Expert: Dr. J. Shawn Leatherman - 3/27/2007

Question
I have been suffering from moderate neck pain for the past 8 months. Recently the pain and discomfort has gotten worse so I have been to 3 chiropractic sessions over a period of 2 weeks. If anything now my neck feels worse!
My symptoms are tingling in the neck area, mild pain and stiffness in my neck and upper shoulders. It seems I have a compressed nerve. My question is: Am I getting worse because it is common during this treatment to get worse before I get better? Will I soon start seeing results or is this chiropractor wasting my money? The discomfort has become unbearable. I am unable to concentrate on anything else but my neck...

Please any advise would be a great help...

XXX  
Violet


Answer
Dear Violet,

First of all, a compressed nerve would give your symptoms down into the arms and hands, so I don not think that is the problem.  Did the chiropractor take any x-rays?  I hope so.  Did you get a diagnosis from the chiropractor.  Did the chiropractor give you a functional examination for the neck?  This should have included range of motion, posture, provocative testing of the neck and reflexes of the upper arm.  Takes a  minimum of 15 minutes to perform properly.

Assuming all of the above has been met, the chiropractor also should have given you a treatment plan to include some functional outcome assessments such as a 50% increase in range of motion, 50% improvement in pain levels within a specified amount of time, like 2-3 weeks.  You also should have completed some type of standardized pain questionnaire like the Neck Disability Index or the SF-36 which would allow for a non-biased re-evaluation of your condition.  

Anyway, to address you other concerns, yes many time people actually get worse in the first week of treatment with a chiropractic physician and this should have been explained to you.  That being said, you should see improvements in 4-6 visits, if not then the treatment plan should be changed, or you may need to have deep tissue massage and stretching added into the program.  Most of my patients get a  combination of massage, chiropractic adjustments, and some form of rehab exercises.  In a perfect world all of the above should occur until you are getting functional improvement.

Address all of these issues with your chiropractor and expect him/her to respond appropriately with logical responses that make sense.  If not, you may need to find a better chiropractor to continue your care.  Most patients do well and only a handful need an outside medical referral for their problems.  Your presentation thus far does not warrant that.  Good luck Violet.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net