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Chronic Neck Pain (Part 2)

Last time we discussed two mechanisms of chronic recurrent neck pain that are associated with the brain stem and brain. Today I want to talk about the role of sensation and the muscles in causing recurrent neck problems.

We are sensory-driven beings. What that means is that activation of our sensory systems causes activation of our muscle systems. In “Chronic Neck Pain (Part 1)” , we discussed the visual system’s and vestibular system’s effects on motor activity. Here in Part 2, I want to discuss proprioception.

Proprioception is the brain’s way of getting information about the body. To do this, receptors in all of our muscles, ligaments, and joints tell the brain where each part is, how much weight is on that part, whether or not the part moving or still and how fast is it moving. Proprioception is probably the most important information for the brain’s control of the muscles.

One of the most dramatic and well-known examples of this is when the doctor taps your knee and your leg kicks out. What happens in this example is that the fast tap stretches receptors in the tendon that send a signal to the spinal cord, which results in a muscle activating. This response happens in all our muscle as we move about, stretching and loading our joints, but it is often less apparent than the knee-tap test because the responses are slower, smaller, and longer-lasting. The integration of millions of these receptors is responsible for our posture and body position.

One of the most powerful influences on the muscles’ response to proprioceptive input is the cerebellum. It calibrates the sensitivity and intensity of the muscle’s response in a way that helps the body move efficiently. In fact, reflexes are one of the ways we assess the effectiveness of the cerebellum’s activity.

If the integration of the receptors is not accurate, it causes excessive tightness or looseness in the muscles, and this can predispose a person to recurrent symptoms in the joints. An adjustment stimulates the receptors with a fast movement that causes a reflex to reset the tone in the neck muscles, but the abnormal tension can come back if cerebellar integration is poor.

To fully resolve chronic pain, treatment must include activity that reestablishes normal cerebellar activity. This can be done with vestibular and balance exercises, shoulder and hip activities, and eye exercises. Combining the appropriate cerebellar activation with chiropractic adjustment has a good probability of resolving chronic neck pain.

For these reasons, I recommend cerebellar assessment for any patient who has recurrent neck problems.

For further information you could search for “cerebellum-posture and cerebellum head tilt” online. But unfortunately, most of this literature is very technical. If you are looking for information more accessible to a lay-audience, try searching for “proprioception and posture.”

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