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Man looking down at handheld device, straining neck.

“Text Neck Syndrome” Is No Joke; Your Chronic Neck Pain is Trying to Get Your Attention

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Chronic neck pain has been a growing problem since the arrival of handheld technology. “Text Neck,” also called forward head posture, is a condition caused by the repetitive stress placed on the cervical spine from looking down. In addition to chronic neck pain, bending your neck for too long may also cause upper shoulder pain, headaches, muscle stiffness and postural changes. But neck pain can also be an important clue to the existence of underlying health issues.

Looking down for an extended period of time puts you at risk of overstretching the supporting muscles, tendons, and ligaments of the cervical spine. These elastic structures should recoil back to normal, but there are many reasons why the connective tissue in the neck doesn’t rebound, including:

  • Disc problems – cervical discs can wear out and start to degenerate over time, making the neck feel painful and stiff.
  • Facet Arthritis – when cartilage that covers the ends of the facet joints wear out pain and stiffness can result.
  • Hypermobility Syndromes – neck pain, headaches, “heavy head” are all common symptoms of cervical hypermobility.
  • Hormonal Changes – cervical spine (neck) problems could be an indicator of low thyroid in women and low testosterone in men
  • Chronic Infection – untreated viral and bacterial infections can lead to painful inflammation of the neck muscles.
  • Altered Metabolism – Chronic neck pain has also been associated with metabolic syndrome and a high body mass index.
  • Nutritional Deficiencies – B12 and Vitamin D deficiencies can cause or worsen neck pain.
  • Emotional Stress – Many people “carry stress” in their neck which presents as pain and can cause real physiological changes.

Diagnosing & Treating Chronic Neck Pain

At the Kaplan Center, we’ll look at multiple areas of health to determine the root cause of your pain and all the factors that may be exacerbating your symptoms. Neck problems are best treated by a multidisciplinary team and comprehensive treatment is key to long-lasting results. Depending on your evaluation and test results, recommended treatments may include:

  • Osteopathic manipulation – Manual therapies are often used for treating chronic neck pain. Craniosacral therapy, visceral manipulation, myofascial release and strain/counterstrain are just a few of the techniques that we can use to rebalance and realign musculoskeletal, connective, visceral, and other body tissues to ensure optimal body function.
  • Physical therapy – Chronic neck pain can often be successfully treated with physical therapy. Our physical therapists can evaluate and treat your condition with strengthening and stretching exercises, as appropriate.
  • Acupuncture is thought to work by blocking pain messages to the brain with competing stimuli through the release of endorphins (the body’s natural painkillers) and the secretion of neurotransmitters, which affect one’s perception of pain.
  • Hormone replacement – When hormonal changes are the cause of your pain, hormone replacement therapy can help improve symptoms for both men and women.
  • Stress reduction – Mind body therapies can help lower stress.
  • Nutrition & supplementation – Positive dietary changes and supplementation will help correct deficiencies and can improve your pain symptoms and overall wellbeing.
  • Regenerative medicine therapies, including prolotherapy and platelet-rich plasma have been very successful in treating chronic neck pain related to texting and poor posture.

The treatments above can help relieve your immediate pain, promote long-term symptom relief, and help prevent future episodes of neck pain. In our experience, a combination of treatment strategies works best.

Don’t ignore the message, let us help you! Please give us a call today to make an appointment – 703-532-4892. Ext 2.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

treating chronic pain

Treating Chronic Pain

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The number of patients diagnosed with chronic pain conditions continues to rise in the United States, topping 51 million in 2021. 1

Chronic pain is defined as pain that lasts for more than 3 months, a time frame that under normal circumstances should accommodate the body’s normal healing process. But when the body doesn’t respond how we expect it to, lives can quickly be interrupted, and for many, it can be life-shattering.

Chronic pain is treatable and there are many effective options available, so why are millions of people being left behind?

One of the biggest challenges in diagnosing and managing chronic pain is the fact that providers have to rely almost exclusively on the individual’s description of their pain and the disability it causes. Pain is subjective – there is no biomarker, blood test, or imaging study that can objectively detect the presence and severity of pain.

However, research that looks at the way our brains and nervous systems initiate and sustain severe chronic pain continues to point to the same conclusion – that chronic pain, in and of itself, is not the problem to be treated. Instead, chronic pain should be seen as a symptom of an underlying medical problem, and it is to this underlying problem that treatment must be targeted.

Specifically, chronic pain is a symptom of inflammation in the brain, or what I call “a brain on fire”. This inflammation is triggered by the body’s own immune system, which is designed to respond to any kind of assault. For example, physical injury, infections (such as Lyme disease or COVID-19), exposure to environmental toxins, concussions, celiac disease, loss of oxygen to the brain caused by sleep apnea, and even long-term emotional trauma, can set off an inflammatory response in the brain and central nervous system. Identifying the source(s) of inflammation is critical to breaking the cycle of chronic pain; and frequently, the sources are multiple, compounding, and cumulative.

To accurately diagnose and treat the causes of neuroinflammation that manifest as chronic pain, providers must:

  • Take a comprehensive medical history of each individual.
  • Work to correctly identify and treat the underlying root cause(s) of chronic pain.
  • Educate people about their relationship with chronic pain. Like all relationships, how this is managed can make life substantially better or worse.

Pain Management Programs

Intensive pain management programs can be an extremely important tool in helping patients manage their pain and live a better life. They typically involve a treatment schedule that spans several weeks, during which time attendees are typically seen by a team of healthcare providers with a variety of specialties. Although programs vary somewhat from one to another, each is likely to include:

  • Initial consultation with a provider who has pain management experience.
  • Specialized lab tests.
  • Nutritional intervention, including anti-inflammatory elimination diets and consultations with nutrition experts.
  • Behavioral health techniques, such as meditation and relaxation therapies.
  • Acupuncture.
  • Movement therapies, such as yoga (especially restorative yoga and yogic philosophy training), and physical therapy, including core strengthening and biomechanics.

The goal of this type of intense programming with an emphasis on education is to help individuals think differently about their pain while providing them with new tools to manage their pain and re-engage in their lives. Additionally, if the programs are designed to approach pain as a symptom of an underlying medical condition and the treatment aims to resolve the root cause of the pain, there is a very good possibility that the pain will go away.

The Bottom Line

  1. Chronic pain is not a disease but a symptom.
  2. The way we treat pain now has, for the most part, been a costly, abysmal failure. Opioids are the most pressing issue but there are also serious concerns about the number of unsuccessful and unnecessary procedures (surgeries in particular) and the proliferation of the use of dorsal column stimulators (implanted electronic devices placed near the spinal cord to treat chronic pain), and the overutilization of spinal blocks (injections of anesthetic into the spine). The research evidence for these approaches for the treatment of chronic pain ranges from fair to poor. 2,3,4,5
  3. Behavioral health programs have some of the strongest data and the greatest success in treating chronic pain conditions. And, more importantly, when these programs are not successful, they don’t make the situation worse (unlike surgery and other invasive procedures).

What Needs to Happen

Individuals suffering from chronic pain must, in every single case, be offered a comprehensive workup with an individualized treatment approach.

We need to continue with research into the causes of inflammation in the brain, while also working on developing a treatment for brain inflammation that leads to chronic pain. We also need to develop testing that will provide us with an objective indicator of the chronic pain/underlying disease and its response to treatment.

In the interim, we should focus on improving the lives of our patients by using targeted therapies that address the biology of the pain, rather than its symptoms; anything short of this is like putting a Band-Aid on a bullet hole.

–Dr. Gary Kaplan

Sources:

1. Rikard SM, Strahan AE, Schmit KM, Guy GP Jr.. Chronic Pain Among Adults — United States, 2019–2021. MMWR Morb Mortal Wkly Rep 2023;72:379–385. DOI: http://dx.doi.org/10.15585/mmwr.mm7215a1.

2. PMID: 24308846
3. PMID: 25840040
4. PMID: 26824399
5. PMCID: PMC3777049

Long-COVID Recovery Program

Our Long-COVID Recovery Program provides comprehensive care to patients who still have COVID-19 symptoms more than six weeks after recovering from the initial infection. If you are experiencing symptoms beyond six weeks of being diagnosed, please give us a call at 703-532-6302.

More Info

 

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

 

This article was originally published in September 2016. It was reviewed and updated in September 2023.

Texting Neck and What it Does to the Spine

What Texting Does to the Spine

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Did you know that your head becomes 5 times heavier when your head position is bent down to text? In fact, each degree of forward tilt adds a tremendous strain on the neck and its muscles such as the levator scapulae that are attached from the shoulder blades to each side of the neck.

At a minimum, when these muscles are stretched for a long time or misused it can lead to headaches; other more serious symptoms can include dizziness, herniated disks, pinched nerves, neck sprain, and abnormal posture (by compensation).

“Text Neck Syndrome,” also called forward head posture, can not only lead to chronic pain and postural problems but can be an important clue to the existence of underlying health issues, like hormonal changes, nutritional issues, facet arthritis, or emotional stress.

Treatments for Texting Neck Syndrome

At the Kaplan Center, we offer osteopathic manipulative therapy, postural rehabilitation, PRP, injection therapy, and physical therapy to correct those ailments. Furthermore, nutritional and hormonal correction, when indicated, can have a formidable impact on improving the musculoskeletal system. For men and women over 40, we recommend checking your testosterone level for general health and improving strength and libido. The impact of testosterone is well known on overall vitality which leads to a better tone in the muscle and standing upright as opposed to slouched with fatigue (see diagram below on the effects of testosterone).

Bottom line: If you have neck pain, don’t ignore it as it’s likely to worsen over time and cause more serious problems later in life. Get yourself checked and tested so we can help you feel better now.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

preventing compression fractures

8 Steps That Can Help You Prevent Painful Compression Fractures

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Research shows that one-quarter of post-menopausal women eventually suffer from compression or collapsing of some vertebrae, the bones that comprise the spinal column. Compression fractures can not only increase one’s risk of future fractures, but they can also compromise one’s ability to function and may cause disabling chronic back pain.

Although these injuries are common, they can usually be prevented, delayed, or mitigated by adopting a healthy lifestyle that includes:

1. Engage in resistance training, such as weight training, yoga, or Qigong every other day, ideally for 30-60 minutes per workout.

There is good news for those who struggle to find those 30-60 minutes: a 10-year study that was completed in 2015 measured the bone mineral density (BMD) of 741 participants pre and post-yoga regimen. Participants who routinely engaged in 12 yoga poses each day for just 12 minutes showed a reversal of osteoporotic bone loss.

2. Do weight-bearing exercises like running, walking, or hiking, for at least 30 minutes each day.

Weight-bearing exercises work against gravity and stimulate bone cells to produce more bone.

3. Get your Vitamin-D levels tested to ensure that they’re between 50-70 ng/mL.

If your levels are low, consider getting more sunshine (exposing some of your skin for 15-30 minutes each day) and taking a supplement. Most people need between 3,000 to 5,000iu of supplementation, but some may need up to 10,000 international units. If you take Vitamin-D supplementation, your 25-hydroxy Vitamin-D level should be checked twice a year.

4. Check your calcium and magnesium intake.

Women should consume a total daily amount of calcium between 1200 and 1500 mg, with no more than 600 mg from supplemental calcium. Taking in more than this amount in supplemental form can lead to an increased risk of heart disease and kidney stones. Good sources of dietary calcium are sardines, white beans, almonds, oranges, leafy greens, and dairy.

Taking magnesium can increase bone mineral density and reduce fracture risk.

5. Consider bioidentical hormone replacement therapy.

Before prescribing medications, we at Kaplan Center explore the possibility of using bioidentical estrogens and progesterone or estrogen analogues like Evista to prevent bone loss.

6. Talk with your doctor before using medications to treat bone loss.

Because most of these medications work by decreasing bone breakdown, this can potentially cause more brittle, unhealthy bone, and result in fractures of the femur and jaw necrosis. We generally reserve medication treatment for those with severe osteoporosis or a history of pathological fractures. Before considering bisphosphonates, like Fosomax, Actonel, Boniva, Reclast, or a newer injectable, Prolia, it is recommended to complete dental procedures before starting treatment for osteoporosis. Report any persistent jaw or thigh pain to your healthcare provider immediately.

Another treatment option is Miacalcin, a synthetic version of the hormone, calcitonin. It has been shown to build bone more in the spine than in the hip, offering users some pain relief. Two alternatives to the bisphosphonates and Miacalcin are Forteo and Tymlos, synthetic versions of a hormone called parathyroid hormone which also builds bone. Some of these drugs, however, carry warnings about an increased risk of bone tumors called osteosarcoma.

7. Consider Bone-Density Imaging

It’s important to evaluate the effectiveness of any medications or hormone replacement therapies you may use because each individual inevitably has their own unique response to a given treatment. A bone-density test can help measure the therapeutic benefits of any treatment path you have chosen.

8. Vitamin K supplementation.

Research on Vitamin K and postmenopausal bone loss has shown that it can have a positive effect on bone strength. This 2022 meta-analysis that looked at 16 randomized controlled trials and included 6,425 subjects concluded that “Vitamin K2 supplementation has a positive effect on the maintenance and improvement of [bone mass density lumbar spine] in postmenopausal women, and it can also reduce the fracture incidence”. Supplements are a great way to improve your health, but you should always discuss any new supplements or medications with your provider to ensure that it would be a good option for your unique health profile.

In sum, there’s a lot you can do to keep your bones strong! So, do it!

If you would like to talk to a Kaplan provider about any of the treatments above, please give us a call at 703-532-4892.

We are here for you, and we want to help.

Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2

This article was originally published online in May, 2018. Its content was reviewed and updated in May, 2023.

Additional References

Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients. 2013 Jul 31;5(8):3022-33. doi: 10.3390/nu5083022. PMID: 23912329; PMCID: PMC3775240.

Rondanelli M, Faliva MA, Tartara A, Gasparri C, Perna S, Infantino V, Riva A, Petrangolini G, Peroni G. An update on magnesium and bone health. Biometals. 2021 Aug;34(4):715-736. doi: 10.1007/s10534-021-00305-0. Epub 2021 May 6. PMID: 33959846; PMCID: PMC8313472.

Gentle Yoga Poses for Back, Neck and Hips

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Yoga is a wonderful tool to alleviate stress, which in turn can improve both your mental and physical health. Taking just a few minutes each day to gently move and stretch your body can make a big difference. Here are some gentle yoga poses to try at home, demonstrated by Laura Dorsett, MTS, RYT500.

Seated Pigeon Pose

This gentle stretch opens up the hips, glutes, and lower back.

Eagle Arms Posture

Eagle Arms helps to release tension in the head, neck and shoulders.

Runners Lunge/Yogic Lunge

Yogic Lunge opens up the hips and releases the lower back.

Seated Spinal Twist

Seated Spinal Twist gently loosens strained muscles in the back to revitalize the spine and posture.