Chiropractic Neck Pain Treatment

Neck pain refers to any discomfort in the area around the neck, including the arms, shoulders, and upper back. Neck pain may occur as a result of overuse of the muscles or a sudden blow. In some cases it may even occur as a result of sleeping in improper positions.

Anatomy of the Neck

Proper treatment of neck pain begins with an understanding of the root causes. This is facilitated by a grasp of basic cervical anatomy.

Extending from the skull to the pelvis, the vertebral column, also known as the backbone, is composed of smaller bones called vertebrae. These bones are separated from one another by masses of fibrocartilage known as intervertebral discs that are connected to each other by ligaments. The vertebral column must be strong enough to support the head while being flexible enough to allow movements like turning, rotating, and bending forwards or backwards. This combination of stability and flexibility makes the backbone a marvel of anatomical engineering.

There are seven cervical vertebrae in the neck. Though they are the smallest of all the vertebrae in the spine, their bone tissues are deeper than those of any other. Notably, there are transverse foramina within the cervical vertebrae, holes through which the vertebral artery, vein, and nerves pass on their way to the brain. Moreover, because the spinous processes of six of the seven vertebrae are forked, they are able to provide attachments for muscles. The one that is not, the first vertebra, supports the head. This vertebra is known as the atlas. The one below it, the axis, forms the pivot upon which the atlas rotates.

Neck Pain Conditions

A pinched nerve is damage to a nerve through compression or constriction by surrounding tissue that produces radiating pain and a burning sensation. While this condition can occur throughout the body, pinched nerves in the cervical region (or pinched neck nerves) can be especially damaging because the nerves in this area have a wide sphere of influence. For example, a pinched nerve at cervical level C5 can cause shoulder pain and deltoid weakness, and in some cases may create numbness in the shoulder. A pinched nerve at C6 can cause weakness of the biceps and wrist extensors, along with radiating pain along the arm all the way down to the thumb. A pinched nerve at C7 can cause pain from the shoulder to the middle finger, while a pinched nerve at C8 can impair the reflexes of the hand.

Myofascial pain is a condition that can lead to chronic pain. This is a disorder affecting the fascia, the dense connective tissue covering the muscles and bones. In a normal state the myofascia is soft and pliable, able to stretch freely, and spreads almost without interruption throughout the body like a fine carpet. However, inflammation or trauma can cause the myofascia to become tight and restricted. This in turn can cause problems such as headaches, muscle spasms, neck pain, sciatica, and difficulty breathing.

Myofascial pain is thought to originate from spots of tenderness, or “trigger points,” found in various places in the muscles and fascia of muscle tissue. These trigger points are hyper-irritable muscle spindles that are electrically active and painful to touch. Trigger points can be either active or latent. Active trigger points are always sore and make it difficult to use the muscles. Latent trigger points are only tender when touched, but may become active when the muscle is strained or injured.

The most common cause of myofascial pain is repetitive postural strain, though it can also result from stress, lack of sleep, nutritional deficits, and hormonal and psychological disorders.

Upper Back and Neck Pain Treatment

Neck pain pinched nerve treatment depends on the severity and cause of injury, but rest is generally effective and physical therapy is often recommended by physicians. A consistent program of neck pain treatment exercise, especially, can help strengthen the core muscles and relieve pressure being applied to the nerve root. Stretching and flexibility exercises can assist range of motion in the cervical joints, while strengthening exercises will help to maintain posture and eliminate sudden eruptions of pain.

Treatment options for cervical myofascial pain include conventional neck pain home treatments like anti-inflammatory drugs to reduce pain, along with therapeutic massage to tighten loose muscles and relieve cramps. A physician may recommend a daily regimen of physical therapy that involves stretching and strengthening exercises. Chiropractic treatment for neck pain is a hands-on approach in which a licensed chiropractor applies gentle pressure to the affected areas, increasing range of motion and relieving painful symptoms.

Treatment of Neck Pain at the New York DNR

At the New York DNR we employ a variety of advanced approaches for neck and shoulder pain treatment. Among them are dynamic neuromuscular stabilization (DNS), neural mobilization, Pilates, variety of different myofascial techniques, and postural control training. Acupuncture and shockwave therapy may also be employed in certain cases as treatment for chronic neck pain.

While many conventional treatments for chronic neck pain are focused on strengthening muscles, the DNS approach differs in beginning with restoration of motor control ,muscular synergies and intrinsic stability. This, in turn, re-establishes muscle balance and re-trains the human body in posture and movement, effectively re-training the muscles by taking the patient back to the ingrained habits first learned in early childhood. Those habits are re-learned and in some cases corrected to prevent recurrence of injury and development of future injuries.

Although professional athletes use DNS therapy and exercises for rehabilitation, neck injury prevention, and performance enhancement, this treatment is not limited to those who play sports for a living. Its general application extends beyond the sports community, and it has proven an effective treatment for all patient groups.

Our clinic offers extracorporeal shockwave therapy (ESWT) in the event of severe myofascial pain syndrome. Focused low energy shockwave therapy for the neck is a cervical neck pain proven to eliminate trigger points in cervical musculature.When this process is initiated, injured tissue gradually heals itself. ESWT is a relatively new, non-surgical treatment that regenerates damaged tissue, and has been used to combat a variety of tendon, muscle, and bone disorders.

Range of Available Unique Physical Therapy Treatments at Nydnrehab

Research at NYDNRehab

About the Author

Dr. Lev Kalika is clinical director of NYDNRehab, located in Manhattan. Lev Kalika is the author of multiple medical publications and research, and an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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