Expert: Gerald Anzalone, D.C. - 7/7/2010

Question
Hello.  I had been having headaches after golf, working out, etc. and was told by a friend to go and see a chiropractor.  After meeting with him, he did scans, xrays, etc, and concluded I had a "Military Neck", and about a 10 degree bend to the one side, causing muscles to pull and cause the pain.  After 3 neck adjustments I noticed sitting at the computer one day head felt frozen, and didn't want to move.  It eventually did, but when seated I was getting big headaches.  I saw him, he re-adjusted the one side, and taped one shoulder back telling me to heat it that night.  The next morning, and ever since I have been in severe pain through the back of my neck.  I called that chiro, and another one who both assured me it is normal due to swelling in tissues that are not used to being manipulated.  It has been 8 days since my last adjustment, and I have been icing for three, and still I have aching at the side of my neck(both sides), and an aching pain all up my neck and at the base.  I went to a clinic yesterday, and he didn't seem concerned, but sent me for cervical xrays.  I also now experience tingling in my hands.  Seems worse driving, sitting at my desk...
Any Advice,
Thanks

Answer
Duncan,

Thanks for your question.

First, the explanation that you are having worse or different symptoms because you are "having swelling in tissues that are not used to being manipulated" is laughably ridiculous. You may not be a good candidate for manipulation; moreover, the answer to having worse or continued symptoms following a manipulation is NOT more manipulation or taping of the shoulder. You need a different approach to treatment and most likely a different provider.

I recommend discontinuing manipulation with this treatment approach and seeing a massage therapist for non-forceful muscular therapy, or another chiropractor who can provide soft tissue manipulation rather than thrust manipulation, as well as your primary care physician regarding your headaches.

Additionally, there is no solid evidence or scientific opinion to support the idea that a loss of the normal cervical lordosis (or curve of the neck) is necessarily linked with symptoms. It also does not take x-rays to evaluate muscle tension. This can be done by palpation.

Finally, tingling in both hands suggests that you may have a disc problem. I recommend seeing your primary care physician for evaluation of this condition.

It should be noted that certain types of headaches (called cervicogenic headaches) often improve with appropriate manipulation of the neck; other types of headaches caused by muscular trigger points or muscle tension respond better to manual muscle therapy techniques, or in severe cases, trigger point injections.

Please see the following links for additional information:

Neck pain and manipulation:

http://www.aafp.org/afp/2005/0101/p117.html

Cervical disc herniations:

http://www.webmd.com/a-to-z-guides/cervical-disc-herniation-topic-overview

Trigger points:

http://www.triggerpointbook.com/triggerp.htm

I hope that this helps to answer your question.