Chiropractic Management of Traumatic Cervical Injuries

Stephen asked if he needed to wear a cervical collar. The chiropractor explained that he rarely used neck supports except in severe sprains because sometimes they made neck injuries worse. It was better to rest the neck, apply ice packs, and move the neck to some degree to prevent the neck muscles from stiffening up further.

The next day Stephen felt less burning and stiffness in his neck. The chiropractor's assistant applied ice and ultrasound to the neck. The chiropractor then did gentle resistance-type maneuvers to the neck called muscle energy therapy and applied gentle pressure to muscular trigger points, as well as gentle stretching.

When Stephen returned in two days, he was feeling better. He still had stiffness and pain in his neck, but no burning pain. The chiropractor palpated the spine and found less resistance in vertebral motion, less acute tenderness to direct pressure, and an increase in general motion. He now explained an adjustment to Stephen.

Cervical Adjustment
With the patient on his back, the chiropractor isolated a motor unit (or two spinal segments) with restricted in lateral flexion. He put resistance into the tissue and gave a gentle directed thrust into the neck (along the planes of the facet motion). There was a "pop" and Stephen felt an immediate release of tension. After the adjustment, the chiropractor re-examined the restricted segment and found increased motion in the joint.

Over the next two weeks, Stephen had a few more appointments where his neck and upper back was adjusted and then treated with additional soft tissue therapies. He was given instructions in neck exercises. He slowly returned to more activity. At the end of a month, he was pain-free and his neck had returned to normal motion.

Treatment Benefits
It was important for Stephen to have his neck treated. First, treatment was necessary to relieve the pain. Second, it addressed the disturbed spinal mechanics caused by the injury. Chiropractors feel it is important to address mechanical problems in the spine in order to aid in preventing future injuries and slow degeneration in spinal joints. The symptoms of pain associated with an accident can sometimes resolve without treatment, but in certain cases the underlying disturbed mechanics represented by spinal joints lacking optimum range of motion become chronic.

Significant gross range of motion (general motions of the neck forward and backward, to the side and in rotation) can often be normal while specific motor units lack full motion. These areas of disturbed mechanics can make the neck more vulnerable to injury and degeneration.