Who:

49 year old female, wife, mother and deli worker consulted with our chiropractic office for neck and arm pain.  She was referred to our office by her sister.

Past care:

ER: Prescribed Hydrocodone.

OTC: Advil

Symptoms:

Moderate-severe unrelenting pain on the left side of her lower neck. The pain also radiated to her left elbow and down the left side of her middle back.

She was not aware of what brought this on, but has had similar pains, although not nearly as painful, in the exact area for the  last 5-7 years.  She believes that the cause of this was a rear end collision in the early 90’s.

She has not been able to sleep for the past three nights and has had to sit in a recliner rather than laying down because of the pain.

To help to relieve the pain she did the following:

1. Aleve pills  (12-16 per day)

2. Hydrocodone (1 a day)

3. Rest. Unable to work.

These things made it worse:

1. Turning her head in either direction

2. Looking up or down

3. Sneezing and cough causes severe pain to shoot down the arm

Chiropractic/orthopedic examinations:

1. Two (2) disc tests made her pain worse, including the cough test.

2. Bending her head to the right and turning to the left increased her pain to a level of 10.

X-Ray studies:

The side view of her neck revealed a loss of the cervical arc. See her x-ray below on the left (with red markings).

Notice how the neck is bowing the wrong way (compare to the good one on the right). Also, see how the discs have worn down between spinal bones 4 and 5 and 6 and7 (compare to the thick discs on the right).

Working Diagnosis:

1. Bulging disc at C5-C6.

2. Degenerative disc C5-C6

Treatment:

I treated her with computerized chiropractic adjustments.  I set the force on the instrument to 200 Newtons (equivalent to 44 pounds of force).  This is the optimum setting for the cervical spine (neck).

Outcome:

After 5 days of the computerized chiropractic adjustments her arm pain was 80% relieved, most of her middle back pain had left and her neck pain was reduced 60%.

I re-examined her at 4 weeks.  All her pain was gone.

 Set her up for periodic care one time a month to improve the arc in the neck and to help with nutrition to the disc.

Comments:

This type of case I see fairly often, that is, pain in the neck down the arm and into the shoulder blade, everything on the same side.

I believe what lead to this problem was the loss of the arc (bad alignment) in her neck was from an  old rear end collision in the early 90’s. She never had her neck treated and it remained in a bad position for too many years (about 20 years).

This type of position is detrimental to the life of the disc.  It puts too much stress on it and causes it to deteriorate prematurely.  When this occurs the jelly like material inside the disc can migrate back into the nerve.  Many people know this as a bulging disc.

Most people think they slept wrong or pulled something.  However, this patient had  a classic pain pattern of a bulging disc at C5-C6. These usually clear up pretty well with the computerized adjustments, especially if the bulge is between 1-3 mm.  Larger disc bulges, in the 4-6mm range are more difficult and take longer to correct. 

I use the term “correct” loosely, because you really don’t correct a worn out disc.  For the most part, the jelly substance that bulges, does not go back where it belongs.  The computerized chiropractic adjustment decompresses the  spinal bones, which restores proper movement, reduces inflammation and muscle spasm, all which help to un-pinch the nerve.

In order to reduce the chances of this returning, it is important to keep stress off the disc. I usually recommend receiving chiropractic adjustments to this vulnerable area, at least 1 time a month to reduce the gravitational forces on an already worn joint. Unfortunately, it is a very low percentage of people that follow through with this once their pain is gone. Many of my patients never followed up once a month, and needed surgery later.