Neck Pain and Arthritis

When we say the word “arthritis,” many images pop up in our heads. Some people think of crippled hands or perhaps Mr. Smith who talks about his bad hip being, “…bone on bone!” Or, how about the neighbor who has a bum knee and walks with a limp and a cane? Rarely do we think about the neck being associated with “arthritis.”

Before we go too far into this discussion, we should define the term, “arthritis,” which means joint (“arth-“) swelling (-itis). Simple enough, right? Wrong! Without getting too complicated, we must realize there are MANY different types of arthritis such as osteoarthritis, rheumatoid arthritis, lupus, gouty arthritis, psoriatic arthritis, etc. To narrow this down a bit, we will limit our discussion to osteoarthritis, also known as degenerative joint disease.

Degenerative joint disease or DJD, is the most common type of arthritis that EVERYONE eventually ends up with – whether we like it or not. That’s because, over time, our joints wear out and become “arthritic.” While it’s true that weight bearing joints wear out quicker (like hips and knees more so than elbows and shoulders), DJD can affect any joint. There are many causes of DJD, including a genetic or hereditary tendency but the most common cause is wear and tear over a long period of time. Of course, the rate of acquiring DJD in the neck (or anywhere else for that matter) is directly related to how “nice” we have been to our body, in this case, the neck. For example, after a car accident, a common injury to the neck is whiplash. This occurs because we literally cannot control the speed of the head as it rapidly moves forwards and backwards upon impact and it’s all over within 600-800 milliseconds! Since we can’t voluntarily contract a muscle that fast and when joints move beyond their normal stretch length, the ligaments – those non-elastic, tough tissues that securely holds bone to bone – will only “give” so much and then tear, which is technically called a “sprain.” This leads to an accelerated rate of degeneration.


Blood tests are negative with DJD (unlike many of the other types of arthritis), and an x-ray can help determine how “arthritic” the joint is and whether the smooth, silky ends of the joint (called hyaline cartilage) are worn down and if bony spurs are present. In the neck, DJD can create a lot of symptoms which may include pain and stiffness, especially in the mornings after laying still and not moving during the night. After we get up and move around, “…it loosens up.” As the condition advances, neck movements become tight and restricted with pain, which further limits movement, and sooner or later, the patient must rotate their whole body to look to the side. If the arthritis hits or bumps into a nerve as it exits the cervical spine, neck soreness, and numbness/tingling may radiate down an arm, at times to the hand, usually only affecting certain fingers. Headaches, especially in the back of the head, can also occur from the reflex muscle “splinting” due to the pain associated with arthritis. As Dr. Peter Ulrich, MD points out (http://www.spine-health.com/conditions/arthritis/cervical-osteoarthritis-neck-arthritis) chiropractic adjustments, “…help control chronic symptoms or provide relief for more severe episodes of pain from osteoarthritis.”

We at Heathrow Chiropracticrealize that you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for neck/arm pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Are all Supplements Created Equal?

Supplement Quality--What's the Deal?

In the United States alone there are approximately 1,000 supplement manufacturers. These companies can be anything from a mom and pop operation putting raw materials into capsules in a garage to a multimillion dollar lab with high tech equipment comparable to some of the large pharmaceutical companies. And there's no government regulation of the supplement world. This often leads the consumer to question the purity and manufacturing process of what they see on the shelves, as they should. All supplements are definitely not created equal. But just because the government doesn't regulate the supplement industry (which is good, because they would probably make it worse) doesn't mean the industry doesn't have some internal regulation.

I now direct you to the Natural Products Association, a company that, among other things, has a "Good Manufacturing Process" seal of approval available to supplement companies that pay to have their labs audited. If the supplement company goes for it, and passes, they get to put the "GMP" stamp of approval on their products. I already mentioned that there are 1,000, give or take, supplement companies in the U.S. There are only 77 companies that have made it through the process and sport the GMP label.

And of the 77 that have made it that far, only one company can claim that they also, in fact, manufacture actual pharmaceuticals, and therefore have inspectors and auditors of various natures in their facilities on a very regular basis. And that supplement company is Anabolic Labs--the guys I deal with.  Not just because of their level of quality; their actual line of products is congruent with my thinking about what people need less of: inflammation. They're making it easy these days by putting 30 day packages together of the four supplements I think most people should take: vitamin D, magnesium, fish oil, and a multivitamin that contains no iron (more on that in a future post). The clinical results from a low inflammatory diet (more on that, too) and the addition of the aforementioned supplements can be impressive.

I'm not telling you not to take the stuff they sell at your corner vitamin/supplement store, I'm just telling you to be aware that there are quality control measures in place. There are some good companies that aren't participating .   The one company that I personally have always trusted is Anabolic Laboratories!

Office workers and their Necks

More people than ever sit in front of a computer for a living these days, and if you're reading this it's likely that you're one of them. So before you get back to being productive for your boss, let's review some ways you can spare your neck in the process.

First, the basics: Your head weighs, on average, about 12 pounds. You have a fairly complicated series of joints and muscles holding that weight off your shoulders and giving you the freedom to look around. Like every other complicated system, the more moving parts to deal with, the more likelihood for something to go wrong. Some of the muscles that get tweaked and stretched when your head moves too far forward (the classic computer posture) are the deep flexor muscles. That would be these guys:

These muscles work in concert with others in the posterior part of your neck to give both stability and freedom of movement to the head. They also get beat up when we get our heads too far forward and keep them there all day, like you may very well be doing right now. Interesting fact--every inch forward your head moves takes three times more power to support the weight. Makes sense--if you hold a bowling ball close to your body it's easier to support than holding it out in front. And your head weighs about the same as a bowling ball. No disrespect.

Eventually, certain muscles get too tight which causes others to turn off ("reciprocal inhibition," again). This happens because muscles activated on one side of a joint cause the muscles on the other side of the same joint to become inhibited--when you flex your bicep, your tricep has to turn off so you can perform the movement. Your neck is no different, and when it happens for hours on end in only one direction neck pain is often the result. This is sometimes referred to as "upper crossed syndrome." It looks like this:

Upper crossed syndrome can lead to a wide variety of pain and instability problems, including shoulder pain, pain around the shoulder blades (especially at the upper, inside border), and, of course, neck pain. None of which is very fun. 

Incidentally, the shoulder pain I just referred to is more than just pain, it's lack of stability. The shoulder blades are essentially the reason your shoulders move the way they do, and the serratus anterior muscles you can see in that picture (the ones that get inhibited) are important when it comes to stabilizing your shoulder joint. If they get turned off and you go try throw a softball around or swing a racket of some kind you could be in for some shoulder issues. More on that in a future post.

An ounce of prevention, as they say, so let's look at the exercise I give every patient with neck pain who walks in the door here: The Brugger. This is done while sitting on the edge of your chair. Step one--tuck your chin straight back while keeping your eyes nice and level. This will create a really nice double chin that you can be proud of. Step two--try and keep your head in position while placing your palms in a a forward facing position with your arms slightly bent and back a little. You should feel a nice stretch where your chest connects to your shoulders.You'll be in this position at the end of the movement: Hold this position for three deep breaths and then go on about your business.

Sometimes the neck pain associated with the upper crossed syndrome is due to joint restrictions in your neck. Static postures held for hours on end can cause the joints to stop moving like they should, which can often lead to pain. Classically, the base of the neck (where your neck connects to your body) gets locked up, and when the muscles of the shoulders join the party to protect the compromised joint, the combination drives people to my office. The joint right at the base of the skull is another key location for dysfunction, and the combination of those locations can cause blistering headaches with a fairly predictable pattern, such as this:

Fortunately, those headaches respond quickly to manipulation of the affected joints, especially when combined with soft tissue work to release the trigger points in the muscles. I recently had a patient leave the office with tears of joy welling up in her eyes because her chronic headache had disappeared for the first time in about a year. 

So do your Bruggers, and take your eyes of the screen and focus on something on the other side of the room while you do them. This will help your back, neck, shoulders, and your eyes, too. Why don't you start now? And if the headaches have already begun, and this doesn't make them go away, come see me at Heathrow Chiropractic. Tell 'em the blog sent you!