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Chronic Neck Pain for 20 Years

Monday morning of this week I had the pleasure of evaluating and treating a gentleman who had been suffering from a sudden flare-up of chronic neck pain. He had been suffering from pain between his spine and shoulder blade on the right side almost daily over that 20 year period of time. It started while performing a military press (picture). With his last repetition, he had his neck flexed forward and turned his head to the right. The pain started immediately and has continued to linger since that time. Several weeks ago he had a minor slip and fall on the ice that involved him landing on the buttocks and catching himself with his arms straight behind him. He basically got jarred, however falling in that position typically results in the neck flexing forward.

This gentleman had a bad experience with a chiropractor a few years ago. He went in for a "maintenance" visit and ended up having his cervical spine manipulated (asymptomatic at the time). As a result of the manipulation, he experienced immediate shooting pains into both of his arms. It really scared him and he had been hesitant to return ever since. A special thanks goes out to another patient of the clinic who recommended our office to this gentleman based on his positive experience following inadequate results with another practitioner.

After a thorough history and examination, we were able to identify that his problem wasn't from his mid-back referring pain over to the shoulder blade. It wasn't from "trigger points" or knots in the muscles underlying the area of pain. The muscles hurt, but it wasn't "his pain". Symptoms also were not a referral from his shoulder or from joints in his neck that needed to be "adjusted" back into place. His symptoms were from a chronic disc injury [termed a disc derangement] in the middle of his neck that was referring pain to the shoulder blade. It started because the neck was placed in a flexed position under load (picture) and that was enough to displace the inside of the disc. The injury was re-aggravated from the fall because the head likely came into flexion very abruptly.

Disc Derangements don't need to be "adjusted" back into place. You need to identify the movement that eases the symptoms with repetition and in doing so you have found the patient's Go To Exercise. Disc decompression, in the form of gently pulling the neck in a certain way, is also a viable treatment to get the ball rolling.

How was this gentleman after one visit? "If I had to put a number on it, I'd say I have zero pain. This is the best I have felt in 20 years," he stated. And guess what, I didn't even do what a traditional chiropractor would've done...adjust his neck. He put on his coat, a task that normally caused pain every time over the past 20 years, and he was on his way. He stopped in this morning several days after his initial visit. He has been doing his Go To Exercise, stretching, not worrying about the minor symptoms, and he hasn't had the pain at that shoulder blade since Monday. If that isn't cost effective care, I don't know what is.

“Be the change you wish to see in the world.” ~ Mahatma Ghandi

Join the movement. Primary Spine Care is a growing movement with the goal of changing how we deliver spine care services to patients in the United States. Partner with a Primary Spine Practitioner today for your spine care needs!

Hans W. Bottesch II, D.C., completed his clinical training as an evidence-informed Chiropractor in the Veterans’ Affairs Medical Centers (VAMCs) of upstate New York. He has been trained as a Primary Spine Practitioner and has published articles in the lay press community. He currently practices out of Bloomsburg Spine & Sport. You can contact him at

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