Expert: Scott F. Gillman, DC, DACBSP - 9/25/2009

Question
Hi. I am a paramedic and work for an ambulance company so I do a lot of lifting. I went to sleep the other day feeling fine, no back or neck pain at all and awoke the next morning with a cramp or something in the center of my back in the spine. It hurt so bad I couldn't move for the better part of the day. I finally decided to go to a chiropractor, something I've never done before but I was desperate. It was Sunday so I had to pay $100.00 instead of her normal $30.00 rate. She got me in and cracked my back and neck and used some kind of clicker tool and she told me that I had a total of 7 or 8 vertebrae out of place. Anyway, she really did make my back feel better but the next morning I woke up with the most severe neck pain I've ever had and every morning since then, about two weeks ago, I'm waking up with severe neck pain that doesn't seem to be getting any better. Do I need to go to a doctor of Ortho and get this fixed, or do you think this will get better on it's own? The pain isn't nearly as bad as it was that first morning after the chiropractor so I guess it is getting a little better but it's been two weeks and my neck still really hurts. Please let me know what you think. Thank you. Steve. Oh, just to let you know I am 29 and in pretty good shape and I don't usually have these problems.

Answer
Stephen,

Neck pain with not radicular pain into the scap' or arm/hand is a good sign.  However, cervical discs can refer pretty low into the medial scapular border.   Your $100 should have bought you a standard physical examination (however brief) that would have included neurologic survey of reflexes, skin sensation, muscle strength tests to the arm/hand and shoulder: If not, get your money back. [Aside: $100 is a bargain to see a doctor on a Sunday... do you think the orthopedist would see you on sunday for the same price?]   Most mechanical middle back pain or neck pain resolves with a variety of treatments in time so long as there's no complication.   It sounds like there's nothing complicating on your end.  But I would still be concerned about ruling out a cervical disc lesion such as a bulge/herniation.  If your exam surely doesn't point to the cervical disc, then the other likelihood is simply myofascial irritation surrounding a stuck/irritated/malfunctioning joint in your neck.   I would start by having the chiropractor do some active myofascial release or Graston technique to the neck and trap regions to see if that squelches the neck pain.   At home, take a look at your sleep postures, pillow, work-station postures when sitting, and ergonomics of your lifting.   Your chiro' should be able to assist you with these.   Also, if all your chiro does is Activator (click click) and nothing else, you are at a disadvantage (IMHO)...

'Hope this was helpful.

Dr. G'