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The Neck: The Cervical Spine



·                  Vertebrae and Discs

·                  Joints

·                  Nerves

·                  Soft Tissue

·                  Range of Motion

·                  Understanding Neck Problems

o                                             Stiffness

o                                             Instability

o                                             Degenerative Joint Disease

o                                             Nerve Root Problems


Know Your Neck


Your neck (cervical spine) is made up of the top seven vertebrae of your spine. A healthy neck is strong, flexible, and pain free, and the joints of these vertebrae are balanced and aligned with a slight natural curve. Your neck supports your head, protects your spinal cord and spinal nerves, and allows you to move your head in a variety of ways.


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Vertebrae and Discs


Your neck is made up of seven bones (vertebrae), naturally aligned in a slight forward curve. The vertebrae have openings foramina) where spinal nerves pass into the shoulders and arms. Discs are shock-absorbing pads of cartilage between the vertebrae. Healthy discs have a tough covering, a jelly-like interior, and a certain amount of "give" to adapt to various head and neck movements.


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The joints in your neck allow you to move your head. Each vertebra joins with the next in two places (the facets and the Joints of Luschka), giv­ing the spine great flexibility.


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Your neck is the channel connecting your brain with the nerves throughout your body. Spinal nerves branch off from the spinal cord and pass through the foramina. Each spinal nerve is "rooted" to the spinal cord with two small nerve roots.


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Soft Tissue


Soft tissue includes muscles, tendons, and ligaments. Muscles work together to move and support your head. Tendons are tough tissues that connect muscle to bone. Ligaments are strong bands of tissue that stabilize and con­nect the vertebrae.

Trigger points are small, localized areas of pain and muscle spasm, a common symptom of many neck problems. Referred pain originates in the neck but is felt nearby in the shoulders, arms, hands, or face. Each muscle has its own pattern of referred pain.



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Range of Motion


Your neck moves more than any other part of your spine, and can move in three basic ways. Each of these movements has its own range of motion-the amount of motion that is nor­mally possible. Most neck problems affect your range of motion in some way. The three types of motion are called flexion, rotation and tilting. Flexion is dropping your head for­ward; extension is dropping your head backward. Their combined range of motion is about 90°. Rotation is turning your head from side to side, and has a range of motion of about 180°. Tilting your head from side to side has a range of motion of about 120°.


      Flexion                               Rotation                       Tilting



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Understanding Neck Injuries


Stiffness: Hypomobility


The Problem: If you have a stiff neck, you may also have pain and muscle spasm, an aching, tired neck, headache, and referred pain to your face, shoulder, arm, or hand. Stiffness may be caused by poor posture, muscle fatigue, tension from physical or emotional stress, and long hours in one position. Stiffness can come on suddenly, or you can accumulate fatigue and stress over many years. Left untreated, stiffness can result in muscle tension headaches and eventually lead to the breakdown of cartilage inside your joints (osteoarthritis).


The Treatment: The goals of your adjustments are to relieve pain, improve your range of motion, and restore the alignment of your neck. Soft tissue adjustments focus on any trigger points. With bony adjustments, your chiropractor uses a gentle, thrusting pressure on specific ver­tebrae. Various therapies (electrical stimulation, ultrasound or diathermy) may be used before your adjustment to relax your neck. Adjustments may be followed by stretching and/or exercises.


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Instability: Hypermobility


The Problem: If your neck problem is instability, you may be feeling pain, muscle spasm, and the curious sensation of a wobbly neck. Instability is often caused by a whiplash injury from a car ac­cident. Your head is hurled in one direction, then another, causing the ligaments, muscles, and tendons of your neck to stretch too far or tear. You may have had the injury several years ago, with neck pain and looseness ever since. Left untreated, instability can result in stiff scar tissue around your joints, referred pain, headache, and disc problems.


The Treatment: The goals of your adjustments are to relieve pain and spasm, to restore the alignment of your neck, and to increase its strength and stability. Because ligaments stabilize the neck, these are the focus of soft tissue adjustments. Your chiropractor performs bony adjustments on, above, or below the site of injury.Your chiropractor may stabilize your neck with a cervical collar before beginning your adjustments Various treatments (electrical stimulation and ice) may be used before the adjustments to help decrease spasm in your neck. A cervical collar, cervical pillow, or neck exer­cises may be prescribed afterward to help sup­port and strengthen your muscles.


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Degenerative Joint Disease


The Problem: When discs compress and lose their spring, your joints begin to grind together and wear down. The openings in the vertebrae can narrow and pinch nerves, and bone spurs can develop. You may experience pain, stiffness, a feeling of sand in your joints, muscle tension headache, and nagging neck aches often worse in the morning, Joint degeneration is due to the break­down of cartilage inside your joints (osteo­arthritis), caused by years of wear and tear or an old injury. Left untreated, joint problems can begin to affect your nerves and spinal cord.


The Treatment: The goals of your adjustments are to relieve pain, to help separate compressed joints, and to restore the alignment of your neck. Soft tissue adjustments by your chiropractor focus on stretching the soft tissue in your neck. Bony adjustments help separate compressed joints, and often include gentle traction and slight rotation of the vertebrae. Your chiropractor may apply various  treatments before your adjustments. Neck stretching and/or exercises may be used afterward. Your home care is especially important with de­generative joint problems.


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Nerve Root Problems


The Problem: Nerve root and spinal nerves pass through the vertebrae in your neck and can become irritated. You may experi­ence sharp pain shooting down your arm or tingling, weakness, and numbness in your arms and hands. A nerve root problem can be caused by a variety of joint and disc problems, such as facet problems, a ruptured disc, or severe osteoarthritis. Left untreated, further neck or nerve problems can develop.


The Treatment: The goals of your adjustments are to relieve pain, numbness, and tingling, and to realign your vertebrae to relieve the pressure on the nerve roots. Soft tissue adjustments focus on the tissue around each joint. There are a variety of bony adjustment techniques, depending on the cause of your nerve root problem. Your chiropractor may use cold treatment immediately after the adjust­ment to reduce the swelling caused by nerve root problems.


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