A recent literature review finds evidence that patients with chronic neck pain
enrolled in clinical trials reported significant improvement following chiropractic spinal manipulation, according to a March/April 2007 report in the Journal of Manipulative and Physiological Therapeutics (JMPT).

As part of the literature review, Dr. Vernon and his colleagues reviewed nine previously published trials and found “high-quality evidence” that patient’s with chronic neck pain showed significant pain-level improvements following spinal manipulation. No trial group was reported to remain unchanged, and all groups showed positive changes up to 12 weeks post treatment. No trial reported any serious adverse effects.

There are many conditions that can cause chronic neck pain including cervical herniated discs, cervical foraminal stenosis, cervical degenerative disc disease, reverse/straightening of the cervical curve, cervical osteoarthritis, and muscle spasm of the cervical musculature due to posture, stress, overuse, and whiplash.

Neck pain that develops slowly (often over a number of years) and tends to occur during or after certain activities or neck positions is frequently caused by cervical foraminal stenosis. Usually, impingement of one nerve root on one side of the spine causes most of the symptoms.

Pain that radiates down the arm, along with symptoms such as lack of coordination in the arms and legs, difficulty with fine motor skills, and occasional intermittent shooting pains usually occurs with a cervical herniated disc and/or with cervical degenerative disc disease. Neck pain that is often characterized by a low level of chronic pain that sometimes “flares” and gets worse, is made worse by certain positions or activities, and may be accompanied by arm pain can also be due to a degenerative disc.

Patients who feel their worst when they first rise in the morning and at the end of the day, and often feel better when they are able to move their neck around indicates cervical osteoarthritis.

Chronic muscle spasm in the neck causes a general feeling of tightness in the neck, with difficulty turning the head in one or both directions. The patient often feels as if they need to constantly stretch or massage their neck muscles.

All of these causes of chronic neck pain will benefit from conservative treatment including chiropractic care. After diagnosis is made by x-ray and physical exam, a course of conservative care is recommended typically for a minimum period of 90 days. Spinal manipulation restores motion to the cervical vertebrae and increases range of motion in the neck. It also removes any interference that is being caused by the lack of motion. This allows the nervous system to respond appropriately thus decreasing swelling, decreasing pain, and increasing range of motion. If the pain does not respond within 6 to 12 weeks of conservative treatments, then surgery may be recommended.