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When we hear the term headache, we don’t usually think about the neck. Rather, we focus on the head, more specifically, “…what part of the head hurts?” But, upon careful questioning of patients, we usually find some connection or correlation between neck pain and headaches.

The key to this connection can be found in looking at the anatomy of the neck. There are 7 vertebrae that make up the cervical spine and 8 sets of nerves that exit this part of the spine and innervate various parts of the head, neck, shoulders and arms, all the way to the fingers. Think of the nerves as electric wires that stretch between a switch and a light bulb. When you flip on the switch, the light illuminates. Each nerve, as it exits the spine, is like a switch and the target it travels to represents the light bulb. So, if one were to stimulate each of the nerves as they exit the spine, we could “map” exactly where each nerve travels (of course, this has been done). When we look specifically at the upper 3 sets of nerves that exit the spine (C1, C2, and C3), we see that as soon as they exit the spine, they immediately travel upwards into the head (the scalp). Like any nerve, if enough pressure is applied to the nerve, some alteration in nerve function occurs and usually a sensory change is noted (numbness, tingling, pain, burning, etc.). If the pressure continues, these symptoms can last for a long time. These types of headaches are often called “cervicogenic headaches” (literally meaning headaches that are caused by the neck). These can be caused by the nerves getting pinched by tight muscles through which they travel as they make their way to the scalp.

Another connection between the neck and headaches includes the relationship between 2 of the 12 cranial nerves and the first three nerves in the neck described above. These types of headaches usually only affect one half of the head – the left or right side. One of the cranial nerves is called the trigeminal nerve (cranial nerve V). Because the trigeminal nerve innervates parts of the face and head, pain can also involve the face. Another cranial nerve (spinal accessory, cranial nerve IX) can also interact with the upper 3 cervical nerve roots, resulting in cervicogenic headaches. People with cervicogenic headaches will often present with an altered neck posture, restricted neck movement, and pain when pressure is applied to the base of the skull or to the upper vertebrae. Other than a possible numbness, there are no clinical tests that we can run to “show” this condition, though some patients may report scalp numbness or, it may be found during examination.

Though medication, injections, and even surgical options exist, manipulation applied to the small joints of the neck, especially in the upper part where C1-3 exit, works really well so why not try that first as it’s the least invasive and, VERY EFFECTIVE! In some cases, a combination of approaches may be needed but many times, chiropractic treatment is all the patient needs for a successful outcome.

We realize that you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for neck pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

When you woke up today, you thought this was like any other Friday. You’re on your way to work, and traffic is flowing smoother than normal. Suddenly, someone crashes into the back end of your car and you feel your head extend back over the headrest and then rebound forwards, almost hitting the steering with your forehead. It all happened so fast. After a few minutes, you notice your neck and head starting to hurt in a way you’ve not previously felt. When the police arrive and start asking questions about what had happened, you try to piece together what happened but you’re not quite sure of the sequence of events. Your memory just isn’t that clear. Within the first few days, in addition to significant neck and headache pain, you notice your memory seems fuzzy, and you easily lose your train of thought. Everything seems like an effort and you notice you’re quite irritable. When your chiropractor asks you if you’ve felt any of these symptoms, you look at them and say, “…how did you know? I just thought I was having a bad day – I didn’t know whiplash could cause these symptoms!”

Because these symptoms are often subtle and non-specific, it’s quite normal for patients not to complain about them. In fact, we almost always have to describe the symptoms and ask if any of these symptoms “sound familiar” to the patient.

As pointed out above, patients with Mild Traumatic Brain Injury (MTBI) don’t mention any of the previously described symptoms and in fact, may be embarrassed to discuss these symptoms with their chiropractor or physician when they first present after a car crash. This is because the symptoms are vague and hard to describe and, many feel the symptoms are caused by simply being tired or perhaps upset about the accident. When directly asked if any of these symptoms exist, the patient is often surprised there is an actual reason for feeling this way.

The cause of MTBI is due to the brain actually bouncing or rebounding off the inner walls of the bony skull during the “whiplash” process, when the head is forced back and forth after the impact. During that process, the brain which is suspended inside our skull, is forced forwards and literally ricochets off the skull and damages some of the nerve cells most commonly of either the brain stem (the part connected to the spinal cord), the frontal lobe (the part behind the forehead) and/or the temporal lobe (the part of the brain located on the side of the head). Depending on the direction and degree of force generated by the collision (front end, side impact or rear end collision), the area of the brain that may be damaged varies as it could be the area closest to initial impact or, the area on the opposite side, due to the rebound effect. Depending on which part of the brain is injured, the physical findings may include problems with walking, balance, coordination, strength/endurance, as well as difficulties with communicating (“cognitive deficits”), processing information, memory, and altered psychological functions.

The good news is that most of these injuries will recover within 3-12 months but unfortunately, not all do and in these cases, the term, “post-concussive syndrome” is sometimes used.

We realize you have a choice in where you choose your healthcare services. If you, a friend or family member requires care for whiplash, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

At our Cupertino chiropractor office we have served hundreds of people who were in car accidents suffering from "whiplash, neck pain, back pain, headaches, etc. and helped them on the road to recovery. If you or anyone you know has suffered an auto injury, we may be able to help, and if we feel we can not we will help refer you to another facility for the proper care.  As always though, if it is a medical emergency, call 911.

Scoliosis is a term used to describe a curvature of the spine that is not “normal.” The normal curves of the spine include an inward curve in the low back and neck and an outward curve in the mid-back when looking at the person from the side (“sagittal plane”). However, there should NOT be any curves when looking at a person from the front or back (the frontal plane), the spine should be straight. When there is a curve in the frontal plane, this is called scoliosis and it’s usually either a singe curve, shaped like the letter “C” or, a double (or more) curve, shaped like the letter “S”. Though there is a diagnostic code specific for scoliosis, it is not in itself a disease or a diagnosis and frequently, there are no or at worst, minimal symptoms associated with it. For this reason, most of the time, scoliosis is not noticed until the curve progresses significantly and a friend or family member makes a comment about it or a school screening picks it up.

The most common spinal location for scoliosis to develop is in the middle to upper back (called the thoracic spine) but it can also be located at the junction between the mid back and low back, as well as in the low back only or more rarely, in the neck only. Since there are rarely symptoms associated with scoliosis, the way it’s found is by observing one or more of the following:

• One shoulder is higher than the other
• One shoulder blade sticks out more than the other
• One side of the rib cage appears higher than the other (called a “rib hump”)
• One hip appears higher or more prominent than the other
• The waist appears uneven
• The body tilts to one side
• One leg may appear or actually be shorter than the other

The use of x-ray usually is appropriate to confirm the diagnosis, to measure the amount of curve, which can then be used for future comparison, and to rule out a possible unusual cause of scoliosis. Rarely is an MRI required – only in cases where neurological signs and symptoms exist and, in younger children (ages 8-11 years old) as scoliosis almost always occurs during the puberty timeframe when hormonal systems are kicking in, such as ages 12-14. When scoliosis occurs at ages less than 11, when there are neurological changes (reflex, muscle strength and/or sensory functions), and/or when the mid-back/thoracic curve bends to the left (as it almost always curves to the right), an MRI is appropriate to rule out spinal cord pressure.

At our Cupertino chiropractic office, we have helped many people stabilize, reduce and even correct spinal scoliosis. The longer it is allowed to progress the less likely of a full correction and increased possibility of spinal degeneration (or arthritis).

We realize you have a choice in who you choose to provide your healthcare services. If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you, your friends and your family presently and, in the future.