CHIROPRACTIC HELP FOR NECK ARTHRITIS
Chiropractic is a rapidly growing part of conventional medicine. Chiropractic focuses on the neuromusculoskeletal system of the body and improves the connection between the musculoskeletal system and nervous system to treat different health ailments. This mode of treatment involves manipulation and adjustment of the joints and other structures of the musculoskeletal system. The safety and efficacy of chiropractic adjustments have led to frequent use of this treatment modality in conjunction with conventional therapeutic techniques. Chiropractic care has been found to be beneficial for the treatment and management of neck or cervical arthritis.
What is Cervical (or Neck) Arthritis?
Rheumatoid arthritis is a systemic inflammatory condition that may involve the cervical spine, giving rise to neck or cervical arthritis. Approximately 43-86% of individuals suffering from rheumatoid arthritis report involvement of the cervical spine. Cervical arthritis results in erosion of cervical vertebrae and ligamentous laxity. The clinical presentation of cervical arthritis may include subaxial subluxation, atlantoaxial instability, and cranial settling. Cervical arthritis patients also tend to suffer from atraumatic odontoid fracture, neurologic abnormalities, and inflammatory discitis. If left untreated, cervical arthritis can give rise to fatal complications including obstructive hydrocephalus, cardiac arrest, and stroke.
Clinical Features of Cervical Arthritis
Neck pain is the most common clinical manifestation of cervical arthritis. The pain usually occurs in the craniocervical region of the neck. Cervical arthritis patients may also complain of occipital headaches and ear or mastoid pain. This reflects the involvement of greater auricular and greater and lesser occipital nerves as they pass proximally to the atlas and axis vertebrae.
Cervical arthritis patients may also present with signs of neurological deficit which may include the following:
- Muscular atrophy
- Limb parasthesia (burning or prickling sensations usually felt in hands, feet, legs and arms)
- Bladder and/or bowel dysfunction
- Hyperreflexia (overactive or overresponsive reflexes)
- Spasticity (abnormal muscle tightness and spasms due to prolonged muscle contraction, usually resulting from damage to one’s brain, spinal cord or motor nerves)
- Abnormal plantar and/or abdominal reflexes
- Loss of proprioception (loss of your body’s ability to sense movement, action and location)
- Lhermitte’s sign (also called the ‘barber chair phenomenon’, which is an uncomfortable ‘electrical’ sensation that runs through the back and into the limbs, usually elicited by bending the head forward. It indicates indicates compression of the cervical spinal cord or cervicomedullary junction).
- Dysphagia (difficulty swallowing)
- Dysarthria (slurred speech)
- Tinnitus (ringing in ears)
- Vertigo (a feeling of dizziness which occurs without any accompanying movement)
- Visual disturbances
Chiropractic Care for Cervical Arthritis
Chiropractic care is among the safest and most effective therapeutic modalities for cervical arthritis. However, the chiropractic adjustment is not recommended during periods of active inflammation. Chiropractors may adjust the vertebrae and surrounding tissues depending on the presenting complaints and the health status of the patient. Chiropractors may use adjunctive therapies to modulate inflammation along with adjustment of the involved area of the spine. The adjunctive therapies include ultrasound, electrotherapy, cold laser, and infrared sauna to relieve pain, swelling, and stiffness of cervical joints.
Chiropractic Manipulation for Cervical Arthritis
Chiropractors first perform a thorough physical examination and radiologic imaging reports to identify the site of pathology. In the case of active inflammation, the practitioner may opt for any of the above adjunctive treatments. Chiropractic care involves the following steps.
- The practitioner will balance the ‘tendon regulation’. This is referred to as a kneading motion that is applied to relax muscles found in the midline of the neck. These muscles include sternocleidomastoid, splenius capitis, and splenius cervicis. These muscle tendons are manipulated five to seven times with force that can be tolerated by the patients.
- The second step for reducing cervical pain is ‘balancing osteopathy’. In this step, the patient is required to sit in an upright position. The chiropractor holds the jaw and occiput of the patient between his or her hands. The chiropractor then forcefully pulls these upward for 9 seconds and then relaxes for 3 seconds. During this procedure, the chiropractor turns the patient’s head in four directions at an angle of approximately 45 degrees – left, right, front, and back. Finally, the chiropractor wrenches the neck obliquely at a position where a pathologic lesion of cervical vertebrae is located. The angles at which the neck is flexed and their corresponding vertebrae are listed down below.
- The neck is flexed at 15 degrees if the lesion lies at C1 to C3
- The neck is flexed at 0 degrees if the lesion lies at C4 to C6
- The neck is flexed at 30-45 degrees if the lesion lies at C7 to T1
The patient is then required to repeatedly rotate the neck 40 degrees towards the right or left and then towards the affected side. The success of the treatment is indicated by a single or multiple ‘snapping’ sounds while rotating the neck.
6. The last step involves the balancing of ‘collaterals-dredging’. This is where the chiropractor holds the patient’s upper limb and then shakes the upper limb quickly and forcefully. This action is repeated three times. Next, the ear helix is kneaded and pulled upwards using the thumb and forefinger. The process is repeated for the upper, middle, and lower helix for 30 seconds each with tolerable force.
Chiropractic adjustment of the cervical spine alleviates pain and improves the range of movement in patients suffering from cervical arthritis.
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