Category Archives: Botox

How to work out a stiff neck

Everyone, at one time or other, has had a stiff neck.  How do you deal with it?

The cervical spine consists of 7 block-shaped bones called vertebrae.  They are stacked, one upon the other forming the spinal column.

The neck vertebrae have two major functions

•To bear the weight of the head

•To protect the spinal cord or spinal nerve roots inside the spinal column

Each vertebra has bony projections called “processes” that are sites for the attachment of ligaments and muscles that help stabilize and move the spine.

Between each vertebra are cushions, called discs. Each disc has a soft jelly-like center called the nucleus pulposus, which is surrounded by a tough fibrous outer envelope called the annulus fibrosis.

Each vertebrae has areas for the attachment of muscles.

In the neck there are a series of ligaments that are important for stability of the vertebral column.

stiff-neckA stiff neck occurs when there is either a muscle strain or there is damage to the ligaments.  Muscle strains can be due to injury or to prolonged abnormal positioning. An example of injury might be trauma to the muscles during athletic events.

Abnormal positioning is a more common occurrence. This happens when one holds their head in one position for too long a period of time.  Sitting at the computer or driving long distances are two situations where this occurs. Another example is when a person wakes up with a stiff neck because of sleeping in a weird position.

The interspinous ligaments at C5-7 are also prone to tear following neck injuries. The interspinous ligaments are slack when the head and neck are in the upright position.

During hyperextension of the head (when the head is bent backward), the ligaments slacken

In hyperflexion (head is bent forward,) the cervical interspinous ligaments are tightened and they are vulnerable to tears at the tips of the spinous processes.

The classic injury to the interspinous ligaments occurs with rear-end automobile whiplash incidents.

The ligaments at the tips of the spinous processes are mixed with the fibers of the long ligaments of the neck, which are attached to the  base of the skull.

Fibers of the trapezius muscle also blend with these ligaments. This is why  neck injuries may produce symptoms of pain and tightness in the head and shoulder muscles.

If there is no history of trauma, a stiff neck is usually a result of muscle tightness.  Moist heat applied for twenty minutes two to three times a day, neck support during sleep using a curved pillow, and a soft cervical collar worn for two to three days can be helpful.  Non-steroidal-anti-inflammatory drugs and muscle relaxants can also be beneficial.

If symptoms don’t resolve, then a visit to the physician is advised.  Physical therapy modalities such as electrical stimulation and ultrasound can help with pain resolution. Gentle stretches and range-of-motion exercises may be prescribed.

With a history of trauma, then the treatment approach is different.  A visit to the doctor is recommended to make sure there is no significant damage to the neck. Imaging procedures such as MRI may be done before treatment is instituted. Pain resolution may take a long time with significant muscle injury or damage to the interspinous ligaments. This is particularly true if there is underlying osteoarthritis affecting the neck.

Helpful treatment modalities for more severe problems can include acupuncture, chiropractic, prolotherapy, Botox, and massage.

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Radiation Therapy Provides Relief For Plantar Fasciitis

Helen Albert writing in Medwire reported on a study of 62 patients, published in the International Journal of Radiation Oncology, which showed that “external beam radiation therapy, similar to that used in treating cancer, provided effective pain relief for patients with plantar fasciitis.” plantar-fasciitis

For the study, “researchers found that 80% of those who received standard-dose therapy experienced complete pain relief, 64% of whom maintained this relief for up to 48 weeks.”

Comment: I would be concerned that radiation would bring along its own potential risks.  There are better and safer options for this condition. It’s like using a bazooka to kill a mouse.

One option we’ve used is ultrasound-guided injections of platelet-rich plasma (PRP). Another is ultrasound-guided injection of Botox.  Both of these are far safer than radiation.  Another treatment that seems to work and is safe is shock wave therapy.

For more information on arthritis treatments and other arthritis problems,  go to:

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A new use for Botox?

First reported in Singapore, then confirmed by a number of studies elsewhere, the popular cosmetic drug, Botox, has another novel use.botox

For sufferers of chronic plantar fasciitis, it appears to not only relieve pain but actually reduces the thickness of the plantar fascia, as measured by diagnostic ultrasound.

I found out about this from a physician in our community who wanted me to try the treatment for his chronic plantar fasciitis.  Using our standard ultrasound-ultrasound-guided-plantar-fascia-injectionguided technique, I did so.  Not only have his symptoms resolved, the serial measurement of plantar fascial thickness has shown improvement as well.

Botox is also being studied as a symptomatic treatment for knee osteoarthritis.

It apparently has an effect on nocioceptive receptors (pain receptors.)

For more information on  arthritis treatments and other arthritis problems go to:

Arthritis Treatment

And don’t forget to sign up for  free weekly arthritis tips and a free copy of our special report “The Consumer’s Guide to Arthritis”

Just go here Contact