When we experience muscle pain, one thing is for sure: we want to get rid of it as soon as possible. As a provider of in-home massage therapy services, people often contact my company first when seeking relief from things like neck pain, low back pain, and other pain. In most cases we do recommend massage, but oftentimes when the condition is severe, it will be in conjunction with therapies and/or recommendations from other health care providers in order for an individual to get the most immediate and effective results.

So where should a person with muscle pain turn first and why? Primary Care Physician? Chiropractor? Massage Therapist?

Making the right choice largely depends on how a person answers the following questions:

What is the severity of the condition and how long has it been present? What is your general health condition and history, including family medical history? Are you willing to take medication prescribed by a traditional medical doctor or must the therapy be all "natural"? Is the pain caused by something specific like an injury or a pre-existing condition? What kind of insurance, if any, is available and what services will it cover? If there is no insurance to cover therapy, what kind of budget do you have to pay for treatments out of pocket?

This may seem like an overly conservative if not complicated approach if we're just talking about a stiff neck, but the idea is to identify any potentially more serious health conditions, and also to avoid paying for anything that could be covered by insurance.

First let's get the insurance question out of the way. When it comes to massage therapy, often the only kinds of insurance policies that will pay for it (including at home massage) are auto insurance or workman's compensation insurance for car and work injuries. Massage therapists can not officially diagnose any condition, so a doctor's prescription is always required. There is a lot more to this particular side-topic, so for additional information about how this works, please see an articles I have already written about what kinds of insurance covers massage therapy.

It should also be noted that normal health insurance may cover physical therapy, but this is quite different from massage therapy and often requires a prolonged treatment plan.

Next and perhaps more importantly; when someone approaches us with serious pain, we want to make sure that it's not something they should see a doctor about first. If it is something with a sudden onset, highly abnormal (not just a stiff neck), or possibly associated with other health problems (just to name a few possible red flags) we might recommend seeing a medical doctor first. This assumes that the individual would be open to using medication, because in addition to the myriad of tools at physician's disposal, it is highly likely that a doctor will prescribe an anti-inflammatory or possibly a prescription pain killer if the pain is severe.

It's important for people to understand that while massage therapy can be very effective in reducing pain caused by muscle tension and related restrictions, it can only achieve so much with one visit. Typically, in order to address more chronic kinds of pain, multiple sessions will be required to make significant headway. Therefore, it is often not a bad idea to see a doctor who may be able to prescribe medication to help the condition, both in terms of reducing pain immediately, and also for reducing inflammation in general, which is often largely responsible for musculoskeletal pain. These efforts can actually make subsequent massage therapy sessions even more effective.

Think of the tight muscles like a frozen stick of butter. If you try to press into it when it's right out of the freezer, it's almost impossible to make a dent. However if it has been defrosted to room temperature (like muscles on an anti-inflammatory), it could be in a much easier state to work with in the care of able hands. This being said, it's also important to be careful about the use of pain killers before getting a massage and advise the therapist of the current use of any medications.

Another option for those with muscle pain which would fall somewhere in between going to a medical doctor and seeing a massage therapist would be going to see a chiropractor. While a chiropractor can not prescribe medication, they can diagnose certain conditions, perform x-rays, and provide natural therapy including "adjustments" among some other things that massage therapists are not authorized to do. In some cases they may also be able to accept normal major medical health insurance along with a co-payment. For some people this is a good "in-between" option providing a relatively high level of care that is also "natural". At the same time, there can be drawbacks.

Your neck consists of seven very small vertebrae and supports the entire weight of your head. The average weight of the human head is 10 to 12 pounds, which isn't very light when you consider the neck is constantly supporting it!

Add in how much neck strain is incurred when you sit for long periods in front of the computer and you steadily increase the amount of work and strain you are expecting of your neck.

The neck also allows your head in nearly all directions which adds even more stress to your neck. With all of this responsibility, the neck is subject a great deal of stress, which often results in chronic pain and stiffness.

Once neck pain has been persistent for any period of time, you may begin to develop neurological symptoms. These may include numbness, tingling, or a "pins and needles" feeling. Usually these complaints are in the neck at all, but can be felt in the fingertips or up and down the arm.

If you begin to experience any of the neurological symptoms, this is usually an indicator that the neck problem is becoming worse. The early phase of pain is just stiffness, then it moves to real pain that can be sharp in nature. The pain will continue to get worse until the radiating symptoms begin.

Many people have neck pain and it is often extremely bothersome. Medical doctors cannot do a whole lot to permanently relieve neck pain. They can prescribe medications to mask your neck pain and they can do x-rays and other tests to see where the pain is coming from.

When they do find something wrong with the neck they will probably want to schedule surgery, which can prove to be a painful procedure with a long recovery. Surgery, while sometimes necessary, really should be considered a treatment of last resort. You can always do the surgery, but if you do the surgery first, you eliminate many other effective and conservative options.

If you have neck pain it may be wise to consult with a chiropractor before going to the extent of something much more serious such as surgery. Some of the first things that a chiropractor will do on your first visit will be to ask you questions about your neck pain.

Some questions they may ask are:

- When did your neck pain start

- What have you done to try to ease your neck pain

- Are there any other parts of your body that your neck pain stems to or from?

These are a few questions that your Chiropractor will most likely ask. After the initial consultation they will then perform a physical examination. The examination will consist of chiropractic tests, orthopedic tests, and a neurological examination. This entire process will allow the chiropractor to get to the root of your problem and allow him or her to come up with a solution to your pain.

A common practice of chiropractors is to perform a neck adjustment. A neck adjustment is a form of spinal manipulation, and is very specific in nature. This is a very precise technique and is usually very effective in alleviating neck pain.