The Hidden Cause of Neck Pain

Join us for a deep dive into the cervical spine and how structure could be the cause to many conditions and symptoms. Hump Day Conversation #8!!

Top 3 Reasons People See A Chiropractor00:30-00:54
The Importance of Posture Structure00:55-02:11
Normal Neck X-ray02:12-05:55
Abnormal Neck X-ray05:56-10:03
Structure Dictates Function10:04-12:50
The Hump12:51-17:24
The Goal17:25-21:56

Transcript:

Dr. Clayton Roach:

I think this episode is going to rock. We’re switching gears towards chiropractic related topics and we chose to talk about the pain in the neck. By no means do we mean your spouse! Our number one reason for people to see a chiropractor is low back pain, followed by neck pain. Headaches are also popular. For the last two, we can find a link between them. So we’re going to talk about neck general anatomy and what it looks like. I find we always want to jump to what’s abnormal. But we forget about what we can’t see. Furthermore, what’s abnormal if you don’t understand what normal is?

Dr. Ben Boudreau:

Exactly. If we don’t know what normal is supposed to be then we’re just sitting in uncomfortable positions. As a result, we become comfortable doing that same sort of action repeatedly. Knowing what is supposed to be normal helps you put yourself into that position and encourages that type of behaviour.

Dr. Clayton Roach:

In this video, we’re going to tell you what causes the hump in the back of the neck. It isn’t because of your grandmother, it’s not genetic but there’s a reason why that happens. We have slides for you tonight to switch it up so I’m going to share my screen. The challenge tonight is for everyone to share this on Facebook live. As a result, this will help people understand what we do as chiropractors. I’ve seen this for 15 years; people think they have an idea but we’re going to clarify a few things tonight.

Dr. Ben Boudreau:

My favourite…radiology! Basic human anatomy here, there are seven vertebrae in the spine. In between those vertebrae, there are little spaces and that’s where your discs sit. They’re supposed to be nice and regular. The same thing with the vertebral bodies, they’re supposed to be nice and square. You can see the pedicles here in the posterior aspect of the vertebral bodies and on that sits your joints. See how the joints are normal cervical vertebrae? They have a little bit of space in between, and they’re not irregularly shaped. The spinous process is the laminas just behind and the pointy parts. We can all feel on the back of our neck.

Dr. Clayton Roach:

I get this question all the time, people will feel a bump, that bump is C2. C2 is a little different because it’s got dens, a pointy thing that sits below C1.  C1 is like a circle or loop and C2 has this long part that sits right in there and imagine all through that sits the spinal cord. It goes all the way down. Right over here is the trachea. That’s where people can breathe and that’s where the oxygen is going. Anywhere you see air on an x-ray it’s going to appear black, where you see hard tissue, like bone it’s going to appear white. When people have osteoporosis, the bones will appear a little grayer because there isn’t a lot of calcium in the bone.

The bone structure is not as dense, so it is going to appear a little bit grayer. You can see the sinus cavities here and you can see what’s called the EOP, the little bump on the back of the head. One thing you want to see is the back of the line here, the back of the vertebrae where you follow my cursor that should be a perfectly straight line. Ben, what happens if you don’t see a chiropractor, you text six hours a day, you sit at a desk all day long and at home you sit on the couch with bad posture.

Dr. Ben Boudreau:

Let’s start with the alignment of the vertebrae. We can see here that we have a nice 42-degree curve and during your first visit with Dr. Roach and Dr. Boudreau, one of the assessments is of the natural curve of the spine. 42 degrees is a healthy curve of the spine. Looking to the right, we can see that the alignment of the spine is completely straight and when the head juts forward, the spine is in a straighter position rather than assuming more of a curved position. As you can see George’s line isn’t aligned, some of these vertebrae, especially the fourth are slid ahead slightly more than the rest. This may not look relevant, but this is totally relevant because we’re getting straightening of the spine and the areas where the nerves come out are decreased in size and causes pain.

Dr. Clayton Roach:

Here you can see the spacing between the vertebrae as being fairly wide. This is beautiful and as Ben mentioned in a different view, you’d be able to see that the hole where the nerves come out from is also wide. Over here, the spacing is very thin and the vertebra is starting to jut out. The problem is that the hole where the nerve must exit is now smaller in comparison to normal anatomy and from C4 to T1 those nerves go down the arm. For some of you that have numbness and tingling going down the hand, the neck is probably the cause. There are reasons why you could have numbness and tingle in the hands and fingers without the neck being the cause but a good majority of them are going to be caused by what is going on in the neck.

Dr. Ben Boudreau:

Yes, and the spacing is one of the most important things to consider, especially when you’re looking at a spine that’s straight. If we look posterior to that line that Dr. Roach drew, just behind it you can look at those facet joints and you see that the alignment of the facets isn’t correct. There is very little spacing between those joints which produces increased rubbing and therefore welcomes further degeneration.

Dr. Clayton Roach:

This is a good example, here’s the facet joint on the normal vertebrae that line you can see, you can almost not see it at all on this one. That creates inflammation, it creates pain and you become that patient that rubs the back of their neck saying I don’t know why my neck hurts. If we don’t create a better curve with 42 degrees some of your symptoms are never going to go away because you’re always compromised over here. Let’s go ahead and look at what this looks like from the outside, Ben.

Dr. Ben Boudreau:

From the outside we can see our friend here to the left has a nice posture, the shoulder is aligned with the base of the eardrum and the curve is approximately 42 degrees. Our individual on the right, you can see how the earlobe is jutted forward and it’s ahead of the shoulder, creating more of a straight curve. I like to use the muscle here in the neck as an alignment indicator to show how the curve is performing and I drew a line that goes right along the back of the muscle there. Not good on the right side, whereas on the left side the muscle is in a posteriorly oriented position, in the position that indicates a proper curve.

Dr. Clayton Roach:

Without a proper curve the ear does not line up with the center part of the shoulder and we are starting to see more people with curves in their neck that aren’t 42 degrees. I saw this in an eight-year-old not too long ago. What’s happening is that we’re spending more time on devices that propagate that posture and we’re starting to see eight, nine, ten years old starting to complain of headaches. What happens when this is your posture, and the head is forward all these muscles back here get jammed so you start to get the pressure back here that then builds and creates pain right above the eye.

For example, you could have pain right in the back of the neck, but you can also get that referral in the front. Then you take a pill, and it numbs the pain, but it does nothing to fix this. Lastly, you need more pills to make the same pain go away over time, so the key is to change the structure. We talk about structure all the time because without proper structure you never create a better function and without function, you don’t change your life. Now to talk about the hump, Ben.

Dr. Ben Boudreau:

Here’s the hump in all its glory. You can see the head is jutted forward and as Dr. Roach said the base of the skull pushes more into a posteriorly oriented position and the vertebrae move ahead all the way down to the neck and into the thoracic spine. The segments beneath your hump jut out posteriorly and the back begins to flatten out. What that does is it places extra pressure on that area and those joints are now misaligned creating inflammation for your body to try and protect. What ends up happening is the inflammation continues to build, continues to build, and continues to build.

Dr. Clayton Roach:

This is not genetic okay; this is an issue with improper structure. I just want to mention a lot of these people will have TMJ issues. Jaw pain creates headaches. The reason is that there are muscles that attach to your jaw, to your neck, everything here is connected. This is a closed circuit; you can’t have one thing wrong and everything else is perfect. That’s why people that treat patients who treat only where the pain is are missing the boat. You cannot treat where the fire is because this is an expression of what’s happening over here. We need to make sure that we always look at where the cause of the issue is because once you can do that you will have an impact not just short term but for a lifetime.

Dr. Ben Boudreau:

The start of this happens in the neck but all that pressure must be dissipated somewhere. The head weighs resting between 10 and 13 pounds for every forward inch of head carriage, and the neck isn’t going to be able to offload all that pressure onto itself. It must offload it somewhere else and it will offload into the thoracic spine, into your mid-back all the way down into your low back. Or it will go the other way into your jaw and dissipating that pressure into your head and behind your eyes.

Dr. Clayton Roach:

Most women will experience it in the bra strap area. It is so common; we see it every day because the issue is not initially the mid-back the issue is the neck. We’re working from home more at a dining room table, not properly set up so these issues are relevant to what we’re going through in this different world. Anything else you want to add, Ben?

Dr. Ben Boudreau:

As chiropractors, we talk about two different laws in chiropractic and especially in rehab and manual therapy; Wolf’s Law and Davis’s Law. Wolf’s law is that the bones will respond to the pressures that are placed upon them. The example I commonly use is we know in karate people will kick trees over and over and over again until they can’t feel it. This is because the bone builds on top of itself to meet the pressure placed upon it. Davis’ Law is that the tissues will respond and become bigger and will differentiate with the pressures that are placed upon them. The hump is very similar to what we discuss in Davis’ Law. The tissues and the bones are responding to the environment in which it’s placed and just like it was formed it can be reversed.

Dr. Clayton Roach:

That’s a great point, Ben. Took me back to school for a moment. The goal is to have people take action. We’re going to drop our Calendly link, which is an opportunity for someone who wants to address their hump, neck pain, headaches and never really would have connected the two together. Many times, I’ll have people say I get the once-a-weeker and I ask what do you mean the once-a-weeker, do you mean a headache? What do you think is a normal number of headaches to get? Do they say I don’t know, once a week? I say none.

Many people don’t know that headaches are related to the neck, many people don’t know that having headaches is abnormal. It’s not normal because you hang around other people that have headaches. Ben has that Calendly link up for you if you would like to book an appointment. Those of you who are already patients can ask us questions. We want people to take action, and often we’ve talked about the why. If you don’t understand why there’s really no reason for you to take action so we wanted to go into the why tonight.

Dr. Roach Continued:

Why people have what they have and explaining what’s normal and what’s abnormal. I had a patient about three months ago and her migraines were debilitating. She had been everywhere, she was getting botox injections, going to the physiotherapist, had seen other chiropractors before but nobody had ever talked about the structure of her neck. We started addressing the structure of her neck and she now maybe gets a migraine every six or seven weeks. That’s a life-changer because she had to take time off work, couldn’t play with their kids.

The structure is everything, structure dictates function. We look at the body as a system and we need to create an environment within that system for it to heal. The body does its own healing but as chiropractors, we provide the ideal environment for that to happen and we have external stressors to deal with. Your work situation, your ergonomics, all that constantly puts stress on that system, which is why chiropractic is not a transaction it’s a process that we need to manage because stress never goes away. I want to thank our listeners tonight.

Dr. Roach Continued:

I think this was a good introduction to what we’re going to do in the future on these episodes and talk about health. If you like these types of episodes give us a thumbs up, make sure you share these episodes. People want to know this, there’s a lot of people that are struggling and they don’t know where to turn to. They’re going around in a circle from one specialist to the next and from one medication to the next and from one piece of advice to the next, only to find out after five years that their curve has gone from 42 degrees to 3 degrees and they have degeneration and they’re taking more medications. You may be able to help them just by sharing this video. We will be grateful as well to be able to provide some help and change their lives.

Dr. Ben Boudreau:

In conclusion, you know that there’s somebody out there who has this hump and might want to know a little bit more about it from a few professionals so don’t waste this opportunity, use it to show your friends a little bit of education here tonight. We look forward to seeing you in the clinic and we love and appreciate you. Take care and we’ll talk to you again next week.