The Benefits of Naprapathy for the Neck and Spine

Hadi Sunalla, DO, DN, NKT, DOMP, RMO

Introduction

Naprapathy is a system of techniques created by Dr. Oakley Smith, one of Dr. Andrew Taylor Still’s students of Osteopathy. Thus, naprapathy has origins with Osteopathy, taking a holistic strategy to the healing process. It is distinguished by its hands-on approach involving manual techniques specialized in correcting shortened or pathologic soft and connective tissues, such as ligaments and fascia, around the spine and other joints. It relies on breaking up adhesions and restoring order to the body. It is mainly a combination of spinal mobilization, spinal manipulation, muscle stretching, and massage. Furthermore, it is a widely practiced form of therapy in Nordic countries and certain states in the United States. The primary objective is to alleviate pain and reduce disability within the musculoskeletal system (Skillgate, Vingård, & Alfredsson, 2007). The need for non-invasive therapies has never been higher, given the prevalence of pathologies related to the neck and spine. Most people experience neck and back pain at some point of their lives. Globally, neck pain is a prevalent and major disorder in the adult population, representing anywhere from 16.7%-75.1% of adults (Genebra et al., 2017). Coupled with 80% of adults who experience back pain in their lives, neck and back pain are nothing short of an epidemic. Fortunately, naprapathy is an ideal treatment solution for these issues. By reducing pain, improving range of motion, enhancing posture, reducing stress, aiding in injury prevention, and increasing quality of life, naprapathy offers valuable benefits for the neck and spine through the use of manual techniques, serving as an effective and safe option for individuals of all ages.

Pain Reduction

The word naprapathy comes from Napravet, which was the word for people who would shake each other’s backs, similar to Dr. Oakley Smith’s techniques. Interestingly, the Czech word Napra means to correct, and the Greek word pathos means pain, so correcting pain is also in the name. When it comes to pain relief for the neck and spine, according to a randomized, controlled trial titled “Naprapathic Manual Therapy or Evidence-based Care for Back and Neck Pain” conducted by Skillgate, Vingård, and Alfredsson (2007), naprapathy could serve as an alternative therapy for individuals experiencing back and neck pain. The study’s results revealed statistically significant differences between two groups of patients, with the naprapathy group demonstrating more favorable outcomes. These positive results included improvements in neck and back pain, reduced disability, and enhanced perceived recovery. The study involved 409 patients with chronic neck and back pain, lasting more than a year, split into two forms of therapy. One group received naprapathic care, while the other group received support and advice from physicians. After twelve weeks, significant differences were observed between the two groups. In the naprapathic care group, 57% of patients reported feeling “very much better”, compared to only 13% in the control group. Additionally, 69% from the naprapathic care group and 42% from the control group had clinically significant reduction in pain. Furthermore, after twelve weeks from the start of the study, 19% of the naprapathy group achieved complete recovery, compared to only 7% of the control group.

Furthermore, naprapathy relieves pain during and after treatment. This is because pain evokes a response from the body to tighten and immobilize, and naprapathy does the opposite; it allows the body to move fluidly with more mobility. Thus, naprapathy is a powerful solution, and antithesis to pain. Some basic movements skillfully utilized by naprapaths to restore harmony and reduce pain include compression, traction, side-bending, torque, shearing, jamming, shaking, or a combination of these movements. Furthermore, oscillation is the type of movement defined as working in every dimensional angle, which means working through as many planes of motion as possible and combining different forces in alternating directions. The last thing a naprapath wants to do is cause pain, because this elicits the self-protective mechanism which causes immobility and tightness. Thus, treatment should be pain free, as the more pain that is caused by naprapathic therapy, the less effective it is. It is so gentle, in fact, that it is an appropriate treatment for newborns, and 100-year-olds alike, as it promotes the delicate repositioning of tissues such as ligaments, free from pain and forceful movements. Moreover, naprapathy can help women postpartum who experience low back pain. Conventionally, they should allow 12 weeks after delivery for the ligaments in the pelvic floor to naturally restore as much as possible, before considering interventions such as naprapathy, which can help after the initial recovery process (Berg, 2019). Naprapathy can henceforth speed up the recovery and restoration of pelvic ligaments, as well as the spine. It is also among the most effective forms of physical therapy for women 12 months postpartum, to recover from low back pain with desirable and significant results (Cheng et al., 2020). In addition, according to Hurwitz et al. (2009), non-invasive therapies, as well as exercises prescribed by therapists, have been linked to improvement of neck pain, more than alternate strategies, and should be considered for future efforts to treat and prevent neck pain.

Improved Range of Motion

Naprapathy can also help with improving range of motion in the neck and spine. This is significant considering what happens in the initial phase of injury, where inflammation occurs at the level of the joint, followed by a thickening of the connective tissues that surround the affected joint. What effectively manifests, is a reduction in range of motion. Since this is the natural tendency of the connective tissues in the structures of the body, it is important to remedy this effect, by allowing range of motion to restore in joints that have become stuck. In naprapathy, oscillation is used to enhance range of motion at every joint level, which serves this purpose more effectively than manipulation alone. Special care and attention while oscillating causes mechanoreceptors within the joint to reset. This is beneficial to restore range of motion, as the naprapath essentially molds the ligaments into a more ideal position. What follows, is that the ligaments support the joints in normal alignment. Hence, the naprapath enables each vertebra to operate as it was designed to, moving freely, unlocked from a stuck state.

Furthermore, when assessing the range of motion of the neck and spine, the naprapath palpates the spinous process, the pointy middle parts of the vertebrae that project posteriorly from the back of the spine. The naprapath notes shifts at the different levels of the vertebrae, indicating ligaments that have buckled, or tightened up disproportionately. If, for example, one level of spinous process is shifted to the right, relative to the vertebrae above and below it, this indicates a rotation of that vertebra to the left. From there, the naprapath gently places the patient in a position of ease for that joint, facilitating enough slack, or space, in the ligaments and tissues to start applying gentle oscillating techniques. Once a subtle release is felt by the therapist, the ligaments of that joint have been successfully mobilized, stimulated, and optimally repositioned to support the joints of the neck and spine. The naprapath then moves to the next level of joint dysfunction to repeat the process, working on the joint as pain free as possible until the spine has been fully aligned. Naprapathy accomplishes this by treating the joint in a position of ease, molding it from every direction. This stimulates the loose ligaments, sending signals in the body for them to tighten up; meanwhile, tight ligaments release and loosen up, bringing equilibrium to all ligaments of that joint, and improving range of motion. Furthermore, when placing the patient in a position of ease, naprapaths often place patients in the same position they injured themselves in. This targets the level of the dysfunction, where the joint is sufficiently compressed, decompressed, or rotated, in the position where the injury occurred. From there, naprapaths gently unwind and unbuckle those tight ligaments, treating stiffness and imbalances, and restoring joint range of motion.

Enhanced Posture

Naprapathy helps enhance posture for the neck and spine by realigning the many ligaments in the spine; for each vertebra in the spine, there are 27 ligaments connecting it with the structures above and below it. It is these ligaments that hold the joints at their normal position, or at their position of dysfunction. It is because of this that they play a critical role in our posture. For instance, when a patient presents with a cervical vertebra that is rotated to the left and side-bent to the right, the naprapath mimics the position and oscillates the joint, mixing in different forces, and freeing up tension at the level of the dysfunction. Then, the naprapath repeats the process on the opposite side. With naprapathic oscillation, a release of tension and improvement can be felt in minutes. However, there is more therapeutic benefit in having multiple treatments, because ligaments are incredibly dense and strong, and take time to fully adjust. In fact, they are the densest of all the connective tissues in the body; thus, they play a significant role in good posture and poor posture alike. Naprapathy addresses and corrects the connective tissue tension in these ligaments, allowing lasting results, and enhancing posture. Moreover, it may be used to treat patients presenting with deviations of the neck and spine, and can play a part in treating and improving forward-head posture, kyphosis (excessive rounding of the upper spine or hunch-back commonly seen in the elderly population), lordosis (dramatic low back curve), and scoliosis (sideways deviation of the spine in a C or S shape). In this way, naprapaths enhance posture by addressing imbalances that contribute to back and neck pain.

Stress Reduction and Psychological Wellbeing

Due to the interrelatedness of the body and mind, naprapathy promotes stress reduction and psychological wellbeing, especially in patients with neck and back pain. In an article titled “Chronic neck pain and anxiety-depression: prevalence and associated risk factors”, Elbinoune et al. (2016) found a relationship between psychological distress and neck and spinal pain, especially in cases of chronic pain to these regions. The results of the study demonstrated that a significant number of individuals with chronic neck pain experience increased levels of depression and anxiety. Furthermore, Elbinoune et al. states that among the known risk factors for neck pain, psychological distress, such as anxiety and depression, is a major contributor. Moreover, the study cited another paper by Sagheer MA et al., in which similar results regarding a direct correlation between chronic low back pain and psychological distress were found. In regards to chronic low back pain patients, Sagheer MA et al. states that “55% of the patients exhibited abnormal levels of anxiety, while 48.57% displayed symptoms of depression”. Additionally, Genebra et al. (2017) concluded that there is a definitive connection with the presence of neck pain in people who are separated or widowed, with low income and low education levels. This is partly due to occupations that require long periods of sitting and leaning. Interestingly enough, Skillgate (2007) demonstrated an association with an increased risk of neck and shoulder pain in individuals who experienced two critical life changes or traumas in the previous five years. In addition, he found a gender disparity, where women are at a higher risk of neck and shoulder pain due to covert coping styles. However, these results were not consistent in relation to low back pain. He concluded that naprapathic manual therapy was significantly “more effective than evidence-based advice on staying active and on pain coping strategies for non-specific back and neck pain, after 7 and 12 weeks”.

Injury Prevention

Naprapathic care is also valuable for injury prevention. It is a well-known fact in the medical community that a sprained ankle is likely to be re-injured. In other words, another ankle sprain on the same ligament is more likely to reoccur, along with an increased risk of chronic pain and instability in the joint. This is known and well documented as Chronic Ankle Instability. One of the reasons for this instability is the fact that ligaments cannot stretch beyond 4% of their resting state without becoming damaged or sprained. However, manual therapy, such as naprapathy, can play a part in rebalancing the systems of the body and restoring optimal function. Using the same philosophy, naprapathy works on the neck and spine to restore health and function to the ligaments, treating instability and allowing the bodily systems to operate in alignment, preventing future injury. Another factor for recurring injuries is the presence of scar tissue, especially in patients with chronic pain issues. This is because scar tissue causes congestion and inflammation, which leads to restrictions that reduce circulation of lymphatic fluid and blood, and therefore nutrients to the body. Naprapathy targets and breaks down scar tissue from affected areas of the body using oscillation techniques. Furthermore, chronic pain weakens supporting muscles and structures, such as connective tissues, making the body more susceptible to injuries. By reducing pain, muscle tensions are reduced, allowing supporting structures to regain stability and strength. This enhanced musculoskeletal support helps to maintain proper alignment, reduce excessive strain on joints and muscles, and lower risk of injuries to the neck and spine.

Improved Quality of Life

Overall, there is significant evidence suggesting that naprapathy improves quality of life. According to Skillgate et al. (2010), the combination of techniques used by naprapaths enables patients to adopt more active lifestyles, with more tools to manage back and neck problems. This is because pain causes people to withdraw from physical activities and adopt sedentary lifestyles and behaviors, which negatively impacts quality of life. However, when pain is reduced, individuals are more likely to resume and engage in activities more frequently. Furthermore, pain can have significant psychological impacts, which can lead to decreased motivation and increased stress levels. Individuals with pain also have an altered perception of their physical abilities, and are overall less inclined to be active, fearing further injury or more pain. Moreover, self esteem is positively affected by the absence of chronic pain, and the confidence in a treatment system that yields tangible results.

Conclusion

In conclusion, naprapathy offers a comprehensive and effective solution for individuals suffering from neck and back pain. By employing various manual techniques, naprapathy aids in reducing pain and easing the healing process. The manipulation of soft and connective tissues, along with spinal mobilization, muscle stretching, massage, and oscillation, all contribute to pain reduction and improved function. One of the key benefits of naprapathy is its ability to improve range of motion and enhance posture. By targeting and correcting shortened and pathologic soft tissues, naprapathy helps to restore proper alignment to the spine and joints. This not only reduces pain, but also minimizes the risk of future injury, and promotes optimal physical performance. Moreover, naprapathy addresses the underlying causes of pain and dysfunction, promoting long-term healing and treating chronic and acute issues. In addition to its physical benefits, naprapathy plays a crucial role in stress reduction and psychological wellbeing. Chronic pain takes a toll on mental health, leading to increased stress, anxiety, and depression. The holistic approach of naprapathy, which considers the interconnectedness of the body and mind, helps to alleviate stress and promote a sense of overall wellbeing. By addressing both the physical and emotional aspects of pain, naprapathy contributes to an improved quality of life. Furthermore, it is a safe and effective treatment option, suitable for individuals of all ages. To conclude, naprapathy is a promising and comprehensive approach for managing and treating neck and spine issues.

References

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Genebra, C. V. D. S., Maciel, N. M., Bento, T. P. F., Simeão, S. F. A. P., & Vitta, A. (2017). Prevalence and factors associated with neck pain: a population-based study. Brazilian journal of physical therapy, 21(4), 274–280. https://doi.org/10.1016/j.bjpt.2017.05.005

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