Jun 22

Relief For Lifestyle-Connected Neck Pain Via Nervous System Calming

Chronic neck pain is very common today with lifestyle issues like smart phone use, stress, and telecommuting. A meta-analysis of published randomized clinical trials regarding the effectiveness of manual manipulative therapy reported that it has been described as and demonstrated to be a safe, less painful, and common way to ease chronic neck pain and related neck disabilities. (1) And a paper that just came out on June 1, 2023, reported that long-standing neck pain treated with manual therapy statistically significantly improved and reduced heart rate variability consistent with reduced sympathetic tone (a good thing!) and patient-perceived pain. (2) Sympathetic tone is the ‘fight or flight’ response to stressful (like long-standing, chronic neck pain) or dangerous situations and is part of the autonomic nervous system (the system of functions you don’t have to think about controlling like blood pressure, heart rate, digestion, sweating, urination, etc.). These autonomic signals start in the spinal cord and extend out throughout the body. Calming sympathetic tone can go a long way in managing neck pain. Our chiropractic treatment using Cox® Technic spinal manipulation has been well-studied and documented to manage neck pain, too. It’s been shown to reduce intradiscal disc pressures which are seen with neck pain. (3) NIH and HRSA funded studies have shown clinician proficiency in learning and delivering Cox® protocols after training. (4,5,6) Further, case studies have been published demonstrating reduction in pain and disability with Cox® Technic like one case of severe neck and arm pain relieved in 15 visits in 10 weeks and another with 10 treatments in 4 weeks. (7,8) Let us calm your nerves and ease your neck pain! They’re all spine-connected!

TIP OF THE MONTH: 

Add Breathing Exercise to Physical Exercise

Do you think about breathing? How about when you are exercising? Most of us don’t. Breathing just happens. As mentioned in the above article, breathing is part of the autonomic nervous system that makes sure these types of functions continue without our thought. A study examined how chronic neck pain patients breathed and if better breathing exercise would help. 68 chronic neck pain patients were split into 2 groups: one with breathing re-education exercise or routine physical therapy. The breathing group showed significant improvement in neck flexibility, extension, endurance, and strength of neck flexors and extensors. (9) Since this breath work seems to help neck pain patients, studies are now in the works for chronic low back pain patients. One that will study how conscious connected breathing may help emphasized just how closely connected the respiratory system is throughout the body and “bidirectionally related” to emotion, stress, and pain. (10) Another study will have back pain patients do exercise with specific breathing techniques and without and compare outcomes related to pain, disability, anxiety, sleep, quality of life, health status, and more. (11) Breathing more consciously and exercising appears to be an up-and-coming benefit for the treatment plan of chronic back and neck pain!

Listen to this PODCAST with Dr. Lee Hazen and Cheri Hazen on The Back Doctors Podcast with Dr. Michael Johnson as they describe their combined efforts in helping back pain patients realize less pain and better function with The Cox® Technic System of Spinal Pain Management and breath coaching.

We look forward to seeing you soon!


References for HEALTHY NEWS – June 2023

  1. Liu Z, Shi J, Huang Y, Zhou X, Huang H, Wu H, Lv L, Lv Z. A systematic review and meta-analysis of randomized controlled trials of manipulative therapy for patients with chronic neck pain. Complement Ther Clin Pract. 2023 Apr 7;52:101751. doi: 10.1016/j.ctcp.2023.101751. Epub ahead of print. PMID: 37084588.
  2. Harper B, Price P, Steele M. The efficacy of manual therapy on HRV in those with long-standing neck pain: a systematic review. Scand J Pain. 2023 Jun 1. doi: 10.1515/sjpain-2023-0006. Epub ahead of print. PMID: 37261845.
  3. Gudavalli MR, Potluri T, Carandang G, Havey RM, Voronov LI, Cox JM, Rowell RM, Kruse RA, Joachim GC, Patwardhan AG, Henderson CN, Goertz C. Intradiscal Pressure Changes during Manual Cervical Distraction: A Cadaveric Study. Evid Based Complement Alternat Med. 2013;2013:954134. doi: 10.1155/2013/954134. Epub 2013 Aug 20. PMID: 24023587; PMCID: PMC3762077.
  4. Gudavalli MR, Salsbury SA, Vining RD, Long CR, Corber L, Patwardhan AG, Goertz CM. Development of an attention-touch control for manual cervical distraction: a pilot randomized clinical trial for patients with neck pain. Trials. 2015 Jun 5;16:259. doi: 10.1186/s13063-015-0770-6. PMID: 26044576; PMCID: PMC4460764.
  5. Gudavalli MR, Vining RD, Salsbury SA, Goertz CM. Training and certification of doctors of chiropractic in delivering manual cervical traction forces: Results of a longitudinal observational study. J Chiropr Educ. 2014 Oct;28(2):130-8. doi: 10.7899/JCE-14-18. Epub 2014 Sep 19. PMID: 25237767; PMCID: PMC4211585.
  6. Gudavalli MR, Vining RD, Salsbury SA, Corber LG, Long CR, Patwardhan AG, Goertz CM. Clinician proficiency in delivering manual treatment for neck pain within specified force ranges. Spine J. 2015 Apr 1;15(4):570-6. doi: 10.1016/j.spinee.2014.10.016. Epub 2014 Oct 22. PMID: 25452013; PMCID: PMC4375060.
  7. Gudavalli S, Kruse RA. Foraminal stenosis with radiculopathy from a cervical disc herniation in a 33-year-old man treated with flexion distraction decompression manipulation. Journal of Manipulative and Physiological Therapeutics. 2008;31(5):376–380. – PubMed
  8. Manison AM. Chiropractic management using Cox cervical flexion-distraction technique for a disk herniation with left foraminal narrowing in a 64-year-old man. J Chiropr Med. 2011 Dec;10(4):316-21. doi: 10.1016/j.jcm.2011.04.004. PMID: 22654692; PMCID: PMC3315856.
  9. Anwar S, Arsalan A, Zafar H, Ahmad A, Hanif A. Effects of breathing reeducation on cervical and pulmonary outcomes in patients with non specific chronic neck pain: A double blind randomized controlled trial. PLoS One. 2022 Aug 25;17(8):e0273471. doi: 10.1371/journal.pone.0273471. PMID: 36006997; PMCID: PMC9409509.
  10. Pratscher SD, Sibille KT, Fillingim RB. Conscious connected breathing with breath retention intervention in adults with chronic low back pain: protocol for a randomized controlled pilot study. Pilot Feasibility Stud. 2023 Jan 24;9(1):15. doi: 10.1186/s40814-023-01247-9. PMID: 36694217; PMCID: PMC9872326.
  11. Mikkonen J, Luomajoki H, Airaksinen O, Goubert L, Leinonen V. Protocol of identical exercise programs with and without specific breathing techniques for the treatment of chronic non-specific low back pain: randomized feasibility trial with two-month follow-up. BMC Musculoskelet Disord. 2023 May 5;24(1):354. doi: 10.1186/s12891-023-06434-6. PMID: 37147638; PMCID: PMC10161472