Should You Choose A Physiotherapist or Chiropractor for Your Neck Pain?

If you suffer from neck pain and do not know which form of conservative treatment is best, the information contained in this article may help you with your decision.

Physiotherapy

A physiotherapist will review the history of your neck pain, such as location of the pain and type of pain (i.e. sharp, aching) and any other symptoms you are experiencing.   The physiotherapist will also ask about previous medical issues, your health in general, appetite, medications and sleep habits.     The physiotherapist will conduct a physical examination of the affected area.

The physiotherapist will review your posture and conduct cervical range of motion tests.    Muscle strength, sensations and reflexes will be tested.    The physiotherapist will press down along your spine with their thumbs or heel of their hand to determine where the pain is produced and focus treatment on that level of your spine.

Physiotherapists are trained to use manual mobilizations, such as placing pressure to ease small joint movements and push stiff joints into range.    A physiotherapist will teach you mobilizing exercises to maintain movements from the manual treatments.

Physiotherapists also often employ other methods to treatment of neck pain such posture correction, muscle strengthening, fitness exercise, nerve movements, pacing your activities and traction.

Chiropractor

A chiropractor is a trained to specifically work with many neck pain conditions.   Restricted spinal motion can cause neck pain.   A chiropractor is experienced in spinal manipulation.

Neck problems or injuries that a chiropractor may treat could include:

• Neck sprain
• Joint restriction syndromes
• Whiplash
• Cervical disc injuries
• Situations where muscles remain contracted and your neck stays in a twisted position
• Some Degenerative joint issues
• Chronic neck pain.

The chiropractor will examine your whole spine to ensure there are no other parts of the spine causing or complicating your neck pain.   To determine areas of injury or muscle spasm, the chiropractor will use motion and static palpitation which are diagnostic techniques only chiropractors use.   By the use of their hands, he or she will feel for tenderness, tightness and how well each spinal joint moves.  Next the chiropractor will ask you to walk so he or she can analyze your posture and spinal alignment.  

The chiropractor will assess your past medical history and may order x-rays or MRIs to assist with diagnosis and formation of a treatment plan.

Dependent on the diagnosis, a chiropractor may use a variety of techniques including spinal manipulation, manual techniques and therapy instruments.    Spinal manipulation of the neck is a safe, painless procedure and, contrary to some views, has been proven not to cause strokes. 

Spinal manipulation techniques consist of:

1. Specific spinal manipulation - gentle thrusting motions to return motion to a joint;
2. Flexion-distraction technique - gentle non-thrusting manipulation to treat bulging or herniated discs;
3. Instrument-assisted manipulation - non-thrusting manipulation with a hand held instrument (used for patients with degenerative joint syndrome).

Manual techniques which may be used are:

1. Trigger point therapy where pressure is applied directly to tight muscles;
2. Manual joint stretch and resistance techniques;
3. Therapeutic massage;
4. Instrument-assisted soft tissue therapy in which repeated strokes with an instrument are made over the restricted area.

Therapy instruments utilized might be:

1. Ultrasound;
2. Inferential electrical stimulation.

Your chiropractor will prescribe specific therapeutic exercises to augment procedures he or she performed to return your spine to normal movement.

Chiropractors look at each case of neck pain individually and focus on your general health issues, such as nutrition, stress management and lifestyle goals, all of which can contribute to neck pain.   Chiropractors strongly believe in prevention and advocate good posture and body mechanics.

While both physiotherapy and chiropractic care have similarities, chiropractic treatment has the advantage of caring for your overall health rather than focusing on a specific injury or condition.