Chiropractic care is a highly effective form of treatment for many cervical or neck-related conditions. But how do chiropractors determine what’s causing the pain and what approach to take to manage the patient’s condition? Let’s take a look at what chiropractors do when a patient presents with neck pain.
HISTORY
In the detective part of the job, the chiropractor has to determine pain generation or tissue involvement. They also have to rule in/out dangerous “red flags” (cancer, infection, spinal cord injury, fracture) that would require referral to the patient’s medical physician, specialist, or the emergency room. Chiropractors have to identify and tend to “yellow flags” (barriers to recovery like depression, anxiety, poor coping strategies, and more). This process starts with taking a history of the complaint. This helps identify how long the patient has experienced the condition, where the pain is, and if it radiates to other parts of the body. Grading is based on the severity of pain when the pain worsens or improves, and more. Questionnaires help identify the red and yellow flags. Questionnaires also determine how the condition affects activities, mood, and other aspects of the patient’s life.
EXAMINATION
The examination phase begins by identifying the pain generator(s). To do this, chiropractors use various tests to assess pain provocation/reduction, pain radiation, and the patient’s “pain behavior.” Pain behavior is associated with the “positive” or “negative” test result. For example, if bending the head forward (chin to chest) often feels better and looking up often hurts and sometimes provokes radiating pain into an arm, then the chiropractor will perform other tests that assess nerve conductance such as strength, sensory, and nerve compression tests. The examination may also include the use of diagnostic tools, like an X-ray, if necessary.
TREATMENT
Once the history and examination are complete, the chiropractor will be able to make a diagnosis and formulate a treatment approach. This can consist of manual therapies (spinal manipulation, mobilization, soft tissue work, etc.) performed in the office. This can possibly include modalities like traction, TENS, or cold laser. Patients may also receive instruction on the use of heat, ice, activity modifications, and nutritional/dietary information to help reduce inflammation. Additionally, the chiropractor may prescribe the patient exercises to perform at home to aid in the healing process.
Following an initial course of care—such as three visits a week for two weeks—the chiropractor may reassess the patient to determine if visits should be tapered down or if the patient can be released from care to return on an as-needed basis.
