Neck pain and stiffness are very common complaints, and these problems can come and go chronically for years, even decades. Numerous studies point to exercises and chiropractic care as two of the best approaches for gaining control over this common, potentially long-lasting, and sometimes disabling condition. However, focusing only on the neck may NOT be the best approach, but rather, the management of weak pelvic / low back stabilizing muscles can have significant benefits for those suffering from neck pain. Let’s take a closer look…
A group of physical therapists in Brazil and Australia performed a systematic literature review of the benefits of specific stabilization exercises for spinal and pelvic pain and looked at disability, return to work, number of episodes, global perceived benefit, and quality of life factors. They not only searched for the beneficial effects for low back and pelvic pain and dysfunction, but also the benefits for headache with or without neck pain and any related disability. Not only did they find significant research support for improving pelvic pain and for preventing recurrence after an acute episode of low back pain but they also found that cervicogenic headache and neck pain improved from the use of low back / pelvic stabilization exercises! Furthermore, researchers have found that patients achieve more significant improvement when stabilization exercises focus on the individual patient vs. the use of a generic “…one size fits all” stabilization program. Additionally, spinal manipulative therapy (SMT) has been reported as the most effective treatment for cervicogenic headache and neck pain patients. Other studies have found that the combination of exercise AND SMT is more effective than exercise alone.
The bottom line is that stabilizing the lower quarter (low back and pelvis) helps, as it offers the neck and head a better foundation on which to rest. An analogy would be a house with a weak foundation resulting in the whole house being in jeopardy, especially the attic or the area farthest away from the ground. Like the attic, the head is perhaps more dramatically affected by the weak pelvic stability than areas closer to the pelvis / low back.
Researchers have found that doctors of chiropractic can significantly improve neck pain, balance, and headaches in chronic neck pain patients by strengthening the deep neck flexors, or the muscles that attach directly to the front of the cervical spine. We also know that treatments that promote movement such as spinal manipulation, when rendered early-on, can results in better outcomes for the whiplash patient. Therefore, the “key” to the greatest success is chiropractic adjustments + cervical range of motion exercises + cervical stabilization exercises + lumbar/pelvis stabilization exercises! Traditionally, “rest and heat” are commonly prescribed for neck pain patients, or worse, they are placed in a cervical collar and taken off work and told to rest. The evidence published, especially since 2008, STRONGLY disagrees with this approach favoring a treatment plan that incorporates motion, “usual” activity (including work), manipulation, and exercise as soon as possible. Chiropractic embraces not only spinal manipulation but also patient specific range-of-motion and strengthening/stabilization forms of exercises as “main ingredients” to care when patients present for neck pain and headaches.
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