Chiropractic Patient Case Study: Neck Pain Associated with Aging and Osteoarthritis

Patient History and Examination
When he visits the chiropractor, Amos is asked about his neck pain and past history including episodes of low back pain. The chiropractor asks him about his habits, how long he sits, and how much exercise he does. He wants to know if Amos has had any headaches or dizziness. Amos states that he hasn't.

The chiropractic approach is to always see a complaint -- in this case neck pain in the context of the body as a whole. The past history, present day habits, and unusual life stresses are emphasized in the chiropractic history.

In examining Amos, the chiropractor finds that all of his neurological signs are normal. The chiropractor finds restricted joint motion in all the planes of motion. When he examines specific spinal segments he finds "blocked" motion between each two spinal segments. He finds a lack of what is called "joint end play". End play is the normal "springing" movement that is felt in a normal joint when it is extended past its range of motion.

The chiropractor finds tight muscles all along both sides of the neck and into the upper and mid-back. Direct palpation (examination by touch) of the soft tissue in these areas is generally sore and in a few places quite painful.

Radiographic Imaging
The chiropractor knows from the examination that Amos has significant arthritis in his neck. An x-ray of the neck confirms these findings. Amos is shown the x-ray and the signs of spinal degeneration or osteoarthritis in the cervical spine. There is evidence of a thinning of the discs between the vertebra and bone spurs are seen developing out of the bodies of the vertebrae. The chiropractor reassures Amos that for a 74-year-old osteoarthritis with thinning discs is normal.

The image above is a general illustration of the spine
and is not an exact replica of the cervical spine.

Making a Diagnosis
What is significant for Amos is the disabling pain he is experiencing in his neck and back. These complaints correlate with findings of mechanical problems in the spine and x-ray evidence. The chiropractor diagnoses Amos as having neck pain associated with osteoarthritis, or "wear and tear" in the spinal joints. The general lack of motion in the spine has contributed to chronic tight muscles and inflammation of the soft tissues