Question
Hi im a 26 y/o female who has had permanent neck pain,since august of last year, went to the family  doctors with my head stuck to my,shoulder and all the muscles spasmed??? I have been in physical therapy ever since then and while I can keep my head straight,and even turn it now if I go more than a couple days without pt I end up inflamed with my head stuck to my,shoulder again:/ I really dont feel like going through anymore dry needling or cracking or crazy excersizes. I just want to be normal again and treat the problem not the symptoms and so I am asking what kind of specialist should I go to for help?

Answer
Dear Jenna,

Sorry about the neck problems.  I understand that you want to treat the cause and not just the symptoms.  Lets take a look at the narrative that you sent to me...

"permanent neck pain".... this is a symptom
"head stuck to my shoulder".... this is another symptom.
"all the muscles spasmed".... symptom
"Inflamed with my head stuck to my shoulder again".... symptoms

From what you have have written, all that I have to go on are symptoms.  There is nothing here that helps me to know what is truly the cause of your symptoms.

So, the real question is: What IS the cause of your problem?

Until you know the cause of your symptoms, you can't treat the cause, although, as you indicated, you can treat and manage the symptoms. (PT, "cracking", etc)

The only way to find the cause is to do some additional tests.  Here are some ideas:

1) An MRI of the neck would help you to know if you have joint or disc problem in your cervical spine.
2) Laboratory testing could help you to know if you suffer
from an inflammatory arthritic condition, such as RA, lupus, etc.
3) An x-ray might help you to see if you have any signs of premature degenerative arthritic changes, or if you have any congenital defects in the spine.
4) A neurological and physical examination could help to determine if you are suffering from any nerve tissue compression or injury.  an NCV test would confirm or rule out suspected nerve pinching issues.

The unfortunate thing is that often all of the testing comes back as normal, even though the patient continues to have symptoms.

I find it interesting that you are looking for a cure, but you are unwilling to do any "needling, cracking, or crazy exercises."  What are you willing to do?  Surgery? Daily medication/pain killers?   

When you stop and think about it, what typically do doctors have to offer you?  Consider this:

Medical Doctors:  They treat conditions with injected medications, radiation therapy, oral Medicines and/or surgery.  
Chiropractors:  They treat conditions with manipulation (cracking), stretching, strengthening, electrical stimulation/ultrasound therapies, acupuncture, etc.  
Physical Therapists: They treat conditions with therapies, massage, stretching and strengthening exercises.  

I was watching an episode of the Dr Oz Show on television the other day, and he said something that caught my attention because I have often said the same thing to my patients.  He said "I am skeptical of those that say they have a cure for something. The truth is that we manage many conditions, but we cure very few of them."

This is a very true statement.  There might not be a perfect cure of your condition, but there are likely some ways that you will be able to manage your condition.  You need to keep an open mind, and it is likely that you will have to do some therapy and/or exercises to manage your condition... again, depending on what the true cause of your symptoms is.

Jenna,  I know that this is a lot to consider.  Start out with further diagnostic tests.  Try and get a good diagnosis.  Reject the vague and non-descriptive diagnosis of "muscle spasm, muscle pain, joint subluxation, cervicalgia, bone out of place.  Ask for more detailed data, if it is available, and ask for more appropriate imaging or testing.  Even with all of this,   please consider that perhaps there is no perceivable or diagnosable "cause" for your pain. If this is the case, it doesn't mean that you are not it pain, it simply means that science and medicine doesn't have a good answer for you.

Good luck Jenna. I hope that this gives you some good ideas and things to consider.

Keith Biggs, DC
http://www.eastmesachiropractor.com