Facet Joint Injury

Neck Pain can be slow creeping up, with a vague ache that just gets worse or a sharp pain, perhaps when you move. The neck is quite complicated, with seven bones (called vertebrae) in a stack, each one moving on the one next to it. There are small joints in your neck (lot’s of them!) which can be sprained and strained, just like a sprained ankle. This is most common in neck injury from movement;

• Whiplash
• Sports Injuries
• Longer term slow strains, perhaps from posture or stress

Each joint, called a “facet Joint”, connects to the vertebra next to it, and allows smooth controlled movement between them. Like most joints, these connections are two smooth surfaces, lined with a tough and slippery super material called cartilage. The joint is held together with a “capsule”, and it is this that gets strained, leading to swelling in the joint, general irritation of the surfaces and pain. Because the joint covering is like a little ballooon, it can get pressurised by the swelling, which explains why the pain comes on with some movements and not others.
If the joint is strained, you feel pain!

This leads to the famous “cricked neck”, “locked neck” or Torticollis in infants.

If the locking is due to a mis position of fine structures inside the joint (facet lock) then sometimes a click of the joint by a skilled Osteopath will provide instant relief as the joint is freed.

Disc Injury

The tough shock absorbers between your neck bones can put up with a lot of punishment, as anybody who has tried to chew gristle can confirm! These discs only get injured by severe trauma or long term weakening (stress failure)

The disc may press on the nerves to your arms, so you feel a neck injury in your arm, AKA referred pain.

Treatment for the neck will usually involve elements from the following.

• Enquiring as to how this happened…
• Examining the neck very carefully to find tenderness, swelling, mis-position etc. This leads to a diagnosis.
• Calming the nervous system to move the body from a state of alarm and action to a state of healing and repair
• Gently balancing and easing the structure to allow circulation and drainage
• Giving advice regarding rest and or exercise

How is neck pain treated? The approach of most therapies is similar. First, is the pain due to an injury, where some tissue is damaged, or is the pain due to sensitivity, where the body reports injury as pain but no damage has actually occured. There is often an element of both in many cases.

It may be in the person’s interest to overreact to a problem, so that the person takes it seriously and looks after themselves. This is a natural phenomenon, and encourages us to listen to our body and alter what we are doing. If one takes a painkiller in this scenario, the wisdom of the body is ignored, and you run the risk of aggravating the neck pain. If the problem is due to hypersensitivity - neurogenic pain which is perhaps an overreaction to an innocuous problem, then sometimes pain relief, if it helps sleep and relaxation, may be helpful. Physical treatment can help more naturally, using techniques which listen and communicate with the body, and calm the nerves down without simply switching them off. This may include discussing stress and diet, as many things often add together to create a state of excitability.

Because the neck is close to your brain, and supplies the brain with some of its nerves and all its blood supply, how well your neck functions affects your thinking, mood, and is the root cause of tension headaches.
So as your Osteopath clears up your neck trouble for you, so the headaches will ease as well.

Back injury treatment will depend on the tissue involved.

• Muscle Pain - The muscle may be fatigued, tight and stringy. The reason for the overuse must be addressed, and then the muscle relaxed using massage or functional (feedback) approaches. The spinal reflexes affecting the health of the tissues and holistic integration of all the structures is a specialism of Classical Osteopathy, bringing all the parts into harmony.
• Any damaged tissue from pulled muscles must be relaxed and the support systems (blood supply and drainage) must be optimised so that healing can proceed. If it does not you run the risk of a chronic, never ending problem. Sometimes this will lead to a brief aggravation of symptoms after the Osteopathy treatment (healing reaction) as the immune system repairs accelerate.
• Joint Pain - whether due to arthritis, sprain or congestion, the joint needs to be carefully brought into normal relations (straightened out) so that and strain is relieved.This is achieved by articulation (gentle movement of the joint) encouraging balance. Normal micro movements of the joints encourage circulation and drainage, swelling is reduced and repair encouraged. Pain should be eased, but can be briefly increased (healing reaction). This represents a rapid acceleration of the healing process, and typically lasts for 12-24 hours.
• Integration of the spine is always needed, so that each part of the spine is in harmony and supports and is supported by it’s neighbours.
• Disc Pain - Between our vertebrae (back bones) are rubbery pads filled with jelly, much like an old fashioned jam doughnut. If the spine strains forward too much the jam in the doughnut (jelly in the disc) can squidge backwards and irritate the nerves in your neck (referred pain into the arm)). The treatment is to decompress and straighten the bones either side of the disc, encourage support of the spine with gentle exercises etc, and swimming or other supportive exercise to promote recovery. Disc healing can be quite slow, and the injury must be respected. If there is weakness or numbness in the arm or hand a scan (MRI) may be required. Because part of the entrapment of the nerve is swelling around the injury, Osteopathy can help relieve referred pain because our treatment will encourage “micro movements” of the cells and tissues, drastically improving drainage and so relieving swelling and pain.