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A Pain in the Neck

Michele Jang
Michele Jang

By Michele S Jang, PT

Do you have neck pain?  You may think that a MRI is required to find the source amongst the plethora of possible causes of neck pain. The Journal of Orthopaedic & Sports Physical Therapy reports that while diagnostic imaging can identify degenerative processes or pathology, the tissue causing the neck pain is most often still unknown.
Neck pain is one of the most common reasons why people seek our expertise.  I have treated patients with excruciating & debilitating neck pain who have MRI reports showing nothing more than the standard aging processes.  Conversely, I have also treated those with minor neck pain who have horrific MRIs showing major mechanical dysfunctions such as stenosis, disc bulges, hypertrophic facet changes, etc.
I recall one particular patient that I saw for neck pain.  She had two MRIs performed on her neck within 3 weeks of each other.  The MRIs were performed at different facilities.  I often review and explain what the report says to the patient so they can better understand their position.  Interestingly, the interpretation of the neck MRIs differed and actually contradicted each other.  One report claimed she definitely had C5,6 disc degeneration.  The other report claimed that C5,6 were normal.
The message behind sharing these stories with you is to say that diagnosing the cause of neck pain is inconclusive solely based on investigative tests such as MRIs.  A practitioner needs to “get in there” to determine segmental mobility of the cervical spine and to assess muscular and fascial tightness.  In addition, signs and symptoms also need to be evaluated; such as testing for numbness, tingling or weakness of upper extremity muscles.  The pattern of symptoms help to indicate what level of the spine is involved. With this information, a proper plan of care can be established.
Care should include manual therapy techniques to optimize alignment of the spine which reduces disc strain and normalizes muscles, fascia, nerve and other soft tissue. Patients are educated in ways that they can change their movement and improve their posture via exercises so that the neck pain goes away and never comes back.

Michele S Jang, PT is a physical therapist who likes to look outside the box. She has been a physical therapist for over 21 years and has extensive training in manual therapy or the use of hands to help rehabilitate the body. Michele has been an instructor both in the United States and abroad. She offers Free Consults on Tuesday afternoons. Michele also has a team of therapists at Spirit Winds who offer an array of expertise on exercise, fall prevention, foot and shoe assessments, body mechanics and proper breathing technique to increase awareness and healing. Michele can be reached at 805 543-5100 or [email protected].

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