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4 Proven Steps Giude to Alleciate Neck Pain or The 5 Proven Steps Giude to Alleciate Back Pain

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Integrated Health Solutions

The leading Downtown, Carmel and Northeast side Indianapolis Chiropractor

Comprehensive treatment for lasting pain relief.

Did You Know We Treat?

As licensed Chiropractors and Medical Acupuncturists, we have a wide array of training that allows us to help patients in many unique situations. While we typically see back and neck pain, we often assess and help with other areas of pain of dysfunction from head to toe! In this blog, we will discuss:

  • What common areas of pain do we see?
  • What areas can we help with besides the neck and back?

1. What common areas of pain do we see?

When most people think of Chiropractors, they think of neck pain, back pain, and adjustments. While we do see a lot of neck and back pain, we incorporate more into out treatments than just the adjustment.

Why do we do this?

While the coveted “pop” can release endorphins and relieve your pain, it does not fix what caused the pain to begin with. We firmly believe that our purpose is not only to assess the area of pain our patients present with, but to also look at the body as a whole and see what patterns have lead to the pain. Pain is the last symptom to come when the body is in dysfunction but it is the first thing to go with treatment.

This is why we will do a thorough movement assessment with every patient. Based off of the findings, we will incorporate dry needling, soft tissue manual therapy, and functional rehabilitation in addition to the adjustment.

Let’s look at a typical case of neck pain:

“John Doe presented today as a new patient with a chief complaint of cervical pain. Patient denies radiating pain. He believes the problem was caused by a fall 20+ years ago on his snowboard as well as years of computer work and also traveling the majority of the year, so he is often in other beds and on planes. He doesn’t notice the symptoms more at any particular time of day. He feels the pain constantly throughout the day. The pain is moderate. The condition is staying the same. On a scale of 0 to 10, with 0 being no pain at all and 10 being the worst pain imaginable, he rates his pain a 7 today. He describes the pain as dull and aching. The pain gets worse with bending and sleeping and traveling. The pain gets better with chiropractic care but it only provided temporary relief. He has not been to a chiropractor in a few years as his provider switched locations. Activities of daily living affected due to the problem include working and sleeping. He denies recent traumas, surgery, or motor vehicle accidents. He also denies numbness, tingling, or radiation.”

With this patient, we found a lack of neck stability in addition to a lack of core stability. This lead to a build up of tension in he neck musculature. Dry needling was used to repair this tissue. Soft tissue manual therapy was used to provide palliative care. An adjustment was provided for pain relief and to re-establish joint range of motion. Finally, functional rehabilitation was implemented to work on the areas lacking stability.

Now, here is a typical back pain case:

“Jane Doe presented today as a new patient with a chief complaint of lumbosacral pain. The pain travels to her right sacroiliac area. She doesn’t know what may have caused the symptoms in particular. She had back pain prior to giving birth via c-section to her first baby 10.5 months ago. The pain used to be constant but bearable now it is getting worse and not going away ever since she tried to start working out again a few weeks ago. She typically does strength training and some light cardio. She notices the symptoms more in the morning to put on her pants and also with movements such as picking up her son. She feels the pain constantly throughout the day. She has had the symptoms over the past 4 months. The pain is moderate. The condition is getting worse. On a scale of 0 to 10, with 0 being no pain at all and 10 being the worst pain imaginable, she rates her pain a 7 today. She describes the pain as dull and aching. The pain gets worse with most movements, bending, carrying things and going from lying to standing. Nothing makes the pain better. Outside of the c-section 10.5 months ago, patient reports no other traumas, surgery, motor vehicle accidents, or issues with bowel or bladder function.”

Following pregnancy and C-section, stability also gets shaken up. Without that properly being re-introduced to a woman’s body, muscles begin to compensate. The body prioritizes keeping the spine and brain safe and stabilized. When our main components of stability are lacking, the compensation patterns that build result to pain down the road. As with the neck case above, we used dry needling, soft tissue manual therapy, adjustments, and functional rehabilitation to help with this case. After five visits this mother was virtually pain free and on her way to return to her normal activity levels.

2. What areas can we help with besides the neck and back?

  • Foot pain / plantar fasciitis
  • TMJD (Jaw pain)
  • Tennis/golfer elbow
  • Shin splints
  • Ganglion cysts
  • Menstrual issues
  • Gall bladder
  • UTI
  • Vertigo
  • And many more!

Let’s check out a few cases involving some of these areas of concern:

1.   Foot pain / plantar fasciitis

“29 year old male patient presents to the clinic with new pain complaint that has taken priority over his shoulder. He states his shoulder is feeling great and he is feeling stronger in his workout. He says both of his heels are very sore and he has not changed much in his activities of daily living besides his lifting routine which he reports involves a lot of lunges. Over the past few days he has been having severe pain that hurts to get up from seated or to put pressure on his heels at all. He has been wearing the shoes suggested to him as well as the insole from the running store. Nothing has been palliative except for temporary relief with stretching. 5/10 VAS that is constant throughout the day. Time of day does not matter in regards to his pain, it is more-so the pressure on his heels that causes pain. No other changes to his health history since his last visit.”

Upon assessing this patient, I included a lunge and noted that the heel could not stay down and there was quiver/imbalance. Whenever imbalance is a factor, performing that movement, especially with weights involved leads to compensation patterns. In traditional medicine, this likely would be diagnosed as plater fasciitis. Hence the orthotics (which we removed). We treated the inflamed tissue with dry needling and active release technique but then took it one step further by targeting foot and knee mechanics. At his most recent visit, lunging was pain-free!

2.   TMJD (Jaw pain)

“34 year old female patient returns to the clinic for shoulder maintenance and she states that treatment has helped her get through her day with less pain. She does note that tension comes up from time to time and the treatments help keep pain reduced so that she can bike, work, climb, and play tennis with better range of motion and less pain. During treatment today, she mentioned that she also has a long history of jaw issues. She states that when she was a teen, she remembers her jaw popping and it has never been the same sense. Now she says that she has an abnormal way to open and close her jaw and she cannot chew foods like steak or hard foods, as a result, so she avoids them. She said she believes she clenches, and she has tried a mouthguard from her dentist, but nothing has made it better. For the past few months, it has been bothering her more so she thought she would inquire about it today. She denies headache or blurred vision. She states sometimes it will still lock on her to where she can’t fully open or close. Pain is worse on the left.”

For this patient, we noticed her right side of her jaw opened last and least (pointing to pterygoid tension). This can lead to pain on the left due to compensation. She had bilateral clicking that was more audible than any patient I had treated for TMJD before. Dry needling into her sub occipitals helped due to her anterior head carriage straining the fascial connection to the jaw. A large component of our success, I attribute to the post-isometric relaxation techniques I used. While I would ideally say this patient is 100% symptom free, I prefer to be fully transparent in saying that we got this patient about 70% better. That success has lead to zero cases of lock jaw, reduced jaw pain, and better coping mechanisms I empowered her with for what to do to not only prevent but to self treat this area.

3.   Tennis/golfer elbow

“63 year old female presented today as a new patient with a chief complaint of right forearm pain. The pain travels to her right wrist and right elbow. She believes the problem was caused by exercise as she transitioned from pickleball in the summer to paddle tennis which has a heavier racket. She states she usually plays about 1x/week but a few weeks ago played 4 days in a row and her R forearm has been sore since. She doesn’t notice the symptoms more at any particular time of day. She feels the pain frequently throughout the day. She has had the symptoms over the past 3 weeks. The pain is moderate. The condition is staying the same. On a scale of 0 to 10, with 0 being no pain at all and 10 being the worst pain imaginable, she rates her pain a 5 today. She describes the pain as dull, aching and sharp with wrist extension. The pain gets worse with carrying things, exercise, pushing and lifting. The pain gets better with anti-inflammatories but only temporarily. Activities of daily living affected due to the problem include cleaning, doing laundry, exercising and house work. She denies weakness, numbness, tingling, or radiation. She has not had pain like this before. She would like to continue playing 1x/week. She denies other trauma, surgery, mva not listed on intake.”

This patient is extremely active and it was extremely important to her to stay that way.  Treating this patient’s forearm extensors as well as the triceps with dry needling and active release technique in addition to training her with eccentric load, isotonic, and concentric load allowed her to continue to play the sports she loves and stay active with personal training, pain-free!

4.   Shin splints

“28 year old male presented today as a new patient with a chief complaint of lumbosacral pain. He also has left knee and right knee pain. Aaron denies radiating pain. He believes the problem was caused by lifting a heavy object at Christmas and it has not been the same. He doesn’t notice the symptoms more at any particular time of day. He feels the pain constantly. throughout the day. He has had the symptoms over the past 6 months. The pain is moderate. The condition is getting worse. On a scale of 0 to 10, with 0 being no pain at all and 10 being the worst pain imaginable, he rates his pain a 5 today. He describes the pain as dull and aching. The pain gets worse with bending, carrying things, sitting and running. The pain gets better with heat and rest. He denies recent traumas, surgery, mva, but he had a wrist surgery several years ago and also had a stress fracture “on each shin” in childhood and still experiences shin pain with walking to this day.”

While this patient presented originally as a standard low back patient, a deeper dive into assessing his squat, single leg stance, and foot mechanics showed a lack of intrinsic foot stability. This likely lead to his continued “shin splint” symptoms. We treated the inflammation in his lower extremity musculature, worked on foot mechanics and lower extremity strength ad after a few visits he was walking pain free!

5.   Ganglion cysts

“33 year old female presented today as a new patient with a chief complaint of right wrist pain. She also has right forearm pain. Hannah denies radiating pain. She doesn’t know what may have caused the symptoms but was told it is a ganglion cyst that may or may not go away on its own. She notices the symptoms more in the evening and typically feels better in the morning until she has to work on the computer as a CPA or care for her 3 children (4.5, 2 years, 4 months). She feels the pain constantly throughout the day. She has had the symptoms over the past 3 months. The pain is moderate. The condition is staying the same. On a scale of 0 to 10, with 0 being no pain at all and 10 being the worst pain imaginable, she rates her pain a 5 today. She describes the pain as aching, sharp, stiff and swelling. The pain gets worse with most movements and bending of her wrist. The pain gets better with heat and ice and a brace but she cannot wear it often due to restricting her ability to do her job/care for her kids. She went to …… to get it drained but it was not successful so they suggested surgery. She states she feels like the draining somehow made it bigger as well. She denies previous history of this type of pain/inflammation. She denies trauma, surgery, mva not listed on intake.”

This was such an interesting case. Spoiler alert: WE AVOIDED SURGERY!!!!! For ganglion cysts, they come back, that is just their nature. Draining them is extremely painful and operating on them is not guaranteed to be successful. Her cyst lives in one of her forearm extensor tendons. We conservatively treated her with dry needling into the muscle belly of this tendon as well as the surrounding muscles that likely are compensating as a result. We did a lot of scraping and soft tissue work as well as rehab to load her tendon, safely and pain-free. Manipulation was provided to encourage joint range of motion and improve proprioception. Her pain went away. Her tennis game is back. She is continuing to amaze me by being a full-time working mother of three and constantly keeping up her travel. Due to the nature of cysts returning, the patient agreed and consistent check-ups every few weeks are important in order to keep her living a pain-free lifestyle.

6.   Menstrual issues/Gall bladder/UTI

I looped these together because it was a similar approach that lead to different results.

Case 1: “39 year old female presents to the clinic as a new patient for the first time. Her primary concern is the cramping and bloating associated with her period. She says her back pain is considered mild compared to her abdominal pain. Sometimes the pain will cause her to have to miss work. She gets the pain starting about 5 days prior to her period, throughout her period, then about 5 days following her period. Temporary palliative relief includes OTC pain killers, natural pain relievers and herbs, heat, and e-stim pads at home. She states she is not on birth control and has not been for about 2 years.  Her pain causes her to wake up at night and peaks in intensity about 3-4 am to an 8/10 VAS. She states that this has been going on for about 5 years. Relevant medical history: pt had gallbladder removal about 5 years ago and has since become dairy and gluten free. For the past 3 years, she states she has also been getting migraines about every 4 months that are also 8/10 VAS that occur day 1 of her period but she has no other headaches. With these migraines, she get sharp stabbing frontal pain and distorted vision. When asked, patient states she does tense/clench her jaw on a regular basis. Work involves a desk posture. She denies labored breathing, dizziness, shortness of breath, chest pain, heart palpitation, numbness, tingling, radiation. She has had no children. She denies recent trauma, surgery, mva.”

Case 2: For this case, I will highlight a few different visits

06/11/2021- 77 year old female patient presents to the clinic for the first time for c/c neck pain with accompanying low back pain. She states it all began 13 years ago when she hit her hip on a filing cabinet on the left greater trochanter, causing her to feel like she has a “shifted pelvis.” She went to an orthopedic surgeon who suggested immediate surgery but she wanted a more conservative route so tried physical therapy (PT). PT did not help her she states. She used to have success with the pain management clinic at ….. but the clinic was shut down. The pain has been a constant dull ache ever since and equal B/L across the low back. On occasion she will get a sharp pain with movements in her low back but no NTR down legs. She states she believes this has also been the reason for upper body tension due to her alignment being off. She says that since 2006 from a fall on her shoulder when walking too fast, she has been stiff/sore especially with bad weather in her neck and right shoulder. She denies fracture, trauma or surgery. She does report a history of migraines that are worse in the morning that she believes used to stem from stress snow she does a saline flush because she thinks it could be due to allergies.”

9 treatments provided, patient went from a “12/10 pain-scale to a “1/10”.

06/13/2022- Patient returns to the clinic for a re-exam with c/c being low back pain. She states that her husband has been diagnosed with cancer since she was last in the clinic so she has not had a chance to stick to her functional rehab or come in for treatment. Last Wednesday, she was sitting in the waiting room from 10:45 am to 8 pm waiting on her husband’s appointment and noticed low back tension that went down into her legs causing stiffness. She says she has been stiff in the mornings the past few months and she has not been able to do yoga and she did not like her YMCA trainer so she stopped going. She is trying to get back to walking but she is getting burning into the fronts of her thighs with exercise. She has experienced these symptoms before 8-9 years ago where she was getting stiff and heavy legs so went to an orthopedist who told her she had stenosis and needs surgery. She wanted a more conservative route so began to try chiropractic distraction and acupuncture in addition to yoga and physical therapy. She says these symptoms are starting to feel similar but not as severe. She says that her right collarbone is also clicking with R arm movements although her neck pain is still not bothersome, from treatment she received here at IHS last year. She denies change in bowel or bladder function or urgency but states she is on medication due to age and leaky bladder. She denies any other health changes, traumas, surgeries, MVA since last in the clinic outside of having covid mildly as well as deciding to take part in cognitive studies for Alzheimers, due to family history of Alzheimers.”

7 visits completed, showing progress 

“09/07/2022- Patient returns for separate reason to receive traditional acupuncture. She states that over the Holiday weekend, she experienced a very severe UTI where she was peeing blood so went to the ER. She was given a form of antibiotic that caused her severe illness with the flu. She returned to the ER and her meds were changed due to how harsh the meds initially prescribed were on her liver. She is now feeling better but she would like some acupuncture to balance her liver and kidney function.”

1 visit completed and then we returned to treating her neck and back. At this time, she experienced the loss of her husband.  She still continued treatment here at IHS for other areas of pain. One visit in particular she noted:

04/03/2023- Patient returns for follow-up stating the treatment “is working” and her calf pain is feeling improved, her neck stiffness is reduced, and she feels that her bladder/kidney issues are improving. She states she is really happy with her progress.”

Consistent preventative care continued to take place.

01/08/2024- Patient returns for follow-up stating that she noticed some right foot tension on the plantar surface during yoga the other day. She is feeling some neck and back tension from the busy holiday season. With fatty food intake, she is noticing right sided rib pain.” 

With treatment this day, we had a huge response when I acupunctured a point on her gall bladder meridian (GB34). Her follow up:

01/22/2024- Patient returns for follow-up stating she went to her doctor, per my request to get her gallbladder checked out. She has gallstones, per the imaging, and is waiting to address them until she gets back from Mexico.”

I combine patient one and patient two because in both cases, I used a traditional acupuncture approach. Both patients received benefit, and with patient two we even discovered gall stones. While I must say at first I was skeptical of traditional acupuncture, these are two great examples of improving quality of life in ways you may not think of when thinking of a Chiropractor. Case 1 is now on an 8 week wellness schedule with menstrual symptoms almost completely gone, jaw tension gone, and reduced headaches. Case 2 come for wellness also and has not had gall bladder issues since, or another UTI for that matter….

7.   Vertigo

From a patient typically seen for TMJD and neck pain: “I recently had an episode of extreme dizziness at the end of a yoga class. It was especially concerning since I was on my back. I had a scheduled appointment for TMJ treatment right after class with Dr. Jen and mentioned it to her. She asked questions,  began nodding knowingly and said she would test me for vertigo. She explained that this type can occur when the crystals in the inner ear become dislodged and that by doing the Epley maneuvers they will resettle. I was anxious, but confident that she could fix me. She literally has my health in her hands!”

So, there you have it folks! My passion is to help people return to their activities of daily living, pain-free. I am so grateful that I was given then opportunity to help these awesome patients. This blog was really enjoyable to write, as all of these patients are now back doing what they love to do.

Written by Dr. Jen Brenneisen

Questions on how we can help? Call us for an exam and consult today!

P: 317-449-2020
E: amie@ihsindy.com

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