Back and Neck Pain – General Recommendations
Many of my patients have been in my private practice for a long time and most have come to respect my medical advice for a wide range of issues often completely unrelated to the primary reason they are under my care. Thus, it isn’t surprising to me when one of my cancer or chronic fatigue or Lyme disease patients contact me for advice about back and neck pain.
Back and neck pain commonly develop after a trauma to those areas, such as a motor vehicle accident with whiplash or a bad fall, particularly if the neck is involved. Often chronic neck and back pain begin with some such incident, even if long ago.
I believe the first cervical bone, the atlas, is the key to the spinal structure. This interesting bone is called the atlas because akin to the Atlas of Greek mythology holding up the earth on his shoulders, the atlas bone sits under the skull and holds it up. It’s a critical area because when the atlas is subluxed, that is moved out of its normal position because of trauma, the rest of the spine tends to shift, creating misalignments of the vertebral bodies, pressure on the discs, followed by pinched and painful nerves. Unfortunately, once the atlas is out of kilter, it does not go back into place by itself.
Trauma to the head or spine, such as whiplash, a fall down a flight of stairs or off a bike, can also throw off the alignment of the spine. The spine should be fairly straight when we walk, and even minor disturbances in its positioning can disrupt the gait and create pressure on the toes. Structural therapies can be helpful, but only if the therapist knows what he or she is really doing. Improperly administered bodywork can lead to only more harm, an outcome I have seen repeatedly with my patients.
Dr. Roy Sweat, a chiropractor in Atlanta Georgia and in my opinion the greatest chiropractor who has ever lived, has spent the last sixty years studying and researching the atlas. He developed an instrument that precisely allows him to put the atlas back into place. The adjustments are precise, non traumatic, and effective – I have referred over four hundred patients to him and his son Dr. Matt Sweat over the past 27 years with all manner of problems including chronic neck and back pain, migraine headaches, vertigo, all manner of neurological dysfunction, and virtually every one of them has had a good response. (For reference, their clinic phone number is 770-457-4430). If one of my patients presents with back or neck pain, or other neurological problems has a history of trauma, I always refer them to Dr. Sweat.
Dr. Sweat, though a chiropractor, does not use his hands directly, but instead his very sophisticated instrument very gently adjusts only the atlas. He first performs x-rays to determine the precise angle of misalignment of the atlas, then applies his instrument using vector mechanics to achieve the end result, a restored atlas and spine. Because the treatment is so focused, the instrument need only exert a minimal force to achieve the desired result, and generally patients don’t feel a thing.
His adjustments hold better than any other type of spinal treatment I have ever witnessed, and believe me, I have seen many. In my case, after I walked full steam into a glass door that I thought was open space and nearly knocked myself out (I walk very fast and am usually distracted thinking about enzymes and science), I flew to Atlanta for an adjustment with Dr. Sweat. His single treatment held with no further intervention needed for more than six years. Yes, I am an unusual case because I’ve been following good nutritional practices for 40 years, and with good nutrition in play, spinal treatments work faster and hold better. In my experience, my patients who consult Dr. Sweat often need, once stabilized, only occasional re-treatment.
So, as a first step, I recommend patients with back or neck pain have their structure evaluated. If your spine is out of proper alignment, the abnormal pressures will perpetuate inflammation around the nerves, and with inflammation comes pain. In addition to structural approaches, certain nutritional therapies do help with chronic nerve pain.
Though I cannot make specific suggestions for anyone who is not my patient, I find that injectable vitamin B12 helps enormously, either the methyl or hydroxy form, one milligram daily for two weeks, followed by maintenance doses twice weekly. In my office I also recommend, along with the B12, vitamin B1 (thiamin) 100 mgs daily again in the injectable form. Reports dating from the 1950’s suggest that these two nutrients in combination, administered as injections, reduce inflammation around nerves and in turn reduce chronic pain. I use this therapy for trigeminal neuralgia, a form of devastating nerve pain that often resists conventional treatments. B12 and B1 work very nicely, usually within a week. I also use this combination for pain occurring after surgery.
In addition to these nutrients, alpha lipoic acid, an antioxidant our own cells routinely synthesize, along with n-acetyl cysteine, an amino acid, reduce inflammation around nerves and help with chronic neuropathy. In Europe, physicians prescribe lipoic acid in doses of 600 mgs or higher, with n-acetyl cysteine in doses of 1800 mgs a day as oral supplements to treat a variety of neuropathic pain syndromes, such as accompany advanced diabetes.
Dr. Batmangheldj, Iranian by birth, now lives in Virginia, wrote a wonderful book called “Our Bodies Many Cries for Water”. In this book, the doctor points out that our discs between the vertebral bodies serve as important cushions and are largely made of water. I think of these discs as water balloons between the vertebral bodies. Most of us, the doctor reports, don’t drink enough water, so our discs over time dry out, and can collapse – leading to pain anywhere along the spine as the bony vertebral bodies, now un-cushioned, jam onto the spinal nerves. In this circumstance, pain can travel along the tracts of the spinal sensory nerves, leading to syndromes such as sciatica. Dr. Batmangheldj recommends adequate hydration to keep the discs supple and expanded.
Glucosamine and chondroitin are often suggested treatments for arthritis pain. These two substances help regenerate cartilage in the joints, and also help regenerate discs in the spine. Though the media and the scientific community has belittled the effectiveness of both, I find them very useful for both arthritis and disc pain. I also recommend a product called “Chicken Collagen,” which similar to glucosamine, helps the discs regenerate.
Of course, I believe that the appropriate diet, supportive additional supplementation, and detoxification, help the healing along.
By Nicholas Gonzalez, M.D.