are  neuro-musculo-skeletal.  

For  example: sometimes  we  can  wake  up  with  a  ‘stiff  neck’,  or  a  muscle spasm.... sometimes a slip, trip, fall, heavy lift, or even a motor vehicle accident can cause a ‘stiff neck’.   Sometimes  we  just  slept  wrong !   Often-  the true    c a u s e   of  the neck stiffness and pain;  the underlying  c a u s e    of the complaint  - is a misalignment,  a ‘kink’  in  the  neck -  more  properly  termed  a   Vertebral  Subluxation.  Treat the   c a u s e,  not just  the  symptoms - for  true  improvement.

         Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)
The  vertebral  subluxation  complex  is  the  underlying  cause  of  many  healthcare  problems.   A subluxation  interferes with the proper functioning of the nervous system   (the master system which controls and coordinates all function within the body)   and may cause various other conditions, symptoms  and  problems.


This is a serious condition identified by its five parts:

                                     Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion  the other four components.
                                     Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms  elsewhere in the body.
                                      Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring  repeated spinal adjustments.
                                      Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate.  Other soft tissues may suffer permanent damage.
                                      Pathophysiology:
         Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
          Vertebral  Subluxation   cannot    be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical- problem  requires   a mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.  For good health- Treat the   Cause,  not just the Symptoms.

Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine

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And, it sounds like I may have already given you this information, but it is info I give my Staten Island Whiplash, stiff neck, pinched nerve people:



“Pinched  Nerve”   

( Also Known As-  neuritis, neuralgia, brachial-neuritis, sciatica )

“pinched nerve” – is only ½ a diagnosis,  WHAT is causing the ‘pinch’? Your Doctor of Chiropractic will examine and evaluate you to make sure you are not showing signs of neurological damage or disease, tumors, cancers,  severe pathology, perhaps a Herniated Disc, or a Vertebral Subluxation Complex.
Sometimes  we  can  wake  up  with  a  ‘pinched nerve’,  or  a  muscle spasm.... sometimes a slip, trip, fall, heavy lift, or even a motor vehicle accident can cause a ‘pinched nerve’.  Very often -  the true    c a u s e   of  the pinched nerve, painor numbness  in the:    neck and/ or  shoulder  and/ or  arm  and/ or  hand;   pain in the back and/ or   buttock/ hip/ leg/ knee/ foot -  is a misalignment,  a  ‘kink’ in the neck or back - more properly termed a Vertebral Subluxation.
              Vertebral   Subluxation   Complex    (a.k.a.  ‘subluxation’)
The vertebral subluxation complex is the underlying cause of many healthcare problems.
A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.


This is a serious condition identified by its five parts:

      Spinal Kinesiopathology:
         This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
      Neuropathophysiology:
         Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
      Myopathology:
          Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
      Histopathology:
         A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
      Pathophysiology:
         The VSC contributes to OsteoArthritic degeneration.  Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.


The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.
         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
          Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.    For good health-
Treat   the   Cause,  not just the Symptoms.


“Pinched  Nerve”   ( Also Known As-  neuritis, neuralgia, brachial-neuritis, sciatica )
“pinched nerve” – is only ½ a diagnosis,  WHAT is causing the ‘pinch’? – That “pinch” has to be taken care of FIRST!

As the “pinch” – the MECHANICAL component of the problem, the CAUSE of the problem is being taken care of  through Chiropractic treatment,   perhaps additional help would speed your return to health:

Nerve Health Support:
-----B complex containing thiamine, folic acid, B-12 and niacin is highly suggested for nerve support.  High dose
B-vitamins should only be taken at the advice of a licensed healthcare professional.
-----B-6 is lower in patients with neuropathy.  Vitamin B-6 reduces the glycosylation that can cause nerve damage.  Amounts greater than 200mg/day can cause neuropathy symptoms.
-----Calcium and magnesium are important for nerve conduction and as muscle relaxants.
-----A multi-vitamin/mineral supplement is suggested for comprehensive support.
-----Essential fatty acids are necessary for nerve health.  Essential fatty acids include omega-3 fatty acids (fish and flax oil) and omega-6 fatty acids (black currant seed oil, borage oil and evening primrose oil).
-----Proteolytic enzymes may be beneficial in neuritis for the inflammation.
-----Lecithin aids in nerve support.
-----Natural herbal remedies including passion flower, valerian, chamomile, scullcap and white willow bark may be helpful.
-----Eat a healthy diet.  Avoid foods that stimulate the nervous system such as caffeine, chocolate, refined sugars, soda pop and cigarettes.
-----Drink plenty of filtered water.
-----Chiropractic care is imperative to remove nerve irritation.
Joint Support:
-----Glucosamine sulfate helps strengthen joint integrity.  Glucosamine is effective in relieving joint pain associated with osteoarthritis.  Glucosamine's pain-relieving effects may be due to its cartilage-rebuilding properties.  These disease-modifying effects are not seen with simple analgesics and are of particular benefit.
-----MSM is known for its pain-relieving properties in such conditions as fibromyalgia, osteoarthritis, bursitis, tendonitis, back pain and muscle soreness.  Not many clinical trials have been done using MSM, but clinical observations support the theory that MSM is beneficial in pain managment.
-----White willow is an antiinflammatory and analgesic agent.  White willow was used as far back as the Middle Ages to reduce pain and fevers.  The salicylates found in the white willow bark are responsible for the anti-inflammatory and anti-fever effects.  Acetylsalicylic acid, otherwise known as aspirin, is chemically similar to the salicylates.
-----Boswellia and turmeric (curcumin) are potent antiinflammatory herbs.  Curcumin may have similar action to aspirin.



Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine


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Well, I hope I have hit all the bases.

Please let me know.

It is August-- I hope all is well in Ocean City,,,,, ooops that is Maryland, not Delaware,
sorry !!!!

If you need further, do not hesitate to RE-contact me here at AllExperts.com : http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm

Thank You for the question, I do wish you Good Health Naturally!

Dr. Victor Dolan, DC, DACBSP
email newsletter:.......... http://drvictordolan.chiroweb.com