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Tag: pain

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Straight Leg Test: Understanding Its Purpose

Can the straight leg test help find the cause of back or hamstring pain in individuals experiencing it?

Straight Leg Test

The straight leg raise test is often used to diagnose sciatica/radiculopathy, herniated discs, and other spinal problems. The healthcare provider giving the test performs most of the movement as they assess what’s causing the leg and/or back pain. The patient lies on their back with the legs straight. The provider will have the patient perform specific movements and inform them of how it feels. Then, they’ll raise the leg to see if and at what point symptoms begin to show. Providers often use this test alongside imaging studies.

Purpose

The straight leg raise is one of the most common manual tests done during physical exams. The straight leg raise test seeks to reproduce the pain or other symptoms in a controlled fashion to provide clues to what’s happening. It is a manual exam, and the healthcare provider will:

  • Position the patient
  • Moves the patient
  • Create pressure to see how well the patient can resist it

This is often used alongside imaging tests, such as an X-ray or CT scan. (Allegri M. et al., 2016) Its goal is to check for nerve movement and sensitivity of nerve tissue to compression. The straight leg lift test is neurodynamic because it uses movement to diagnose nerve problems. (Baselgia L.T. et al., 2017)

During the Test

Expect to feel some pain during the test, as the whole point is to see what aggravates the symptoms. They may be caused by:

  • Tight hip or back muscles
  • Back muscle spasms
  • Slipped disc
  • Spinal instability

Most of the tests are passive, with the provider doing the lifting. The patient can help achieve the most accurate result by staying as relaxed as possible and being clear about what is felt. (Pande K. 2015) The procedure:

  • The patient lies on their back with their legs straight.
  • The provider will ask the patient to turn one of the legs in.
  • This tells them what hip position affects the lower back symptoms.
  • They’ll then ask you to bring the leg toward the body’s center.
  • Then, they’ll lift the straight leg until the patient experiences symptoms.
  • Pain suggests a herniated disc.
  • If there is no pain, this also provides valuable information.
  • The procedure is repeated with the other leg.

Modifications

It’s important to let the examiner know about any limitations. The straight leg raise test has modifications if the patient cannot lift their leg while it’s straight or if they have difficulty lying on their back, which can also help avoid an injury during the test.

Variations

The healthcare provider may repeat the test with the ankle in a dorsiflexed position/raising the foot. Then, they’ll have the patient do it with their chin tucked into their chest. (Young R. et al., 2013) These variations can help check for nerve involvement in specific locations, such as the spinal cord or the dura mater, the membrane covering the brain and spinal cord. (Venne G. et al., 2017) The spinal cord nerves are likely involved and affected if the usual pain is in the back or leg but not the chin, neck, or foot. (Camino Willhuber GO, Piuzzi NS. 2023)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

From Injury to Recovery with Chiropractic Care

References

Casiano, V. E., Sarwan, G., Dydyk, A. M., & Varacallo, M. A. (2025). Back Pain. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30844200

Pesonen, J., Shacklock, M., Suomalainen, J. S., Karttunen, L., Mäki, J., Airaksinen, O., & Rade, M. (2021). Extending the straight leg raise test for improved clinical evaluation of sciatica: validity and diagnostic performance with reference to the magnetic resonance imaging. BMC musculoskeletal disorders, 22(1), 808. https://doi.org/10.1186/s12891-021-04649-z

Allegri, M., Montella, S., Salici, F., Valente, A., Marchesini, M., Compagnone, C., Baciarello, M., Manferdini, M. E., & Fanelli, G. (2016). Mechanisms of low back pain: a guide for diagnosis and therapy. F1000Research, 5, F1000 Faculty Rev-1530. https://doi.org/10.12688/f1000research.8105.2

Baselgia, L. T., Bennett, D. L., Silbiger, R. M., & Schmid, A. B. (2017). Negative Neurodynamic Tests Do Not Exclude Neural Dysfunction in Patients With Entrapment Neuropathies. Archives of physical medicine and rehabilitation, 98(3), 480–486. https://doi.org/10.1016/j.apmr.2016.06.019

Pande K. (2015). The Use of Passive Straight Leg Raising Test: A Survey of Clinicians. Malaysian Orthopaedic Journal, 9(3), 44–48. https://doi.org/10.5704/MOJ.1511.012

Young, R., Nix, S., Wholohan, A., Bradhurst, R., & Reed, L. (2013). Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis. Journal of foot and ankle research, 6(1), 46. https://doi.org/10.1186/1757-1146-6-46

Venne, G., Rasquinha, B. J., Kunz, M., & Ellis, R. E. (2017). Rectus Capitis Posterior Minor: Histological and Biomechanical Links to the Spinal Dura Mater. Spine, 42(8), E466–E473. https://doi.org/10.1097/BRS.0000000000001867

Camino Willhuber, G. O., & Piuzzi, N. S. (2025). Straight Leg Raise Test. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30969539

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Pinched Nerve in the Neck: Managing Your Pain

Can physical therapy help individuals with a pinched nerve in the neck?

Pinched Nerve In The Neck

A pinched nerve in the neck can cause pain, numbness, and weakness that extends through the neck, shoulder, and arm. (American Academy of Orthopaedic Surgeons, 2024) Over-the-counter pain medications, resting the muscles, and gentle stretching can help. However, if you’re still in pain after a few days, see a healthcare provider. Common treatments include:

  • Rest
  • Over-the-counter (OTC) pain meds
  • Physical therapy
  • Steroid injections
  • Wearing a neck collar

Surgery is rarely needed, but it can provide relief if other treatments don’t help. Most of the time, a pinched nerve resolves within days or weeks.

How a Pinched Nerve in the Neck Feels

The term for neck nerve pain is cervical radiculopathy (cervical spine pain). Common symptoms of a pinched nerve in the neck are: (American Academy of Orthopaedic Surgeons, 2024)

  • Sharp pain that extends into the shoulder and arm.
  • The pain worsens, or there is a shooting sensation when turning the head.
  • Tingling or feeling of pins-and-needles in the fingers or hand.
  • Weakness in the arm, shoulder, or hand.
  • Numbness or loss of feeling.

Often, these symptoms occur only on one side. Some find their pain less when they lift their hand onto their head, which can relieve pressure on the nerve.

Causes

The cervical spine is the spinal cord area around the neck. It’s made up of seven vertebrae. Nerves branch off the spinal cords in the spaces between the vertebrae. Nerve compression occurs when the space between two vertebrae is reduced, putting pressure on the nerve, pinching it, and causing pain. Pinched nerves develop from age because the spinal discs between the vertebrae become compressed over time. Age causes about 70% to 80% of nerve compression. Other factors that cause pinched nerves include: (Harvard Health Publishing, 2021)

  • Degenerative disc disease
  • A herniated disc
  • Injuries like car accidents falls, or other trauma to the spine
  • Spinal stenosis

Self-Care Relief

If you have nerve pain and think it is a pinched nerve, self-care can help (National Institute of Neurological Disorders and Stroke, 2025)

Rest

  • Find a comfortable position and try to allow the muscles in your neck to relax and rest.

Heat or Ice

  • Warmth and coolness can relieve pain and inflammation.
  • Use a warm or cool compress for 15 minutes at a time.

Over-The-Counter Pain Medications

  • Pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), can help bring relief.

Treatment for Severe Symptoms

If pain doesn’t resolve within a few days, or if it is so bad that you can’t go about daily activities, it’s recommended to see a healthcare provider. They can diagnose a pinched nerve after a physical exam and may also recommend imaging, including an X-ray, CT scan, MRI, or EMG, to reveal what’s causing the symptoms. After diagnosing the condition, the healthcare provider will develop a personalized treatment plan, which may include the following (Harvard Health Publishing, 2021)

Physical Therapy

  • Physical therapy can help build strength and flexibility in the neck.
  • This is especially important if there is frequent nerve pain in the same spot.

Cervical Collar

  • A soft cervical collar is a brace that fits around the neck.
  • It supports your head so the neck muscles can relax, facilitating healing.
  • The collar can also keep the head from turning in painful ways.

Oral Corticosteroids

  • Oral steroids like prednisone can help reduce inflammation.
  • If inflammation or swelling in the neck puts more pressure on the nerve, they can help.

Steroid Injections

  • Steroid shots right into the painful tissue reduce inflammation right away.

Muscle Relaxers

  • These medications keep the muscles in the neck from seizing up.
  • As the muscles relax, this brings pain relief.

Narcotic Pain Medications

  • Narcotic pain medications can be used short-term by individuals who have severe pain.
  • A healthcare provider will inform the patient of the benefits and drawbacks of these medications, which include opiates.  

Neck Exercises

Gentle stretches can help alleviate the pain and strengthen the muscles. (National Health Service, 2025)

Chin to chest

  • Bring your chin toward your chest.
  • Hold for 20 seconds, then return to a neutral position.
  • Do this five times.

Eyes to Sky

  • Lean your head back and look toward the sky.
  • Hold for 20 seconds, then return to your starting position.
  • Do this five times.

Side to Side

  • Turn your head to the right as far as possible, bringing your chin in line with your shoulder.
  • Hold for 20 seconds, then turn as far as possible toward the left.
  • Repeat four times.

Ear to Shoulder

  • Bring your ear down toward your shoulder.
  • Hold for 20 seconds, then repeat the exercise on the other side.
  • Alternate between the right and left, stretching each side five times.

While it’s normal for exercises to hurt from stretching the muscles, they should never hurt more than a five on a pain scale of 1 to 10. If they do, stop exercising (National Health Service, 2025)

Healing Time

Healing and recovery depend on the severity of the injury. Some individuals find that the pain from a pinched nerve goes away in days, while for others, it can last for weeks. The pain goes away and then returns. If pain doesn’t go away with the conservative treatments or lasts more than a few days, talk with a healthcare provider or return for a second visit. Rarely do individuals need surgery to bring pain relief. The healthcare provider will discuss whether surgery is the best option and what to expect regarding pain relief. (American Academy of Orthopaedic Surgeons, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Revitalize and Rebuild with Chiropractic

References

American Academy of Orthopaedic Surgeons. OrthoInfo. (2024). Cervical radiculopathy (pinched nerve). https://orthoinfo.aaos.org/en/diseases–conditions/cervical-radiculopathy-pinched-nerve/

Harvard Health Publishing. Publishing, H. H. (2021). Treating a pinched nerve. https://www.health.harvard.edu/pain/treating-a-pinched-nerve

National Institute of Neurological Disorders and Stroke. (2025). Pinched Nerve Definition. Retrieved from https://www.ninds.nih.gov/health-information/disorders/glossary-neurological-terms#-P-

National Health Service. Service, N. H. (2025). Exercises for neck problems. https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/neck-and-back-problems-and-conditions/exercises-for-neck-problems

By admin 0 Comments Chiropractic Care, Work Injury , , , , , , , , , , , , , , , , ,

Triceps Tendonitis: A Guide to Prevention and Treatment

Triceps tendonitis can be frustrating, especially when you need to rest from normal activities. Can knowing the causes, symptoms, and diagnosis help individuals understand the treatment and prevention of the condition?

Triceps Tendonitis

Tendons are connective tissue that attach muscles to bones, enabling the joints to move. Triceps tendonitis is inflammation of the tendon at the back of the elbow. It is most often caused by overuse of the triceps muscles. The condition can cause pain, swelling, and loss of function. It’s common in jobs that require regular hammering, shoveling, and overhead reaching, as well as in weightlifters, gymnasts, and boxers.

Causes

The triceps muscle runs along the back of the upper arm and is attached to the point of the elbow by a tendon. This muscle straightens the elbow. Tendonitis develops from repeatedly straightening the elbow against resistance. This causes tiny tears in the tissue, which leads to inflammation. Triceps tendonitis commonly occurs from repetitive manual labor tasks or sports activities like throwing sports, gymnastics, or boxing. Exercises that target the triceps muscle can cause tendonitis to develop, including kickbacks, dips, push-ups, and bench presses. For this reason, triceps tendonitis is also known as weightlifter’s elbow. (Orthopedic & Spine Center, N.D.)

Symptoms

Inflammation leads to a series of chemical reactions in the area of the injury. There are five main symptoms of inflammation:

  • Redness
  • Warmth
  • Swelling
  • Pain
  • Loss of function

With triceps tendonitis, the pain and stiffness are felt at the back of the elbow. Weakness may also present when using the affected arm. Tendonitis usually causes more pain with movement than when resting. Pain can occur when straightening the elbow, which puts tension on the triceps, or bending the elbow, which stretches the tendon.

Diagnosis

A healthcare provider will ask questions and perform a physical exam to diagnose tendonitis. (Harvard Health Publishing, 2014) A healthcare provider will ask you to describe the pain and the activities that make it better or worse. The elbow will be assessed for movement issues, swelling, or deformities that could indicate a worse injury, like a tendon tear. A healthcare provider will order X-rays or other imaging, such as MRI, to assess for a bone fracture or more extensive damage to the tendon.

Treatment

Several types of treatments include self-care, physical therapy, and medications.

Self Care

Triceps tendonitis can be treated at home if symptoms are addressed early. These include:

Rest

  • Rest the triceps tendon by avoiding activities that cause pain for a few days.

Ice

  • Apply ice to the triceps tendon for 15 to 20 minutes, two to three times daily.
  • Massage the area with an ice cube for several minutes.

Range of Motion Exercises

  • Decrease stiffness in the elbow with gentle range of motion exercises.
  • Slowly bend and straighten the elbow in a pain-free range, 10 times.
  • Repeat several times per day.

Physical Therapy

Physical therapists use various therapies and tools when treating tendonitis, including (Prall J. & Ross M. 2019)

PT Modalities

  • Physical therapy modalities are used to decrease pain, inflammation, and stiffness.
  • Examples include ultrasound, electrical stimulation, and light therapy.

Manual Therapy

  • Manual techniques for tendonitis include soft tissue massage, friction massage, stretching, and joint mobilization.

Exercise

  • Stretching and strengthening exercises that target the triceps muscle and any other muscle weakness that might have contributed to the condition.

Activity Modification

  • A therapist will look at the activities that led to the tendonitis and ensure you use the correct form and proper body mechanics.
  • Sometimes, a physical therapist can make on-site changes in the work environment to help prevent further injury.

Medications

Medications that are used to treat the condition (Aurora Health Care, 2025)

NSAIDs

  • Nonsteroidal anti-inflammatory medications are often used to treat tendonitis.
  • Many are available over-the-counter, including Aleve, Bayer, and Advil.
  • These medications can also be prescribed in higher doses by a healthcare provider.

Pain-Relievers

  • Additional over-the-counter medications such as Tylenol can help decrease pain.

Oral Steroids

  • These medications might be prescribed for short-term use to decrease inflammation if over-the-counter medications are ineffective in treating symptoms.
  • Long-term use of oral steroids can cause more damage to the tendons. (Spoendlin J., Meier C., Jick S. S., & Meier C. R. 2015)

Corticosteroid Injections

  • Tendonitis is frequently treated with an injection of steroid medication to decrease inflammation.
  • However, having multiple injections in the same area can eventually cause tendons to weaken more. (NYU Langone Health, 2024)

Platelet-Rich Plasma

  • PRP is made by taking a small amount of blood and separating the platelets or cells that release growth factors to promote healing.
  • The liquid is then injected into the tendon.
  • PRP is controversial; some studies support its use, while others do not.
  • While PRP may show some promise, insurance may not cover PRP treatments because of the ambiguity in the clinical data.

Injury Medical Chiropractic and Functional Medicine Clinic

Prevention is key. Warming up before a workout, stretching, and using the proper form can help prevent triceps tendonitis. Temporarily halting activities to address symptoms can prevent more serious injury. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

From Inflammation to Healing

References

Orthopedic & Spine Center. (N.D.). Triceps Tendonitis or Weightlifter’s Elbow. https://www.osc-ortho.com/resources/elbow-pain/triceps-tendonitis-or-weightlifters-elbow/

Harvard Health Publishing. (2014). Tendonitis. https://www.health.harvard.edu/diseases-and-conditions/tendonitis

Prall, J., & Ross, M. (2019). The management of work-related musculoskeletal injuries in an occupational health setting: the role of the physical therapist. Journal of Exercise Rehabilitation, 15(2), 193–199. https://doi.org/10.12965/jer.1836636.318

Aurora Health Care. (2025). Tendonitis symptoms & treatment. https://www.aurorahealthcare.org/services/orthopedics/conditions/tendonitis

Spoendlin, J., Meier, C., Jick, S. S., & Meier, C. R. (2015). Oral and inhaled glucocorticoid use and risk of Achilles or biceps tendon rupture: a population-based case-control study. Annals of Medicine, 47(6), 492–498. https://doi.org/10.3109/07853890.2015.1074272

NYU Langone Health. (2024). Therapeutic injections for bursitis & tendinitis in adults. https://nyulangone.org/conditions/bursitis-tendinitis/treatments/therapeutic-injections-for-bursitis-tendinitis

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The Prevalence of Rotator Cuff Tears and Treatment Approaches

Could older individuals who do not have symptoms of shoulder pain or loss of shoulder and arm function have a rotator cuff tear?

Rotator Cuff Tear Physical Therapy

A rotator cuff tear is a common injury to the four muscles and tendons surrounding and stabilizing the shoulder joint. Studies have shown that (Geary M. B., & Elfar J. C. 2015)

  • 30% of those under the age of 70
  • 70% of those over age 80 have a rotator cuff tear. 

Physical therapy is often recommended as a first-line initial treatment for rotator cuff pain. In most cases, a rotator cuff tear will not need surgical treatment. Determining when surgery is necessary depends on several factors a patient can discuss with their healthcare provider.

Causes

  • Overuse and repetitive motions
  • Trauma (e.g., falls, collisions)
  • Age-related degeneration

Symptoms

  • Shoulder pain, especially with overhead or rotational movements
  • Weakness and difficulty raising the arm
  • Clicking or grinding sounds in the shoulder
  • Limited range of motion

Treatment

The goal of physical therapy for a rotator cuff tear is not necessarily to heal the torn tendon but to relieve pain and improve strength by reducing inflammation and restoring shoulder joint mechanics. This is achieved through physical therapy, ice application, anti-inflammatory treatments like medications, and cortisone injections.

Physical Therapy

The goal of physical therapy is to improve the function of the muscles that surround the shoulder. Physical therapy targets the smaller muscles around the shoulder that are commonly neglected. By strengthening these muscles, the treatment can help compensate for damaged tendons and improve the mechanics of the shoulder joint. A chiropractic physical therapy team will develop a personalized exercise program. Generally, rehabilitation will start with gentle range of motion exercises that can be accomplished using the arms to lift a mobility stick/wand overhead.

Shoulder Pulleys

  • These improve shoulder range of motion and flexibility.

Isometric Exercises

  • These exercises are for the rotator cuff muscles and may then be started.
  • This exercise can improve the contracting of the muscles around the shoulder and offer more support to the shoulder joint.

Scapular Stabilization Exercises

  • These can also be done to improve the muscles surrounding the shoulder blade’s function.
  • This can help improve how the shoulder joint, arm, and scapulae move together when using the arm.

Advanced Strengthening

  • Advanced exercises can be done with a dumbbell or resistance band.

Consult your healthcare provider or physical therapist before starting these or any other exercises for a rotator cuff tear. Doing exercises correctly prevents further pain, injury, or shoulder problems. Specific, focused exercises can help expedite and regain normal shoulder function.

Injury Medical Chiropractic and Functional Medicine Clinic

The prognosis for rotator cuff tears depends on the severity of the tear and the individual’s overall health. With proper treatment, most people can regain the full function of their shoulders. However, some may experience ongoing pain or limitations in severe cases. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Shoulder Pain Chiropractic Treatment

References

Geary, M. B., & Elfar, J. C. (2015). Rotator Cuff Tears in the Elderly Patients. Geriatric orthopaedic surgery & rehabilitation, 6(3), 220–224. https://doi.org/10.1177/2151458515583895

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Headaches and Neck Pain: Causes, Symptoms, and Treatment

Could individuals who are having headaches with neck pain need emergency treatment or need to get started with sustained physical therapy?

Headaches and Neck Pain

Headaches and neck pain are two very common symptoms. They often occur together and signal common health issues, including fatigue, sinus headaches, and migraines. The combination can also occur due to serious health issues such as a concussion or meningitis. Causes of headaches with neck pain range from various causes, such as not getting enough sleep, having the neck in an awkward position, or having a hangover, to life-threatening issues like fluid buildup in the brain. It is recommended that individuals see a healthcare provider as soon as possible to rule out any life-threatening issues. Discuss the symptoms of neck pain with headache, what can cause these symptoms, and discuss treatment and prevention.

Symptoms

Symptoms are similar to what they feel like when they occur alone. Headache can present as:

  • A feeling of fullness in the head
  • Head soreness
  • Sharp head pain
  • Throbbing head pain
  • Pounding head pain

Neck pain can present as:

  • Pain in the back of the neck
  • Pain and/or aching of the upper back and/or shoulders

Associated Symptoms

Additional symptoms are common. Symptoms associated with headaches and neck pain include:

  • Neck stiffness
  • Trouble concentrating
  • Exhaustion or sleepiness
  • Aching throughout the body
  • Nausea
  • Dizziness
  • Vertigo – feeling like the room is spinning.
  • Photophobia – discomfort when looking at bright lights.
  • A feeling of numbness or tingling down the arm

Generally, associated symptoms suggest a more severe cause and can help a healthcare provider make a diagnosis.

Emergency Help

New symptoms of headache or neck pain can indicate a serious condition. If you develop these symptoms together, get prompt medical attention.

Causes

There are a variety of medical conditions that can cause headaches and neck pain. Both of these conditions are caused by irritation of sensory nerve fibers. Sometimes, head or neck pain can spread to other areas because the sensory nerves of these structures are so close together. (Côté P. et al., 2019) Additionally, a medical condition like an infection can affect the other due to proximity. Causes of headaches with neck pain include:

Headaches

  • Sinus headaches, tension headaches, and cervicogenic headaches are usually associated with head pain, but they can also involve neck pain. (Côté P. et al., 2019)

Migraine

  • Migraines are commonly associated with headaches and often cause neck pain as well.
  • In addition, they can cause nausea and body aches.

Fatigue

  • Being tired commonly leads to temporary headaches and neck pain until thorough rest is achieved.

Alcohol Consumption and/or a Hangover

  • For many, drinking can trigger a headache.
  • This is a common migraine trigger, but it can also trigger headaches for those who don’t have migraines.

Muscle Strain

  • Prolonged or recurrent positions that strain the neck muscles, like lifting or sitting at a desk, can cause aching or pain that involves both the head and neck. (Houle M. et al., 2021)

Injuries

  • Trauma such as whiplash or falling can cause soreness in the head and neck.
  • Bruises or other injuries may be present.
  • Severe injuries can cause damage to the skull, brain, spine, spinal nerves, or spinal cord.

Concussion

  • A concussion often causes trouble concentrating, persistent headaches, and neck pain.
  • Usually, these symptoms improve within a few weeks after a mild concussion.

Meningitis

  • Inflammation or infection of the lining around the brain and spinal cord causes pain or tenderness in the head, back, and neck.
  • Neck stiffness and fever are commonly associated symptoms.

Pinched Nerve

  • Arthritis is a common cause of pressure on spinal nerves.
  • A pinched nerve in the upper spine can cause pain in the head and neck and tingling down the arm.

Herniated Disc

  • Degenerative arthritis or trauma can cause a spinal disc to press on a nerve and possibly on the spinal cord.
  • This may cause loss of sensation or weakness of the arm.

Subarachnoid Hemorrhage

  • This is a serious condition caused by bleeding of a blood vessel in the brain.
  • Irritation and inflammation can cause severe head and neck pain, possibly with seizures and loss of consciousness.

Hydrocephalus

  • Fluid can accumulate around the brain, causing pain-inducing pressure.
  • Causes include obstruction of cerebrospinal fluid flow due to brain tumors, brain infections, or congenital malformations. (Langner S. et al., 2017)

Increased Intracranial Pressure

  • Pressure on the brain and the brain’s blood vessels can cause pain.
  • Causes of pressure within the skull include hydrocephalus, head trauma, brain tumors, or swelling from a stroke.
  • Severe cases can cause lethargy or loss of consciousness.

Brain or Spine cancer

  • Cancer of the brain or within the spine can cause pain affecting the head and neck, often with other symptoms, like loss of vision.

Treatment

Talk to a healthcare provider about the following treatments. Treating headaches with neck pain includes methods that address symptoms and methods that treat the underlying cause. The medications used for headaches with neck pain often reduce both symptoms, but this depends on the cause. Treatments that can relieve both headaches and neck pain when they occur together include:

  • Getting proper sleep to alleviate fatigue.
  • Rest and rehabilitation after a concussion or another injury.
  • Physical therapy to keep muscles flexible and relaxed.
  • Non-surgical decompression and traction to decompress the spine.
  • Pain medication to relieve pain after minor trauma.
  • Migraine medication or sinus headache treatment (Petersen S. M., Jull G. A., & Learman K. E. 2019)
  • Fluids for meningitis treatment and antibiotics for bacterial meningitis.
  • Surgical procedures for a tumor or subarachnoid hemorrhage.
  • A surgical procedure to relieve hydrocephalus.

Headache Treatment

You can do a few things to relieve your headaches, and although they won’t directly take away your neck pain, your headache relief might also decrease your neck pain. These include:

  • Avoiding loud noises
  • Cranial massage
  • Applying gentle cranial pressure
  • Avoiding bright lights as much as possible
  • Using specialized migraine sunglasses

Neck Pain Treatment

Some treatments that can specifically treat neck pain include:

  • Exercise, stretching, and physical therapy (Côté P. et al., 2019)
  • Ice or heat
  • Muscle relaxants
  • Anti-inflammatory injections

Injury Medical Chiropractic and Functional Medicine Clinic

It can be difficult to know whether a serious problem is causing headaches and neck pain. The more dangerous conditions don’t necessarily cause more severe pain. This is why getting medical attention is crucial if you have these symptoms together. If you frequently have both headaches and neck pain, it can have a substantial impact on your quality of life. There are ways to manage the symptoms, including preventative measures such as physical therapy, exercises, and avoiding triggers. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Tension Headaches

References

Côté, P., Yu, H., Shearer, H. M., Randhawa, K., Wong, J. J., Mior, S., Ameis, A., Carroll, L. J., Nordin, M., Varatharajan, S., Sutton, D., Southerst, D., Jacobs, C., Stupar, M., Taylor-Vaisey, A., Gross, D. P., Brison, R. J., Paulden, M., Ammendolia, C., Cassidy, J. D., … Lacerte, M. (2019). Non-pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration. European journal of pain (London, England), 23(6), 1051–1070. https://doi.org/10.1002/ejp.1374

Houle, M., Lessard, A., Marineau-Bélanger, É., Lardon, A., Marchand, A. A., Descarreaux, M., & Abboud, J. (2021). Factors associated with headache and neck pain among telecommuters – a five days follow-up. BMC Public Health, 21(1), 1086. https://doi.org/10.1186/s12889-021-11144-6

Langner, S., Fleck, S., Baldauf, J., Mensel, B., Kühn, J. P., & Kirsch, M. (2017). Diagnosis and Differential Diagnosis of Hydrocephalus in Adults. Diagnostik und Differenzialdiagnostik des Hydrozephalus beim Erwachsenen. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin, 189(8), 728–739. https://doi.org/10.1055/s-0043-108550

Petersen, S. M., Jull, G. A., & Learman, K. E. (2019). Self-reported sinus headaches are associated with neck pain and cervical musculoskeletal dysfunction: a preliminary observational case-control study. The Journal of manual & manipulative therapy, 27(4), 245–252. https://doi.org/10.1080/10669817.2019.1572987

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Detecting Alcoholic Peripheral Neuropathy: Signs and Testing

Excessive alcohol consumption: what is alcoholic peripheral neuropathy?

Alcoholic Peripheral Neuropathy

Alcoholic peripheral neuropathy (ALN) is a condition that damages the nerves in the body due to chronic alcohol consumption. It can cause sensory, motor, and autonomic dysfunction, which can lead to disability. This damage prevents the nerves from communicating information. Most symptoms generally start as mild but typically worsen over time as the neuropathy progresses. The most common symptoms are: (National Library of Medicine, 2023)

  • Numbness or tingling sensation in the extremities
  • Pain or a burning sensation in the extremities
  • Difficulty walking
  • Difficulty urinating
  • Difficulty talking or swallowing

 Affected nerves include the peripheral and autonomic nerves, which help regulate internal body functions. Around 46% of chronic alcohol users will eventually develop the condition. (Julian T., Glascow N., Syeed R., & Zis P. 2019)

Causes

The exact cause of alcoholic neuropathy is unclear. But it is directly related to heavy and long-term alcohol consumption. (Julian T., Glascow N., Syeed R., & Zis P. 2019) It is believed overconsumption of alcohol can directly harm and hinder the nerves’ ability to communicate information. Unhealthy nutritional habits are often associated with it as well. Research shows that decreased thiamine/B vitamin plays a role, while others suggest an overall dietary deficiency may play a role. (Julian T., Glascow N., Syeed R., & Zis P. 2019) However, alcoholic neuropathy can also occur without the presence of malnutrition. (Julian T., Glascow N., Syeed R., & Zis P. 2019)

Neuropathy Development and Progression

Alcoholic neuropathy develops depending on many factors, including the amount of daily/nightly alcohol consumed, age and overall health, nutritional intake, and other individual factors. In most cases, the neuropathy takes several years or decades to develop, depending on the amount of alcohol consumed.

Symptoms

Symptoms are usually related to nerve dysfunction and include: (National Library of Medicine, 2023)

  • A tingling or pins-and-needles sensation in the extremities.
  • Numbness of the extremities, most commonly in the legs or feet. (Julian T., Glascow N., Syeed R., & Zis P. 2019)
  • Pain or burning sensation in the arms, legs, or feet.
  • Symptoms that occur in the arms and legs typically affect both sides.
  • Cramps, aches, or weakness of the muscles.
  • Constipation or diarrhea.
  • Nausea and vomiting.
  • Difficulty urinating or incontinence.
  • Difficulty walking.
  • Difficulty talking or swallowing.
  • Heat intolerance.
  • Erection difficulties.

Most symptoms begin as mild and usually worsen over time as the neuropathy progresses. Alcoholic neuropathy affects individuals who consume excessive amounts of alcohol over a long time. (Julian T., Glascow N., Syeed R., & Zis P. 2019)

Diagnosis

Symptoms can vary significantly so that a diagnosis may take time. It usually involves a combination of the following (National Institute of Neurological Disorders and Stroke, 2024)

Medical History

  • Healthcare providers will collect data involving past medical history and all current symptoms.

Physical Exam

  • This exam looks at other medical conditions contributing to symptoms, like diabetes or high blood pressure.

Neurological Exam

  • This is a noninvasive exam to determine the location and extent of neurological damage.
  • Healthcare providers may ask patients several questions and have them complete a series of small movements to check neurological function.

Blood and Urine Tests

  • These tests can detect diabetes, liver and kidney problems, infections, vitamin deficiencies, and other conditions that can cause neuropathic conditions.

Chronic alcohol use can also affect how the body stores and uses vitamins necessary for healthy nerve function. Vitamin levels that a healthcare provider may check include: (National Library of Medicine, 2023)

  • Vitamin A
  • Biotin
  • Folic acid
  • Niacin, or vitamin B3
  • Pyridoxine, or vitamin B6
  • Pantothenic acid

Liver Disease

Individuals with chronic liver disease often have neuropathy. The severity and stage are associated with a higher incidence of neuropathy. (Pasha MB, Ather MM, Tanveer MA, et al. 2019)

Treatment

Alcoholic neuropathy is not reversible, even when quitting drinking. However, individuals with the condition can make healthy changes to minimize symptoms and receive help for chronic alcohol use. The first step is stopping alcohol consumption. (Chopra K., & Tiwari V. 2012) Talk to a healthcare provider about what options are available. Treatment can include:

  • In-patient or outpatient rehab
  • Therapy
  • Medication
  • Social support from groups like Alcoholics Anonymous

A combination of treatments will likely be utilized. Other treatment options involve symptom management and preventing further injuries and may include:

  • Physical therapy
  • Keeping the head elevated while sleeping.
  • Orthopedic splints to maintain limb function and positioning.
  • Wearing compression stockings.
  • Adding vitamins and supplements.
  • Eating extra salt for those without hypertension
  • Medications to reduce pain and discomfort.
  • Intermittent catheterization or manual expression of urine for those with difficulty urinating.

Individuals with neuropathy may have reduced sensitivity in the arms and legs. If this occurs, additional steps need to be taken to prevent other injuries, that include (National Library of Medicine, 2023)

  • Wear special footwear to prevent foot injuries.
  • Checking feet daily for wounds.
  • Prevent burns by ensuring that bath and shower water is not too hot.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Peripheral Neuropathy Myths and Facts

References

National Library of Medicine. (2023). Alcoholic neuropathy. Retrieved from https://medlineplus.gov/ency/article/000714.htm

Julian, T., Glascow, N., Syeed, R., & Zis, P. (2019). Alcohol-related peripheral neuropathy: a systematic review and meta-analysis. Journal of Neurology, 266(12), 2907–2919. https://doi.org/10.1007/s00415-018-9123-1

National Institute of Neurological Disorders and Stroke. (2024). Peripheral neuropathy. Retrieved from https://www.ninds.nih.gov/health-information/disorders/peripheral-neuropathy

Pasha MB, A. M., Tanveer MA, et al. (2019). Frequency of peripheral neuropathy in chronic liver disease. Med Forum Monthly, 30(8), 23-26. https://medicalforummonthly.com/index.php/mfm/article/view/3761

Chopra, K., & Tiwari, V. (2012). Alcoholic neuropathy: possible mechanisms and future treatment possibilities. British journal of clinical pharmacology, 73(3), 348–362. https://doi.org/10.1111/j.1365-2125.2011.04111.x

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Managing Myofascial Pain Syndrome: Breaking the Spasm Cycle

For individuals who have to be in one position for long periods, have poor postural alignment, and perform repetitive motions, what are myofascial pain syndrome spasm cycles?

Myofascial Pain Syndrome Spasm Cycles

Myofascial pain syndrome is a common condition that causes pain symptoms in a particular body area (Jafri M. S. 2014). A myofascial pain syndrome spasm cycle is a recurring pattern in which muscle tension and spasms in affected regions, caused by myofascial pain syndrome, lead to pain, triggering more muscle spasms. This creates a vicious cycle of discomfort and tightness that can be difficult to break without treatment; the pain perpetuates muscle spasms and vice versa.

Spasm Pain Cycle

Left untreated, myofascial pain is often experienced as a recurring cycle of spasm, pain, and spasm. (Kojidi M. M. et al., O2016) The exact cause of the spasm is not known. It may be related to excessive accumulation and release of acetylcholine, which causes sustained muscle contraction. (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Another theory is that repetitive small muscle trauma helps create a trigger point or knot in the muscle. (Thorne. 2021)

Active trigger points in muscles characterize myofascial pain syndrome. (Shah J. P. et al., 2015) These trigger points cause pain in the area where they are located and sometimes in other places, known as referred pain. Each muscle has a particular referral pattern of pain that goes from a trigger point in that muscle to another place in the body. (Shah J. P. et al., 2015) Medical providers and massage therapists trained in this area can identify trigger points by their pain patterns. With myofascial pain syndrome, muscles tense, and joint range of motion may decrease. (Jafri M. S. 2014)

Trigger Points

  • Myofascial pain syndrome is characterized by trigger points and sensitive knots within muscles that can cause referred pain when pressed, contributing to the spasm cycle.

Muscle Tension

  • A repeatedly tense or injured muscle can develop trigger points, which can lead tocle tightness and potential spasms.

Pain-Spasm-Pain Cycle

  • The pain from a trigger point can cause the muscle to further contract and spasm, leading to even more pain and perpetuating the cycle.

How Spasms and Pain Present

Myofascial pain is often caused by long periods of poor postural alignment, muscle injury, and repetitive motions. (Cleveland Clinic, 2023) For example, the upper body slumps forward when sitting at a desk workstation all day. The upper section of the trapezius muscle is located on the back of the neck and top of the shoulder. The upper trapezius muscle works to raise the head. (Yoo W. G. 2015) The trapezius muscle now has to work more than it is used to. This overuse may cause microscopic muscle injury, leading to muscle spasms and pain. (Bron C., & Dommerholt J. D. 2012) (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Without treatment, the muscle spasms, pain, and microscopic muscle injury may persist or worsen, leading to trigger points and chronic pain. (Jafri M. S. 2014)

Causes

Repetitive Motions

  • Repeating the same movement, like typing on a computer, can trigger muscle tension and points.

Poor Posture

  • Maintaining incorrect posture for extended periods can strain muscles and contribute to trigger point development.

Muscle Injury

  • Past injuries can leave muscles susceptible to developing trigger points and pain cycles.

Stress

  • Psychological stress can lead to muscle tension and exacerbate existing trigger points.

Break the Cycle

Physical Therapy

  • A physical therapist can use stretching, massage, and trigger point therapy to release muscle tension and address trigger points.

Exercise

  • Regular exercise, including gentle stretching, can help improve muscle flexibility and reduce tension.

Heat Therapy

  • Applying heat to affected areas can help relax muscles and alleviate pain.

Ergonomics

  • Modifying work habits and posture to reduce strain on muscles.

Stress Management

  • Techniques like deep breathing and meditation can help reduce stress-related muscle tension.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Personal Injury Rehabilitation

References

Jafri M. S. (2014). Mechanisms of Myofascial Pain. International scholarly research notices, 2014, 523924. https://doi.org/10.1155/2014/523924

Kojidi, M. M., Okhovatian, F., Rahimi, A., Baghban, A. A., & Azimi, H. (2016). Comparison Between the Effects of Passive and Active Soft Tissue Therapies on Latent Trigger Points of Upper Trapezius Muscle in Women: Single-Blind, Randomized Clinical Trial. Journal of Chiropractic Medicine, 15(4), 235–242. https://doi.org/10.1016/j.jcm.2016.08.010

Nicol A, C. M., Hsu E, Ferrante M. (2018). Myofascial Pain Syndrome. Science Direct, 207-212. https://doi.org/https://doi.org/10.1016/B978-0-323-40196-8.00025-5

THORNE. (2021). Understanding Muscle Pain, Fascia, and Myofascial Release. https://www.thorne.com/take-5-daily/article/understand-muscle-pain-fascia-and-myofascial-release?srsltid=AfmBOop3Pp0wWEeiQEqpfPgAaTOpLvU7lOAGUv5VRYQdoH8OBcW4D_wk

Shah, J. P., Thaker, N., Heimur, J., Aredo, J. V., Sikdar, S., & Gerber, L. (2015). Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM & R: the journal of injury, function, and rehabilitation, 7(7), 746–761. https://doi.org/10.1016/j.pmrj.2015.01.024

Cleveland Clinic. (2023). Chronic myofascial pain (CMP). https://my.clevelandclinic.org/health/diseases/12054-myofascial-pain-syndrome

Yoo W. G. (2015). Comparison of activation and change in the upper trapezius muscle during painful and non-painful computer work. Journal of Physical Therapy Science, 27(10), 3283–3284. https://doi.org/10.1589/jpts.27.3283

Bron, C., & Dommerholt, J. D. (2012). Etiology of myofascial trigger points. Current pain and headache reports, 16(5), 439–444. https://doi.org/10.1007/s11916-012-0289-4

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Relief from Thigh Pain Associated with Sciatica: Proven Methods

Can individuals dealing with sciatica incorporate nonsurgical treatments to reduce thigh pain and restore mobility in the legs and hips?

The Tensor Fascia Latae

Do you feel stiffness or tightness in your legs, feet, and hips? Have you experienced walking crookedly when running errands? Or have you experienced radiating pain from your gluteal region down to your feet? The hips, thighs, and legs have numerous muscles, tissues, and ligaments surrounding the skeletal bone in the body’s lower extremities. These components allow the lower half of the body to stabilize the upper body’s weight and enable the individual to be mobile throughout the day. One muscle that works together is the tensor fasciae latae (TFL) muscle. The TFL muscle is part of the proximal anterolateral thigh between the deep fibers of the iliotibial (IT) band. It works with the gluteal muscles in various hip movements and assists with the knees. (Trammell et al., 2025) This muscle is poorly misunderstood as it helps with the hips and knee joint and pelvic stability. (Iyengar et al., 2022) At the same time, it has a casual relationship with the IT band.

The Iliotibial Band (ITB)

The iliotibial (IT) band is part of the lower extremities as it is a tough, fibrous fascial tissue that works together with the TFL muscle and has various functional roles that are dependent on posture and allows the individual to be mobile via walking, sprinting, and running. (Hutchinson et al., 2022) However, this muscle’s main function is knee flexion. When environmental factors affect the body, it can cause irritation and inflammation to the IT band, causing knee pain. (Martinez-Velez et al., 2020) When dealing with issues within their lower extremities, they affect the IT band, TFL muscle, and the thighs. Environmental factors can also affect the lower extremities as the surrounding muscles can aggravate the nerve roots, thus leading to sciatica pain. We associate with certified medical providers who inform our patients of how sciatica can negatively impact the lower extremities, especially the thighs. While asking important questions to our associated medical providers, we advise patients to integrate various non-invasive treatments to reduce sciatica and help regain mobility back to the lower body. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

Reclaim Your Mobility: Chiropractic Care For Sciatica Recovery-Video

Sciatica & Thigh Pain

When the general population hears about sciatica, it is a frequent diagnosis associated with low back pain, which causes discomfort within the lower extremities, especially in the thighs. Sciatica is a debilitating condition where the sciatic nerve is often compressed and irritated, causing pain. (Davis et al., 2025) Many influences cause sciatica to develop, and it can cause the individual to deal with a spinal imbalance, which correlates with walking incorrectly, causing the accessory muscles to work overtime and compressing the sciatic nerve, causing thigh pain. (Wang et al., 2022) With thigh pain correlating with sciatica, many symptoms can range from muscle weakness, absence of tendon reflexes to the knees, and sensory deficit. (Fairag et al., 2022) Luckily, treatments are available to reduce thigh pain associated with sciatica and regain mobility back to the lower extremities.

Treatments For Sciatica-Thigh Pain

When treating the lower extremities, especially when experiencing sciatica-thigh pain, many individuals with thigh pain associated with sciatica can incorporate non-invasive treatments to reduce the pain. Many athletic and non-athletic individuals can utilize PRICE (protection, rest, ice, compression, and elevation) to the affected muscles that can minimize the injuries causing pain. (Lempainen et al., 2022) This can help reduce the inflammatory effects causing issues to the thighs and lower extremities. Many non-surgical treatments like physio-exercise therapy, massages, stretching, and spinal stabilization therapies can improve core strength and posture and help with range of motion to relieve sciatica pain affecting the lower extremities. (Aguilar-Shea et al., 2022) Other non-surgical treatments like yoga, physical therapy, and chiropractic care can help improve joint and lower extremity motions, stretch and strengthen weak muscles surrounding the thighs, and relieve sciatic nerve pain. (Kim & Yim, 2020) When people start thinking about their bodies and how pain is affecting their quality of life, many can incorporate non-surgical treatments to reduce the pain associated with sciatica. Many people can make small positive changes in their routine by becoming more physically active, stretching more, eating healthier, and being more mindful of what they are doing, which can reduce the chances of sciatica returning and affecting the lower extremities. This can help them achieve a healthier, better life.

References

Aguilar-Shea, A. L., Gallardo-Mayo, C., Sanz-Gonzalez, R., & Paredes, I. (2022). Sciatica. Management for family physicians. J Family Med Prim Care, 11(8), 4174-4179. https://doi.org/10.4103/jfmpc.jfmpc_1061_21

Davis, D., Maini, K., Taqi, M., & Vasudevan, A. (2025). Sciatica. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/29939685

Fairag, M., Kurdi, R., Alkathiry, A., Alghamdi, N., Alshehri, R., Alturkistany, F. O., Almutairi, A., Mansory, M., Alhamed, M., Alzahrani, A., & Alhazmi, A. (2022). Risk Factors, Prevention, and Primary and Secondary Management of Sciatica: An Updated Overview. Cureus, 14(11), e31405. https://doi.org/10.7759/cureus.31405

Hutchinson, L. A., Lichtwark, G. A., Willy, R. W., & Kelly, L. A. (2022). The Iliotibial Band: A Complex Structure with Versatile Functions. Sports Med, 52(5), 995-1008. https://doi.org/10.1007/s40279-021-01634-3

Iyengar, K. P., Azzopardi, C., Kiernan, G., & Botchu, R. (2022). Isolated pathologies of Tensor Fasciae Latae: Retrospective cohort analysis from a tertiary referral centre. J Clin Orthop Trauma, 29, 101870. https://doi.org/10.1016/j.jcot.2022.101870

Kim, B., & Yim, J. (2020). Core Stability and Hip Exercises Improve Physical Function and Activity in Patients with Non-Specific Low Back Pain: A Randomized Controlled Trial. Tohoku J Exp Med, 251(3), 193-206. https://doi.org/10.1620/tjem.251.193

Lempainen, L., Mecho, S., Valle, X., Mazzoni, S., Villalon, J., Freschi, M., Stefanini, L., Garcia-Romero-Perez, A., Burova, M., Pleshkov, P., Pruna, R., Pasta, G., & Kosola, J. (2022). Management of anterior thigh injuries in soccer players: practical guide. BMC Sports Sci Med Rehabil, 14(1), 41. https://doi.org/10.1186/s13102-022-00428-y

Martinez-Velez, A., Suwan, P., & Dua, A. (2020). Iliotibial band syndrome in non-athletes. Minerva Anestesiol, 86(10), 1111-1112. https://doi.org/10.23736/S0375-9393.20.14194-4

Trammell, A. P., Nahian, A., & Pilson, H. (2025). Anatomy, Bony Pelvis and Lower Limb: Tensor Fasciae Latae Muscle. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/29763045

Wang, L., Li, C., Wang, L., Qi, L., & Liu, X. (2022). Sciatica-Related Spinal Imbalance in Lumbar Disc Herniation Patients: Radiological Characteristics and Recovery Following Endoscopic Discectomy. J Pain Res, 15, 13-22. https://doi.org/10.2147/JPR.S341317

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Learn How to Perform Trapezius Self Massage for Pain Relief

Can individuals who sit for long hours daily prevent tight neck and shoulder muscles by improving their posture, regularly stretching, and massaging their trapezius muscles?

Trapezius Self Massage

The trapezius muscle is a triangle-shaped muscle in the upper back that starts at the base of the neck, spans the length of the upper shoulders, and extends into the middle back. This muscle’s main function is stabilizing and moving the scapula/shoulder blade. The trapezius also helps to move the head, neck, arms, shoulders, and torso, stabilizes the spine, and plays an important role in posture. Physical and mental stress can tighten the trapezius muscle, leading to neck and shoulder pain. Learning to perform a trapezius self-massage can ease tension and provide pain relief. (Domingo A. R. et al., 2017)

Anatomy

The trapezius consists of three parts in three different areas of the back. The bottom of the skull, across the shoulders, and down to the mid back. A trapezius self-massage focuses on the upper portion of the traps. This part is located at the top of the shoulders. To find the upper trapezius, cross one arm in front of your body so that you can place the palm on top of the other shoulder.

stock photo trapezius anatomy muscles isolated on white d illustration

For a trapezius self-massage, you need to know that there are two areas where your upper traps start and where the muscle connects to a bone. The first point is on the bottom of the skull, close to the center of the back of the skull. Start there with your fingers and trace the muscle down the back of the neck to where the shoulders widen. If you get lost, You can walk your fingers up or down the muscle on either side to relocate its origin at the base of the skull, the vertebra at the base of your neck that sticks out. This is C-7, another of the upper trapezius’s origin sites. (University of Washington Department of Radiology, 2025) 

Massage Technique

Massage oil is optional but can hydrate the skin during a massage. You can perform the trapezius self-massage using your hands.

Start at the Base of The Neck

Choose one shoulder to work at a time.

  • Raise the arm on the opposite side of your body.
  • Reach this arm across your body and fold it around your neck so that your fingers rest at the back base of your neck.
  • Apply a decent amount of pressure to the muscle while moving your fingers in a circular motion.
  • The action is similar to kneading dough.
  • Massage this area at the base of your neck for about 30 seconds to start.
  • If this part of your muscle is sore, you can massage it longer.

Slowly Work Out Towards The End of The Shoulder

Once you have spent about 30 seconds massaging the muscle at the base of the neck, work your way out toward the end of your shoulder.

  • In close increments, in your fingers across the trapezius muscle, spending at least 30 seconds at each point.
  • Follow the muscle until you reach the end of the shoulder.
  • Apply enough pressure, and use slow, rhythmic movements so that you feel relief.
  • If the pressure is not relieving or makes you wince, it’s too much.

Repeat as Needed

Repeat each side two to three times before switching to the other shoulder. After massaging, you may notice a certain trapezius area is particularly sore or tense. Zero in on those areas a little longer. Remember to relax throughout the trapezius self-massage. This is an opportunity to learn where tension is in your neck and shoulders and how to apply pressure to relieve it. This knowledge can also help you be mindful throughout your day, whether sitting, doing chores, or other physical activities. If you notice scrunching or slouching, massage the trapezius and remind yourself to keep your shoulders relaxed.

Benefits

Tension and tightness in the trapezius muscle are common, particularly among individuals who work in an office, do manual labor, or deal with a lot of stress. (Marker R. J. Campeau S., & Maluf K. S. 2017) Trapezius strains are a common overuse injury that is more likely to happen when the muscle is tight. (Salavati M. et al., 2017) The injury can cause unhealthy posture to avoid the pain. This poor posture will place more stress on the muscles, leading to a cycle of poor posture and chronic pain. A trapezius self-massage can benefit in many ways, including:

  • Improved blood circulation
  • Better quality of sleep
  • Improved posture
  • Improved range of motion
  • Decreased swelling
  • Faster recovery after workouts
  • Reduced risk of injury

Seeing a Healthcare Provider

Like any other muscle in the body, the trapezius can be injured and requires special treatment to recover. Sometimes, the neck or shoulder pain may not come from the trapezius muscle. Consider seeing a healthcare provider if you have pain in your neck or shoulder that doesn’t get better within a week or two, especially if it isn’t responding to at-home treatment. Regardless of how long you have been experiencing pain or stiffness, contact a healthcare provider if it prevents you from getting adequate sleep or interfering with daily activities. Reasons to see a healthcare provider immediately for neck or shoulder pain include: (Mount Sinai, 2025)

  • There is sudden pressure or pain in the left shoulder, which can sometimes signal a heart attack.
  • A fall or accident resulted in pain, swelling, or problems moving the neck or arm.
  • If there is shoulder pain, a fever, swelling, or redness.
  • The skin on the shoulder area appears discolored.

It’s important to take regular breaks to stretch and move your muscles. You can release tension in the trapezius by doing shoulder shrugs throughout the day and stretching regularly. When the trapezius feels tight or sore, give yourself a massage.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Whiplash Chiropractic Massage Therapy

References

Domingo, A. R., Diek, M., Goble, K. M., Maluf, K. S., Goble, D. J., & Baweja, H. S. (2017). Short-duration therapeutic massage reduces postural upper trapezius muscle activity. Neuroreport, 28(2), 108–110. https://doi.org/10.1097/WNR.0000000000000718

University of Washington Department of Radiology. (2025). Trapezius. https://rad.washington.edu/muscle-atlas/trapezius/

Marker, R. J., Campeau, S., & Maluf, K. S. (2017). Psychosocial stress alters the strength of reticulospinal input to the human upper trapezius. Journal of Neurophysiology, 117(1), 457–466. https://doi.org/10.1152/jn.00448.2016

Salavati, M., Akhbari, B., Ebrahimi Takamjani, I., Ezzati, K., & Haghighatkhah, H. (2017). Reliability of the Upper Trapezius Muscle and Fascia Thickness and Strain Ratio Measures by Ultrasonography and Sonoelastography in Participants With Myofascial Pain Syndrome. Journal of Chiropractic Medicine, 16(4), 316–323. https://doi.org/10.1016/j.jcm.2017.06.003

Mount Sinai. (2025). Shoulder pain. https://www.mountsinai.org/health-library/symptoms/shoulder-pain

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A Comprehensive Guide to Facet Arthropathy

Can individuals managing facet arthropathy treat the condition with over-the-counter pain relievers, prescription muscle relaxers, exercise, and chiropractic spinal manipulation?

Facet Arthropathy

Blog Image Facet Joint Arthritis

Facet arthropathy, or facet osteoarthritis, is arthritis that affects the facet joints in the spine. It causes pain and stiffness due to cartilage degeneration within these joints, often resulting from wear and tear associated with aging. Essentially, it occurs when the small joints in the back of the spine become arthritic and rub against each other painfully.

  • It affects the bony protrusions, called facet joints, that connect the spine’s bones.
  • Symptoms include neck and back pain that can worsen with standing, bending, or twisting.
  • Facet arthropathy is diagnosed using X-rays and other imaging studies.
  • Severe cases may require surgery.

Facet Joints

Twenty-four vertebrae form the spine, with two facet joints between each. Facet joints are small joints located at the back of each vertebra in the spine. They allow movement and stability, help maintain the alignment of the spinal bones/vertebrae, and limit excessive motion. The joints and the cushioning intervertebral disc form a three-joint complex between each vertebra.

  • The three-joint complex allows the spine to move, including bending, rotating, and extending.
  • Synovial fluid lubricates the joints so they can move.
  • The intervertebral disc provides flexibility and dissipates compressive loads.
  • The facet joints stabilize the spine by constraining rotation and bending.

Symptoms

Arthropathy refers to any disease affecting a joint, including arthritis. Osteoarthritis, also known as arthrosis, is a specific type of arthropathy. It is a non-inflammatory, degenerative arthritis. Pain is the main symptom that is typically worse in the morning when awakening, and in the evening, the pain can also get worse when twisting or bending backward. The symptoms can vary based on the part of the affected spine. Low back pain is the most common, a condition referred to as lumbar facet arthropathy because it affects the lumbar spine of the lower back. (Perolat R. et al., 2018) Common Symptoms include:

  • Muscle spasms or cramps.
  • Pain that may come in periodic flare-ups
  • Pain that worsens with standing or inactivity.
  • Dull pain on both sides of the spine.
  • Aching pain on both sides of the spine.
  • Pain in the lower back, buttocks, shoulders, or back of the skull
  • Radiating pain to the buttocks and legs.
  • Pain that improves with sitting, leaning forward, or changing positions.
  • Pins-and-needles sensations in the hands or feet.
  • Clicking sounds when moving the spine.
  • Catching sensations when moving the spine.
  • Muscle weakness.

Causes

Facet arthropathy causes progressive damage to the spine. Spinal osteoarthritis, aka spondylosis, is the most common cause, but it can also occur with a severe form of spinal arthritis known as ankylosing spondylitis. It is primarily due to age-related wear and tear, but injuries or repetitive stress on the spine can also cause it. Arthritis in the facet joints can develop due to:

  • Aging-related wear and tear
  • Disc problems
  • A previous back injury
  • Torn ligaments
  • Spinal fractures

Deterioration of facet joints can also cause bony overgrowths called osteophytes or bone spurs, which can cause radiating pain and restrict the spine’s range of motion.

Degeneration

  • The facet joints and intervertebral discs degenerate due to age-related wear and tear.
  • The cartilage in the facet joints can dry out, crack, and wear down.
  • The joint capsule and synovial membrane can inflame or tear, affecting synovial fluid production.
  • The loss of cartilage can lead to hypermobility, and the joint can stiffen over time.

Diagnosis

Imaging studies are important to the diagnosis. Several types confirm the diagnosis and also characterize the nature and severity of the condition:

  • X-rays provide a plain, black-and-white image of the spinal column.
  • CT scan composites multiple X-rays to create a three-dimensional image of the spinal column.
  • MRI uses magnetic and radio waves to generate images of soft tissues like ligaments and cartilage.

To confirm the diagnosis, a diagnostic block, which is a small amount of local anesthetic, is injected into a facet joint. The needle placement is directed either with an ultrasound or a CT scan. Facet arthroplasty is confirmed if the injection provides immediate relief (American Academy of Orthopaedic Surgeons, 2022). The healthcare provider will want to exclude other possible causes as part of the differential diagnosis. Conditions that mimic facet arthropathy include:

  • Herniated disc
  • Psoriatic arthritis
  • Reactive arthritis
  • Spinal gout
  • Spinal compression fracture

Treatment

The treatment varies based on its location and severity. Generally, conservative treatments are used before more invasive procedures are considered.

Lifestyle Changes

  • Initially, a healthcare provider may recommend rest and avoiding aggravating movements, including any activity that involves bending or twisting.
  • Activities that take the weight off the facet joint, such as sitting, leaning forward, or changing positions, may help ease the pain.
  • Patients may also be advised to adjust their sleep positions to take the pressure off facet joints.
  • Options included curling up on your side or lying on your back with the knees supported with pillows.

Medications

If a diagnostic block is used, a patient may not need medications immediately. However, as the anesthetic starts to wear off, the patient may be prescribed over-the-counter or prescription pain relievers based on the severity of the pain. These can include:

  • Analgesics like Tylenol
  • Nonsteroidal anti-inflammatory drugs like Advil or Aleve
  • Muscle relaxants like Lloresal for acute back pain
  • Antidepressants like Cymbalta for chronic back pain

Physical Therapy

Physical therapy is a major part of the treatment of lower back pain. The treatment plan will include personalized exercises to strengthen the core muscles and avoid stress on the spine. Examples include:

  • Mechanical traction and non-surgical to decompress the spine.
  • Knee-to-chest stretches, hugging your knees for 30 to 60 seconds.
  • Walking 10 to 20 minutes per day.
  • Aquatic therapy to alleviate pressure on the spine.

Surgery

If conservative measures don’t work or provide sufficient relief, a healthcare provider may recommend specialist procedures or surgeries that include:

  • Lumbar intra-articular injections deliver an anesthetic or corticosteroid into the spine for longer-lasting pain relief.
  • Sinuvertebral nerve ablation destroys spinal nerves with a strong electrical current.
  • Extracorporeal shockwave therapy ESWT delivers low- or high-energy electrical pulses to help ease pain.
  • Spinal fusion surgery involves fusing two or more vertebrae to eliminate movement and pain in the facet joints.
  • Facet rhizotomy is a surgical procedure used to sever one of the nerves supplying the facet joint.
  • Stem cell regeneration is an experimental procedure in which stem cells are harvested and injected into damaged joints to restore function.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Facet Syndrome Pain Treatment

References

Perolat, R., Kastler, A., Nicot, B., Pellat, J. M., Tahon, F., Attye, A., Heck, O., Boubagra, K., Grand, S., & Krainik, A. (2018). Facet joint syndrome: from diagnosis to interventional management. Insights into imaging, 9(5), 773–789. https://doi.org/10.1007/s13244-018-0638-x

American Academy of Orthopaedic Surgeons. (2022). Spinal injections. https://orthoinfo.aaos.org/en/treatment/spinal-injections/