Neck pain is the fourth leading cause of disability, with an annual prevalence rate exceeding 30%.
by Luz Senan, D.C.
Most episodes of acute neck pain will resolve with or without treatment, but nearly 50% of individuals will continue to experience some degree of pain or frequent occurrences.1 Chiropractic care is a non-invasive treatment option that may help reduce your neck pain and other symptoms associated with it, such as:
- Cervicogenenic Headaches
- Muscle spasms
- Loss of range of motion
- Pain and/or numbness and tingling in the arms
Chiropractors can also help with the treatment of the following conditions:
- Cervical intervertebral disc injuries that don’t require surgery
- Whiplash or Cervical Sprain Injuries
- Degenerative Joint Disease
- Facet joint pain
In a study published by The Journal of Manipulative Therapy in 2014 concluded that “Interventions commonly used in chiropractic care improve outcomes for the treatment of acute and chronic neck pain. Increased benefit has been shown in several instances where a multimodal approach to neck pain has been used.” Chiropractic has been used safely and effectively for the treatment of neck pain and injuries for years with very good results.” 2
I have been asked several times by patients if the treatment of neck conditions is safe due to rumors that they have heard of strokes caused by cervical manipulation. Chiropractic manipulation consist of multiple techniques, some that include low force and no rotation. The Chiropractic Physician will evaluate the patient’s specific condition and determine which technique may be used according to the specific needs, condition, and age of the patient. It is a safe and effective way of treating neck pain. According to a very recent study published in the Journal of Manipulative Therapy 2017 “They found no excess risk of carotid artery stroke after chiropractic care. Associations between chiropractic and PCP visits and stroke were similar and likely due to patients with early dissection-related symptoms seeking care prior to developing their strokes” 3
How do I know if my neck pain is gradually getting worse and I may need to be evaluated by a Chiropractor?
You start by completing the Neck Disability Index. It is a questionnaire to help determine the severity of your symptoms, and also you can re-take it to measure the improvement after treatments.
Neck Disability Index
This questionnaire has been designed to give us information as to how the patient’s neck pain has affected their ability to manage in everyday life. A series of 60 questions is presented to the patient, who completes the questionnaire by choosing the “best answer” that describes his or her “typical” pain and/or limitations within the last week or two. All questions are divided into 10 sections, 6 questions per section. Only one answer can be chosen in each section, yielding a section score between 0 and 5. After the test is finished, section scores are added up, the total is divided by 50, and then multiplied by 100 to get patient’s percent disability. 4
Section 1 – Pain Intensity
0 I have no pain at the moment.
1 The pain is very mild at the moment.
2 The pain is moderate at the moment.
3 The pain is fairly severe at the moment.
4 The pain is very severe at the moment.
5 The pain is the worse imaginable at the moment.
Section 2 – Personal Care (Washing, dressing, etc.)
0 I can look after myself normally without causing extra pain.
1 I can look after myself normally but it causes me extra pain.
2 It is painful to look after myself and I am slow and careful.
3 I need some help but manage most of my personal care
4 I need help every day in most aspects of self-care.
5 I do not get dressed, wash with difficulty and stay in bed.
Section 3 – Lifting
0 I can lift heavy weights without extra pain.
1 I can lift heavy weights but it gives extra pain.
2 Pain prevents me from lifting heavy weights off the floor, but can manage
if they are conveniently positioned, for example on a table.
3 Pain prevents me from lifting heavy weights off the floor, but I can manage
light to medium weights if they are conveniently positioned
4 I can lift only very lightweights.
5 I cannot lift or carry anything at all.
Section 4 – Reading
0 I can read as much as I want to with no pain in my neck.
1 I can red as much as I want to with slight pain in my neck.
2 I can read as much as I want with moderate pain in my neck.
3 I can’t read as much as I want because of moderate pain in my neck
4 I can hardly read at all because of severe pain in my neck.
5 I cannot read at all.
Section 5 – Headache
0 I have no headache at all.
1 I have slight headaches, which come infrequently.
2 I have moderate headaches, which come infrequently.
3 I have moderate headaches, which come frequently.
4 I have severe headaches, which come frequently.
5 I have headaches almost all the time.
Section 6- Concentration
0 I can concentrate fully when I want to with no difficulty.
1 I can concentrate fully when I want to with slight difficulty.
2 I have a fair degree of difficulty in concentrating when I want to.
3 I have a lot of difficulty in concentrating when I want to.
4 I have a great deal of difficulty in concentration when I want to.
5 I cannot concentrate at all.
Section 7- Work
0 I can do as much as I want.
1 I can only do my usual work but no more.
2 I can do most of usual work, but no more.
3 I cannot do my usual work.
4 I can hardly do any work at all.
5 I can’t do any work at all.
Section 8 – Driving
0 I can drive my car without any neck pain.
1 I can drive my car as long as I want with slight pain in my neck.
2 I can drive my car as long as I want with moderate pain in my neck.
3 I can’t drive my car as long as I want because of moderate pain in my neck.
4 I can hardly drive at all because of severe pain in my neck.
5 I can’t drive my car at all.
Section 9 – Sleeping
0 I have no trouble sleeping.
1 My sleep is slightly disturbed (less than 1 hour sleep loss).
2 My sleep is mildly disturbed (1-2 hour sleep loss.)
3 My sleep is moderately disturbed (2-3 hours sleep loss).
4 My sleep is greatly disturbed (3-5 hours sleep loss).
5 My sleep is completely disturbed (5-7 hours sleep loss).
Section 10- Recreation
0 I am able to engage in all my recreational activities with no neck pain at all.
1 I am able to engage in all my recreational activities with some pain in my neck.
2 I am able to engage in most but not all of my usual recreational activities because of pain in my neck.
3 I am able to engage in a few of my usual recreational activities because of pain in my neck.
4 I can hardly do any recreational activities because of pain in my neck.
5 I can’t do any recreational activities at all.
The original report provided scoring intervals for interpretation, as follows:
- 0-4 points (0-8%) no disability
- 5-14 points ( 10 – 28%) mild disability
- 15-24 points (30-48% ) moderate disability
- 25-34 points (50- 64%) severe disability
- 35-50 points (70-100%) complete disability
If you are suffering from neck pain or any other associated condition and want more information to see if chiropractic care can help, feel free to give us a call.
- Fejer, R., Kyvik, K.O., Hartvigsen, J. The prevalence of neck pain in the world population: a systematic critical review of the literature. Eur Spine J. 2006; 15:834–848.
- Decina P, Descarreaux M, Duranleau M, Marcoux H, Potter B, Ruegg RP, Shaw L,Watkins R, White E. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. J Manupulative Physiol Ther. 2014 Jan; 37(1):42-63.
- Cassidy JD, Boyle E, Cote P, Hogg-Johnson S, Bondy SJ, Halderman S. Risk of Carotid Stroke after Chiropractic Care: A population-Based Case-Crossover Study. J Manipulative Physiol Ther. 2017 Apr; 26(4):842-850.
- Vernon, Mior. The Neck Disability Index: A study of reliability and validity. Journal of Manipulative and Physiological Therapeutics. 14 JMPT 1991; 14(7): 409-15.