Common Causes of Neck and Back Pain

This is Part 2 on Spinal “Subluxations” as common causes of Neck Pain, Back Pain, and Chronic Pain.

Spinal Pain and Problems from abnormal movements of the vertebrae were discussed in Part 1 on Spinal Subluxations.

In part one, we looked briefly at what can be referred to as a subluxation in the spine.

Re-stating the idea that the term subluxation itself probably isn’t the best way to describe the abnormal movement of spinal segments, but it does have a strong history in the Chiropractic profession going back to the founder of Chiropractic.

We’ll consider a few factors in the treatment of these spinal movement problems here.

A few things need to be clarified on the process of improving the spinal movement problem.

It’s not a simple… this “bone is out of place, so you ‘pop’ it back into place.”

Unfortunately this is what a lot of people still believe is happening, clearly it is not. These movement based problems within a spine are overlooked though in evaluating a neck pain or back pain patient outside a chiropractic office.

We previously mentioned how the brain sets and controls the movements of the spinal vertebrae. Problems in this control lead to abnormal movement patterns. These patterns then change the input into the brain creating what can be a viscous cycle worsening problems over time.

We do know that losses of joint movement increases pain and improving those losses reduces pain. This happens through a variety of mechanisms, including importantly with the changes in the pain “gate” originally described by Drs. Melzach and Walls in the ’60’s.

It has to be noted that there are a huge number of problems that can be going on around the cause of the neck or back problem and many specific in each person.

A person’s individual factors greatly change the types of treatment that might be necessary as well as how many treatments over what period of time that it will take to make changes.

One factor may be a recent major traumatic injury that caused the problem.

Considering how our bodies heal from these traumas like “whiplash” from a car accident, it takes a significant amount of time of treatment during the healing process to allow it to heal as well as possible.

Of course, whiplash is a nonspecific diagnosis. It doesn’t tell us what is wrong, only a little about a mechanism of injury.

Various different soft tissues can get injured to varying degrees in motor vehicle collisions. Notably and importantly, often ligaments are torn, discs can be injured, among other injuries.

Another factor might be how long the motor control problem (the “subluxation”) has been there.

The time factor can be significant in causing “plastic” changes in the nervous system that can make it more difficult and time consuming to change.

Time is an important consideration in chronic pain of the neck or back.

Chronic pain, by definition is pain lasting 3 months or longer. This time frame is arbitrary though. Generally the longer a problem like pain goes on, the more “plastic” the changes due to strengthening of that particular part of the nervous system.

The longer both a local and a central problem exist, the greater the “plastic” (stronger) changes are established in the nervous system that require much more time to change with new “plastic” changes.

This is a very complicated process of what is happening in the nervous system.

You can think of “plasticity” in this way, the nervous system changes relative to how it fires or doesn’t fire. The more a certain pathway is used, the stronger it becomes.

This is very similar to how if a muscle is worked by going to the gym, it will over time get bigger, stronger, and become more efficient.

Time or duration of treatment is also one of the important factors in helping improve these problems in order to reverse some of these abnormal changes that happen in something like chronic pain.

After all you wouldn’t expect to go to the gym once and suddenly be in shape… it would be nice though!

Another factor in creating “plastic” changes in the nervous system is frequency of treatment.

More frequent treatments are more likely to drive these changes.

Returning to the gym idea.

If you go to the gym once a year, it’s not really going to help you at all. If you’re going 3 times a week for a while, you’ll start to see some real progress over time.

In part three of this series, we’ll discuss different treatments to help spinal pain, including the differences between medical and chiropractic approaches.