Question
QUESTION: I've been dealing with a neck problem for thirty years.  I've made regular use of massage therapy and chiropractic, and have worked energetically to learn how to manage my neck on my own, developing a good bag of tricks.  Nonetheless, I do have to spend some attention every day on keeping my head screwed on straight:  the problem is a tendency for my neck to get at least slightly "out" at the atlas/axis area.  (Only occasionally do things go "out" in a manner that lasts for more than a day or two or three-- I've had two such major episodes in the past decade.)

I'm reconciled to having to manage this problem for the rest of my life, but I'm always looking for new approaches to making the chronic problem as minor as possible.

It often happens that I go to bed with my neck in pretty good shape but then awaken with it having gone out some. I do try, immediately upon awakening, to get it back in with one of my tricks, and that often works.  But I'm considering taking another measure --to prevent its going out during my night's sleep-- and I wanted to ask you if you thought it worth trying.

Namely, I am considering making it a regular practice to wear a neck brace to sleep in during those nights when my neck is fine at bedtime.  My hope would be that this would enable my neck to stay in good alignment and allow me to start my day without a neck problem to work through.

Does this seem to you an experiment worth conducting?

Thanks for your counsel.

ANSWER: Hello Andrew,


Sorry to hear of your chronic neck problems.

I am not favorably predisposed towards bracing or support of any kind, except in acute conditions.

A brace, a support can rapidly become a permanent 'crutch'.  Muscle atrophy can be measured in only 24 hours with bracing / casting of a body part.  In turn, this atrophy creates greater problems.

Having said that,,, I am against bracing, except when acutely hurting ,, if you have tried everything else , , what the heck, you could give it a try.

Neck braces are uncomfortable awake and upright.  I cannot imagine getting a COMFORTABLE brace for use while laying down and sleeping!

I am sure you have tried cervical orthopedic support pillows.  A proper pillow, proper length at the neck, proper firmness (all easily testable by your Doctor of Chiropractic) should be of help.

I am sure you NEVER sleep on your stomach-- always a no- no for the spine.  I am sure you always sleep on your side (arms DOWN) or on your back.

I am sure you see your Doctor for preventive adjustments:



(handout I give in my office)


What ? ! ,  
I have to brush my teeth!?,,,
after EVERY meal ! ? ,,,
For the REST of my life ! ? ! ...  
I don抰  want  to.  period.  I won抰.  To heck with it !  
If I get a hole (cavity),  THEN  I抣l take care of  it.   Maybe I won抰 get any cavities anyway?.

         It  took  the  American Dental Association YEARS to educate people that they should brush frequently to avoid dental disease.  It has taken YEARS to educate patients that visits to the Dentist for hygiene, cleanings, flossing, coatings, etc.  are  necessary to PREVENT  dental problems.  Some people still do not floss after every meal, some do not even brush often enough  (yyyuuukkkk),  so some people still have severe dental problems  despite  all  the  knowledge  about   PREVENTION   and  dental  health maintenance  that  is  out   there.     Can  you  believe  it  ?? !!


         Some people have the same problem with  PREVENTATIVE  Spinal  Health
that  used to  exist with preventative dental health.  Some people come to the Doctor of Chiropractic and say, ?..do not adjust me, just give me therapy...?  some people say,
?..What ? ! , I have to practice SPINAL HYGIENE !?!, (practice proper postures, proper movement patterns, and  see  the  Chiropractor  periodically !?!),  Naahh, ... I  don抰
want to. period.  I won抰.  To heck with it!  When I get PAIN,  then  I抣l take care of it.
(  pain is often the LAST symptom to appear-  whether a cavity or a heart attack !  )


         Vertebral   Subluxation   Complex    (a.k.a.  憇ubluxation?
The vertebral subluxation complex can be the underlying cause of many healthcare problems.

 A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates  all   function  within  the  body)  and may cause various other conditions,  symptoms and problems.


This  (Subluxation)  is a serious condition identified by its five parts:
      Spinal Kinesiopathology,   Neuropathophysiology,   Myopathology,  
      Histopathology,  Pathophysiology.

  
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.

         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.

         Vertebral  Subluxation  cannot be corrected through chemicals (medicine), stretching, yoga, massage, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.  For good health- Treat the   Cause,  not just the Symptoms.

         Chiropractic  corrects  the  Vertebral  Subluxation  Complex.

You  cannot be 慼ealthy?if you have a Subluxation.  You MAY feel it, with a pain, stiffness, or a 慿ink?in your neck/ back.  You may NOT  even feel it-
just as people often do not feel the cavity growing in their tooth,,,, until it hits the nerve; or you may not feel it at all, like people do not feel high blood pressure or diabetes until AFTER damage has been done!!  PREVENTION-  Visit the Doctor of Chiropractic REGULARLY,,, just like your dentist!  (practice spinal hygiene as you do dental hygiene  -PREVENTION!-


Dr. Victor E. Dolan,   Doctor of Chiropractic;   Diplomat, American Chiropractic Board of Sport Physicians; Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine
++++++++++++++++++++++++++++++++++++++++++++++++++++

I am sure you take your joint support nutrition: Glucosamine, Chondroitin, MSM, SAMe, Omega 3 EFAs, Calcium, magnesium, Vitamin D, etc.

Since you are doing all the right things and are still unsatisfied,,,

Well,

I guess you could try a bracing.

My caution:
I do not think it would work.
I do not think you will find a comfortable brace.

If you are NOT doing all of the above, start to do them.

If you ARE doing all of the above,,,,,, what the heck, try the brace!

Let me know it you are successful (it will go against my prior research and experience that bracing is only for acute conditions, short term).

If  you have further questions, do not hesitate to contact me here at
allexperts.com:
http://allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm

I wish you good luck, and Good Health Naturally,

Dr. Victor Dolan, DC
http://drvictordolan.chiroweb.com (Email newsletter)



---------- FOLLOW-UP ----------

QUESTION: Thanks for your response, Dr. Nolan.  As for your assumptions, they are on target for the most part, except that sleeping on my side I do not have my arms down, but folded up, bent at the elbow.

THe only follow up question would be:  since I would be using the brace only during sleep, may I assume that the reservations you express about ATROPHY do not apply?

Answer
Hello Andrew,

Yes, you are correct (or at least I think so,,,,).

You are already at rest, sleeping.

Good thinking.

So it is well worth the 'experiment'.

There should be little or no muscular activity while sleeping for 6- 7- 8  hours.  Since the muscles are already at rest, the bracing should not cause atrophy.  The atrophy is caused when we are awake and moving, and not allowing our muscles to exert force and power, not allowing our muscles to work.

The muscles are not working while we are sleeping, so probably the atrophy should not occur, movement is minimal.  

Thank you for the discussion.

I would still be interested if you can find a comfortable, 'workable' brace to wear sleeping.  Now this concern may become most significant.

I wish you luck.  You find a good, comfortable brace, let me know!

Thanks again, bye,

Dr. Victor Dolan