Question
I was involved in a severe car wreck in DEC 2007 that resulted in many injuries including fractures in the c2 and c5 vertebra. I wore a halo for 8 weeks, and seemed O.K , just a little stiff. Now though, my neck specifically the back near the c2 gets very tight and I have a hard time looking down until I push on the back of my head. There is an audible pop and instant pressure release with increased mobility. What's wrong?

Answer
Dear Helen,

What you have described indicates fixation of the spinal joints in the neck, which is to be expected after a trauma and injury such as yours.  After a fractured neck, the halo is absolutely necessary for stabilization of the spine, and for the vertebral fractures to heal appropriately.  However, the fact that you were immobilized for two months will restrict motion in the facet joints, which normally allow for the motion of the neck.  This in turn results in a build-up of gas inside the joint capsule which can create pain and further limit motion while causing dysfunctional movement.... a feedback loop.

The pop you hear is the release of this gas from the joint capsule, which reduces the pressure inside and along the joint surface (the facets), and is why you feel relief after the occurrence.  What I would recommend is that you seek out the examination and care of a good local chiropractic physician.  Spinal adjustments are safe even after a fracture has occurred...as long as it has completely healed and there is no residual instability.  The fact that your initial trauma was over 5 months ago indicated that all fracture healing should be complete.  The chiropractor can effectively mobilize the joint space in a controlled manner and teach you stability exercises for the neck. Additionally, specific stretching techniques can be applied for the areas where the active range of motion has been reduced to help alleviate the problem and reduce your pain and discomfort.  Ask your family and friend for a referral to a doctor they trust, and schedule a consultation before you choose one that is right for you.

Good luck Helen.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net