Dr. Allan Horowitz, published newspaper article, The Liberal, Copyright March 6, 1991
In last week’s column I answered a letter from a reader who was wondering if the headaches he was experiencing might be originating in his neck. I promised that this week’s article would be a discussion of how most chiropractors examine a typical patient’s neck.
The chiropractor first asks you some questions in an attempt to find out why you might be having neck pain.
There are many different causes of neck pain and headaches. Talking about when, where, why and how, often answers as many questions for the chiropractor as does the examination itself.
Once some notes about the problem are made, a physical examination is done. You will be asked to bend your head in all different directions (active motion testing). The chiropractor will then repeat these tests, but he/she will do the motions for you while you try to relax your neck (passive motion testing). You may be asked to push your head against the doctor’s resistance.
Reflexes may be tested and some co-ordination tests might be done. Sensation to light touch or sharp sensation might be tested.
Arm, shoulder and hand strength might be assessed. These tests are to determine if there is any neurological disorder or even nerve pinching or irritation present.
The doctor may then push on certain muscles or ligaments or bones, trying to re-create your pain. He may stretch or pull your neck in an attempt to increase or decrease your symptoms.
Each portion of the neck moves, or should move in its own way. Certain ranges of motion, planes of motion and feelings of motion should be taking place at each of the segments in the neck If there is a problem here, the chiropractor will usually feel it when motion palpation is done. This test involves feeling the motion of each joint on each side of the neck. A trained practitioner will be able to detect even slight motion disturbances which may be the source of the patient’s pain. (Next week’s column will discuss the various ranges of motion in a normal neck, and what should be found.)
None of these tests hurt. They feel like someone is stretching or massaging your neck.
Sometimes one or two of the tests may recreate your pain or feeling of a headache. This is usually good, as it allows the examiner to isolate the source of the pain. This usually leads to a quicker relief from the pain, once treatment has started.
X-rays are sometimes taken. (Some chiropractors take the x- rays themselves, others send the patient to a lab or hospital.) The x-rays are another way to see if there is a problem with the neck which might be causing pain.
The chiropractor looks at the shape, size and density of the bones. The curve of the neck is assessed.
The space in-between the bones is the space the disc is residing in and this space is important. The holes where the nerves exit the spinal column can be seen and these are assessed. The joints where one bone attaches to the next are looked at to see if all is well there. The tissues around the neck are visualized.
The normal x-ray series is anywhere from three to seven radiographs and the amount of radiation involved is minimal and not at all dangerous (unless you are pregnant).
Sometimes other tests have to be done, but those mentioned above will usually give the chiropractor enough information on which to base a diagnosis and begin treatment.
As you can see, there is nothing scary, painful or dangerous involved in a proper examination of the neck. Next week, more on the neck.
Allan Horowitz, D.C., is a chiropractor practising in Richmond. Hill and writes this public service column. He will attempt to answer readers’ questions on a variety of topics including headaches, back pain, sport injuries, nutrition and preventive medicine.
Address your questions to Allan Horowitz, care of The Liberal, Box 390, Richmond Hil L4C4Y6.