Dr Notley Chiropractic & Athletic Therapy | Winnipeg

Lumbar Motor Control: Why Your Back “Goes Out” Picking Up a Pen

Dr Notley Chiropractor and Athletic Therapist in Winnipeg — Thu, 04 Jun 2026 14:46:58 +0000

Why Your Back Pain Shows Up When Life Gets Heavy — Not When You Bend Over

Many patients walk into the clinic and say the same thing: “I bent over to pick up a pen — and that’s when it went.” It sounds like bending caused the problem. But new research suggests the bending wasn’t the issue at all. The real culprit is a quiet lapse in lumbar motor control (the precision your nervous system uses to protect your spine). The problem was already there. The pen just happened to tip a system that was already at its limit.

The Test That’s Too Easy to Be Useful

When most clinicians assess chronic back pain, they watch you bend forward, maybe do a knee raise, maybe extend back. Simple stuff. And most people with chronic back pain pass these tests just fine.

A 2026 study, in BMC Musculoskeletal Disorders, put this to the test. Researchers ran 69 people — some with chronic back pain, some without — through eight different movement tasks, from a basic forward bend to a loaded box lift. Here’s the number that matters:

94% of people with chronic back pain passed the forward bend. Only 48% passed the box lift.

The forward bend didn’t find anything. The box lift found everything.

So What’s Actually Going Wrong?

Your spine has a job to do during every movement — it needs to stay controlled while the rest of you does the work. That ability is called lumbar motor control, and it’s not about strength or flexibility. It’s about precision.

Here’s the thing: that precision can be missing even on easy movements. The person who bent over for a pen and felt their back go — the control deficit was already there before they reached down. The pen didn’t cause it. The movement just happened to tip a system that was already at its limit.

A box lift makes the limit obvious. A pen on a good day might not. But the underlying problem is the same.

The Reassuring Part

The study found that people with chronic back pain averaged just one test lower than people without any pain at all — five correct out of seven versus six out of seven. That’s a real gap, but it’s a specific and trainable one. Not a broken spine. Not permanent damage. A precision deficit in how the nervous system is managing spinal movement under load.

Motor control can be retrained. The nervous system adapts. The gap you have today doesn’t have to be the gap you have in six months.

What This Means for Your Assessment

If your back assessment only included simple, unloaded movements, it may not have been sensitive enough to find where your system actually breaks down. The research now tells us that loaded, functional tasks — like a box lift or a hip hinge under resistance — are where the real picture emerges.

At the clinic we use this kind of functional assessment as a standard part of back pain care, at both our St. Vital location on Dakota Street and our Downtown location on Fort Street. If you’ve been told everything looks fine but your back keeps giving out, it may simply be that no one tested it hard enough yet.

Book at drnotley.com — or read more about how we approach chronic back pain care and what lumbar motor control actually means.

Book at Gelley Chiropractic

Book at Precision movement & therapies

Frequently asked questions

Why did my back go out picking up something light?

The weight wasn’t the cause — the control deficit was already present. Light loads can trigger the same problem as heavy ones when the nervous system isn’t regulating spinal movement well. The load just happened to exceed whatever capacity was available in that moment.

Does this mean I should avoid bending?

No. Avoiding bending makes the problem worse over time. The goal is to retrain how your spine controls movement during bending — not to eliminate it. Corrective exercise targets exactly this.

I’ve been assessed before and told I’m fine. Should I get another opinion?

If your assessment only included simple movements, it may not have been sensitive enough. A functional loading assessment — the kind the 2026 research supports — often reveals deficits that a basic screen misses entirely.

Hoffmann A, Meyering L, Frankenstein T, Schäfer A, Schwarz A. Item difficulty of eight tests for the examination of lumbar movement control in flexion in chronic non-specific lumbar back pain. BMC Musculoskelet Disord. 2026. https://doi.org/10.1186/s12891-026-09798-7

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Solving the Headache Puzzle: New Evidence for Winnipeg Residents

Dr Notley Chiropractor and Athletic Therapist in Winnipeg — Tue, 05 May 2026 03:09:42 +0000

Are your headaches coming from your neck or stress? New 2024 guidelines clarify how to treat the two most common types without relying solely on medication.

New research suggests your “neck headache” needs more than just a quick fix. The 2026 chiropractic guidelines show that while adjustments are key, the real secret to lasting Cervicogenic Headache Relief in Winnipeg is a multimodal plan that targets both joint and soft tissue.

If you’ve spent your morning commute white-knuckling the steering wheel on Pembina Highway, you know the feeling: a dull ache creeping from the base of your skull toward your temple. Many of our patients at the clinic try to push through this, assuming it’s just “posture” or stress. However, if that ache is actually a cervicogenic headache, the way we manage it determines whether you get a few hours of relief or a long-term solution.

This post synthesizes the 2026 Clinical Practice Guideline for the chiropractic management of headaches for our patients in Winnipeg. Whether you visit us at our Carlton Street clinic (serving Osborne Village and the Exchange) or the St. Vital clinic, we want you to understand the shift in how we treat these conditions. The data reveals that a “one-size-fits-all” adjustment isn’t the best path—specific diagnosis is.

CURRENT UNDERSTANDING

For years, the standard advice for headaches has been a mix of “take an aspirin and rest” or a generic neck stretch. We often see patients who have been told to simply avoid anything that triggers the pain, leading to a protective “bracing” posture. While this feels logical—who wants to move when their head is pounding?—it often backfires.

By protecting the neck too much, the joints can become stiffer and the supporting muscles more sensitized. This creates a cycle where the very thing you do to avoid the headache actually makes the neck more prone to triggering one. The tension builds, the mobility drops, and suddenly a short drive down St. Mary’s Road feels like an athletic feat of endurance.

THE STUDY: CHANGING THE NARRATIVE

The Trager et al. (2026) guideline is a synthesis of high-level evidence designed to standardize how we help you. The research categorized patients into two main groups: those with Cervicogenic Headaches (CGH) — actually caused by neck structures —and Tension-Type Headaches (TTH).

While spinal manipulation is a powerhouse for CGH, it should rarely stand alone for tension headaches. The data suggests that for long-term TTH relief, a multimodal approach, combining adjustments with soft tissue work and exercise, is significantly more effective than “just an adjustment.”

We must note that this was a consensus guideline based on an umbrella review of existing studies. While it represents the strongest current agreement in the field, we treat these as high-level recommendations rather than absolute certainties for every individual case.

FINDING YOUR NECK’S UNIQUE SWEET SPOT

Diagnosis

The data recommends using the ICHD-3 criteria to confirm your headache is actually coming from the neck (CGH) before starting heavy treatment.

At the clinic: For patients working at desks in The Exchange District, we use the Flexion-Rotation Test to see if your top two neck vertebrae are truly the source of your pain.

Modality Mix

For Tension-Type Headaches, the research suggests SMT is most effective when paired with soft tissue therapy and joint mobilization.

At the clinic: Whether you play ultimate frisbee or are an office working with a tension headache we don’t just adjust; we integrate myofascial work to ensure your muscles aren’t fighting the new mobility we’ve created.

Physical Activity

The guideline supports therapeutic exercise to maintain the gains made during your office visits.

At the clinic: We often prescribe “movement snacks” to prevent the static loading that triggers these headaches in the first place.

Personalized Headache Care

The science is clear: your care needs to be as specific as your symptoms. At Precision Movement and Therapies, near the Pyramid Cabaret, we see many professionals whose headaches are driven by screen time and static posture. Meanwhile, at our St. Vital location, we often help families and active adults manage headaches that interfere with their weekend routines.

Don’t let your headache hold you back

Book at Gelley Chiropractic

Book at Precision movement & therapies

CONCLUSION

The 2026 headache guidelines confirm that specific, multimodal care is the most effective path forward. By moving away from generic rest and toward active, evidence-based loading and Don’t let your headache hold you back, we can change the trajectory of your recovery. We invite our patients to embrace movement over protection. We look forward to helping you get back to the activities you love in this community.

Frequently Asked Questions

Can my neck really cause my headache?

Yes. This is called a Cervicogenic Headache. The nerves in your upper neck are closely linked to the nerves that signal pain in your head. The new guidelines strongly recommend spinal manipulation for this specific type.

Is an adjustment enough for tension headaches?

The latest research says no. For tension-type headaches, the best results come from “multimodal care”—a mix of adjustments, muscle work, and specific exercises.

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Best Lighting for Migraine Relief: Managing Light Sensitivity (Photophobia)

Dr Notley Chiropractor and Athletic Therapist in Winnipeg — Fri, 24 Apr 2026 02:53:31 +0000

Can Light Trigger or Worsen Migraines?

Yes—light can directly worsen migraine pain. This is known as photophobia, and it is one of the most common and disabling features of migraine.

This isn’t simply eye sensitivity. Research from groups including Rami Burstein shows that specific retinal pathways connect directly to brain regions involved in pain processing. As a result, light can amplify headache intensity—not just feel bright or uncomfortable.

Is Sitting in a Dark Room Good for Migraines?

It can help during an acute attack, but it’s not a good long-term strategy.

While reducing light exposure can temporarily decrease symptoms, chronic light avoidance may increase sensitivity over time. The nervous system can become more reactive when it is consistently underexposed to normal sensory input.

Current behavioral research suggests that, in many cases, a better approach is to maintain tolerable exposure and gradually improve tolerance, rather than relying on strict avoidance.

What Type of Light Is Best for Migraine?

The type of light matters as much as the brightness.

Research indicates that:

Blue-rich light (common in screens and “daylight” LEDs) is more likely to aggravate symptoms
Narrow-band green light appears to be better tolerated and may reduce pain in some individuals

Studies published in Cephalalgia and related journals suggest that modifying the spectral composition of light, by reducing blue and cyan, can influence symptom severity. However, these findings come from relatively small and controlled studies, and responses vary between individuals.

In practice, many patients find warmer indoor lighting and reduced glare easier to tolerate.

Do Blue Light Glasses or Tinted Lenses Help Migraines?

They can be helpful for some patients.

Precision-tinted lenses (such as FL-41) are designed to filter wavelengths associated with migraine discomfort. Clinical studies suggest they may reduce light sensitivity and improve comfort in certain environments.

That said, they are not universally effective and should be viewed as one tool among several, rather than a standalone treatment.

Where Musculoskeletal (MSK) Care Fits In

Migraine is influenced by multiple systems, including the musculoskeletal system.

The upper cervical spine shares neural connections with trigeminal pathways in the brainstem. This helps explain why cervical dysfunction can contribute to overall migraine burden and reduce tolerance to common triggers such as posture, screen exposure, and sustained loading.

However, it’s important to be precise:
MSK treatment does not directly treat photophobia.

What current evidence supports is a multimodal approach to migraine management. While no single intervention consistently resolves light sensitivity, combining strategies that reduce overall symptom load—such as optimizing lighting, maintaining exposure tolerance, and addressing relevant musculoskeletal contributors—may improve how patients tolerate triggers.

In this context, MSK care is best understood as helping to reduce background nociceptive input and improve overall tolerance, rather than targeting light sensitivity in isolation.

How to Reduce Light Sensitivity in Migraine

A practical approach focuses on both environment and overall system load.

Start by modifying lighting conditions—using warmer bulbs, reducing glare, and avoiding overly harsh “daylight” LEDs indoors. At the same time, avoid prolonged periods in complete darkness outside of acute attacks. Maintaining consistent, tolerable exposure is more likely to preserve normal sensitivity.

For patients with posture-related aggravation, prolonged sitting, or neck discomfort, addressing these contributors may further reduce overall reactivity and improve day-to-day tolerance.

The goal is not to eliminate all triggers, but to increase your capacity to function despite them.

Key Takeaway

The best lighting for migraine isn’t the darkest—it’s the most tolerable.

Current evidence supports:

Adjusting light quality rather than simply reducing brightness
Avoiding long-term over-restriction of sensory input
Using a multimodal strategy to reduce overall symptom burden

This approach is more consistent with modern migraine science and more sustainable for daily life.

Frequently Asked Questions About Migraine and Light Sensitivity

Why do lights trigger migraines in Winnipeg winters?

Lights can trigger migraines due to photophobia, which is an increased sensitivity in how the brain processes visual input. In Winnipeg winters, reduced natural daylight often leads to increased exposure to artificial lighting and screens, which may worsen symptoms in some individuals.

What lighting is best for migraines at home or the office?

Warm, low-glare lighting with reduced blue wavelengths is generally better tolerated. Harsh LED lighting and bright, high-glare environments are more likely to trigger migraine symptoms, especially with prolonged exposure.

Is it bad to sit in a dark room during a migraine?

Dark rooms can help during an acute migraine attack, but frequent or prolonged light avoidance may increase sensitivity over time. Gradually maintaining exposure to tolerable light levels is generally more effective for long-term management.

Do blue light glasses actually help migraines?

Blue light filtering lenses, including precision-tinted options such as FL-41, may reduce light sensitivity and improve comfort for some people. However, results vary, and they are best used as part of a broader migraine management approach rather than a standalone treatment

Can neck pain trigger migraines and light sensitivity?

Neck dysfunction does not directly cause migraine light sensitivity, but it may contribute to overall migraine burden. The upper cervical spine shares neural connections with trigeminal pain pathways, so musculoskeletal factors can influence symptom severity in some individuals.

Who treats migraine light sensitivity in Winnipeg?

Migraine light sensitivity is typically managed by healthcare providers experienced in headache disorders. Care may include a combination of environmental modification, medical management, and musculoskeletal assessment depending on the patient’s presentation.

References

Rami Burstein et al.
Light-induced exacerbation of migraine headache via retinal pathways
Nature Neuroscience (2010)
https://www.nature.com/articles/nn.2687
Noseda R, Burstein R.
Advances in understanding the mechanisms of migraine-type photophobia
Current Opinion in Neurology (2011)
https://journals.lww.com/co-neurology/Abstract/2011/06000/Advances_in_understanding_the_mechanisms_of.11.aspx
Noseda R et al.
A neural mechanism for exacerbation of headache by light
Nature Neuroscience (2010)
https://www.nature.com/articles/nn.2591
Martin VT et al.
Behavioral management of migraine: avoiding triggers vs coping with triggers
Current Pain and Headache Reports (2014)
https://link.springer.com/article/10.1007/s11916-014-0436-6
Okamoto K et al.
Bright light activates a trigeminal nociceptive pathway
Pain (2010)
https://pubmed.ncbi.nlm.nih.gov/20418004/
Digre KB, Brennan KC.
Shedding light on photophobia
Journal of Neuro-Ophthalmology (2012)
https://journals.lww.com/jneuro-ophthalmology/fulltext/2012/09000/shedding_light_on_photophobia.13.aspx
Ibrahim NK et al.
Green light exposure and migraine headache
Cephalalgia (2020)
https://journals.sagepub.com/doi/10.1177/0333102419887096
Chaibi A et al.
Manual therapies for migraine: a systematic review
Journal of Headache and Pain (2011)
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1007/s10194-011-0296-6
Luedtke K et al.
Physical therapy in migraine: systematic review
Journal of Headache and Pain (2016)
https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-016-0649-8
American Headache Society
Non-pharmacologic treatments for migraine
https://americanheadachesociety.org/resources/primary-care/non-pharmacologic-treatment

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Neck Pain Red Flags: Why Your Chiropractor Asks “Strange” Questions

Dr Notley Chiropractor and Athletic Therapist in Winnipeg — Thu, 16 Apr 2026 02:25:54 +0000

Why We Ask “Strange” Questions About Your Neck Pain

Ever wondered why your chiropractor asks about weight loss or your history of health from 10 years ago? It’s not just small talk—it’s about your safety.

Neck pain is one of the most common reasons people seek care. But before any treatment begins, you’ll often be asked questions that don’t seem directly related—about your general health, your weight, or even conditions from years ago. That isn’t small talk. It’s about safety. When you present with neck pain, the first priority isn’t just identifying the source of pain. It’s determining whether it’s safe to treat in the first place. This process, known as triage, is about ruling out the small percentage of cases where neck pain may be linked to something more serious.

What Are Neck Pain Red Flags?

“Red flags” are clinical signs and symptoms used to screen for potentially serious underlying conditions. A 2024 review by Occhetto and colleagues highlights an important shift in how we use them. Not all red flags are equally useful. Some commonly cited warning signs have little value on their own, while others carry significantly more weight. This matters because it allows clinicians to be more precise—reducing unnecessary concern while focusing on findings that genuinely influence decision-making.

How Clinicians Actually Screen Neck Pain

In practice, screening is less about any single finding and more about how different elements fit together. Clinically, this comes down to three key areas: your history, the behavior of your symptoms, and how those symptoms change over time. Your history helps identify risk factors such as previous cancer, infection, or significant trauma. The behavior of symptoms is equally important. Mechanical pain typically changes with movement or position, while pain that is constant and unrelenting raises different concerns. Progression over time is often the deciding factor. Most mechanical neck pain improves, even if gradually. When symptoms remain unchanged or worsen despite appropriate care, it prompts a reassessment.

Is Most Neck Pain Serious?

In the vast majority of cases, no. Most neck pain is mechanical in nature. It arises from joints, muscles, or nerves that have become sensitive or irritated, and these presentations tend to respond well to movement, time, and appropriate rehabilitation. More than 90 percent of neck pain falls into this category. A small percentage does not, and identifying those cases early is the reason screening is built into every initial assessment.

Which Neck Pain Red Flags Actually Matter?

Older screening models often treated red flags as if they all carried equal importance, but current evidence suggests otherwise. A history of cancer stands out as the most meaningful individual red flag. Other factors become more relevant when they appear in combination rather than isolation. In practice, this means clinicians are not simply checking boxes—they are interpreting patterns.

What Happens If Your Neck Pain Is Mechanical?

When your symptoms follow a typical mechanical pattern, care is usually straightforward. Treatment focuses on restoring movement, reducing sensitivity, and gradually building tolerance through exercise. This is where chiropractic care and rehabilitation strategies are most effective, with the goal of not just short-term relief but long-term resilience.

What If Your Symptoms Don’t Fit the Pattern?

When a presentation doesn’t behave like mechanical neck pain, the approach changes. This may involve further investigation such as imaging, referral to a medical provider, or coordination within the broader healthcare system. The priority is always the same: ensuring you receive the right care at the right time.

When Should You Be More Concerned About Neck Pain?

Most people with neck pain do not need imaging or specialist care. However, certain patterns warrant closer attention. Pain that does not change with movement, remains constant or progressively worsens, or is associated with feeling generally unwell should be reassessed—especially if it is not improving over a few weeks. These features do not automatically indicate a serious condition. They simply guide the next step in clinical decision-making.

The Bottom Line: Safe, Targeted Care Starts With Good Screening

The purpose of asking detailed questions and screening for red flags is not to create concern—it’s to reduce uncertainty. By identifying what is typical and what is not, clinicians can make better decisions about when to treat, when to investigate further, and when to refer.

Frequently Asked Questions About Neck Pain

Is neck pain at night a red flag?

Not on its own.
Many people have positional pain at night. This often relates to sleep setup or stiffness.
We look closer when pain is constant, severe, and does not improve when you change position.

Do I need an MRI for neck pain?

Most people do not. Imaging is reserved for cases where red flag patterns are present or when symptoms are not improving as expected. Overuse of imaging can create confusion without improving outcomes.

When Neck Pain Might Need a Closer Look

Most people do not need imaging or specialist care. You should pay closer attention if your pain:
does not change with movement, is constant and worsening, is associated with feeling unwell,
is not improving over a few weeks.

Neck Pain That Isn’t Improving?

If your neck pain is not changing with movement or not improving after a few weeks, it needs a closer look.

At our Winnipeg clinics, we perform a full assessment that includes movement testing, neurological screening and red flag evaluation.

Book at Gelley Chiropractic

Book at Precision movement & therapies

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Chronic Low Back Pain: Why Team-Based Care Works Better

Dr Notley Chiropractor and Athletic Therapist in Winnipeg — Tue, 07 Apr 2026 22:00:25 +0000

If you’ve been dealing with chronic low back pain, you’ve probably already tried the basics, rest, some athletic therapy, massage, chiropractic, or maybe medication. And maybe it helped. Maybe it helped for a while but it keeps coming back, you’re not alone.

A new study published in 2026 looked at what happens when people with chronic back pain receive a structured team-based program that addresses not just the physical side of their pain, but also the mental, emotional, and social dimensions — compared to standard care. The results matter for how we think about back pain treatment.

Why Back Pain Is Never Just About Your Back?

Here’s something the research has been telling us for years: chronic pain is not simply a signal from damaged tissue. It’s a complex experience shaped by your nervous system, your stress levels, your sleep quality, your mood, your beliefs about pain, and your social situation. That’s not a metaphor — it’s how pain neuroscience actually works.

When pain persists beyond a few months, the brain can become hypersensitive. Small inputs get amplified. Anxiety and poor sleep make it worse. Fear of movement keeps people still — which makes muscles weaker and pain more persistent. This is the cycle that standard pain treatment alone often fails to break.

What the Study Looked At

Researchers at a Croatian hospital took 128 patients with chronic low back pain and randomly assigned them to two groups. One group received a structured multidisciplinary program that combined physical rehabilitation, pain education, condition education, psychological support, and social rehabilitation — all coordinated by a team. The other group received standard multimodal care: the usual combination of medications, physiotherapy, and pain management typical of a hospital setting.

They measured pain levels, physical disability, quality of life, anxiety, depression, stress, and sleep quality. They also used smartwatches to track activity and sleep objectively — not just relying on what patients reported.

What the Findings Tell Us

The coordinated biopsychosocial program outperformed standard care across multiple dimensions — particularly the ones that standard care typically misses: mood, stress, anxiety, and sleep quality. These aren’t soft outcomes. They are central to why chronic pain stays chronic.

This confirms what a growing body of evidence has been building toward: if we only treat the physical component of chronic pain, we’re addressing one thread of a multi-threaded problem. The patients who tend to do best are those who receive comprehensive support that helps them understand their pain, move more confidently, sleep better, and feel less afraid of their own body.

What This Means for You

You may not have access to a full multidisciplinary hospital program — most people don’t. But the principles behind that research can still guide your care:

Understanding your pain matters. Knowing that chronic pain involves a sensitized nervous system — not necessarily ongoing damage — changes how scary it feels. That shift alone can reduce pain.
Sleep is part of your treatment. Poor sleep amplifies pain signals. If you’re not sleeping well, that needs to be part of the conversation with your clinician.
Movement is medicine — done gradually. Fear of movement makes chronic pain worse. Graded, guided movement helps recalibrate the nervous system over time.
Your mood and stress levels are legitimate clinical factors, not separate from your back pain. Addressing them as part of treatment isn’t a sign that “it’s all in your head”; it’s good science.

If you live in Winnipeg and your low back pain keeps returning despite treatment, the issue is often not a single structure but a combination of movement capacity, nervous system sensitivity, sleep quality, and lifestyle stressors. A comprehensive assessment looks at all of these factors together rather than treating symptoms in isolation.

Book an appointment at Gelley Chiropractic or Precision Movement & Therapies in Winnipeg, or reach out with questions at drnotley.com.

Book at Gelley Chiropractic

Book at Precision movement & therapies

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Understanding Your Smartphone and Neck-Related Headaches: A Patient’s Guide

Dr Notley Chiropractor and Athletic Therapist in Winnipeg — Tue, 31 Mar 2026 22:28:43 +0000

Introduction to Cervicogenic Headaches (CGH)

In our clinical practice, we frequently see patients who suffer from persistent headaches that don’t respond to typical migraine treatments. Often, the culprit isn’t in the head at all, but in the neck. This is known as a Cervicogenic Headache (CGH).

We classify CGH as a “secondary headache,” meaning the pain is a symptom of an underlying physical issue in the cervical spine (your neck). Specifically, this involves dysfunction in the upper cervical vertebrae (C1, C2, and C3), the C2–C3 intervertebral discs, and the upper synovial joints. When these structures are strained—often by the way we hold our devices—they send distress signals to the brain.

Why Neck Issues Feel Like Head Pain

You might wonder why a neck problem feels like a forehead or behind-the-eye ache. This happens because of the trigeminocervical nucleus. Think of this as a major “electrical junction box” in your nervous system where pain signals from your upper neck and the sensory nerves of your face and head converge. Because these signals overlap, your brain can become “cross-wired,” misinterpreting a neck problem as pain in your head.

Identifying the Symptoms

When you come into my clinic, I look for specific “red flags” that distinguish CGH from other conditions. These include:

Radiation Pattern: Pain that usually starts at the base of the skull or neck and travels toward the back (occipital) or front (frontal) of the head.
Non-Throbbing Pain: Unlike migraines, which often pulse, CGH is typically a steady, dull ache.
Movement Triggers: Pain that worsens when you turn your head, hold a specific posture for too long, or when a therapist applies pressure to the “trigger points” in your neck.
Restricted Mobility: A feeling of “stiffness” or a literal inability to turn your head as far as you used to.

Cervicogenic headaches are frequently confused with migraines or cluster headaches. Furthermore, they are often linked to cervical spondylosis (age related “grey hair” of the spine). If your headaches are consistently tied to neck stiffness, it is important to assess the spine rather than just treating the head pain.

The Smartphone Link: Understanding Your Risk

In our modern lifestyle, the biggest threat to your cervical health is likely in your pocket. Our research highlights a “3-Hour Threshold”: accumulating more than three hours of smartphone use per day significantly increases your risk of developing CGH.

It is important to remember that these hours are cumulative. Small increments of scrolling throughout the day add up to a high-risk zone. As screen time increases, the intensity of the pain typically follows a predictable pattern:

Daily Screen Time	Typical Pain Severity (Pain rated out of 10)
4–6 Hours	Mild Pain (0-3)
6–8 Hours	Moderate Pain (4-7)
More than 8 Hours	Severe Pain (8-10)

A Note on Gender: While women are statistically more likely to suffer from CGH globally, our latest data shows that among smartphone users, males often report a higher mean pain intensity (1.93 on the scale) compared to females (1.59). Regardless of your gender, your risk increases the longer you stay glued to the screen.

The Mechanics of “Forward Head Posture”

When you lean your head forward to look at a screenyou are essentially doubling or tripling the weight your neck muscles must support. This leads to a specific type of muscle imbalance:

Superficial Stiffness: Muscles like the levator scapulae, sternocleidomastoid (SCM), and upper trapezius become chronically tight and stiff as they struggle to hold your head up.
Deep Weakness: The deep neck flexors, the essential “core” muscles of your neck that provide stability, become weak and inhibited from disuse.

What this means for your recovery: This imbalance creates a cycle of spinal strain and compromised motor control, eventually leading to the functional limitations and headaches you are experiencing.

How Healthcare Providers Diagnose CGH

To confirm that your headaches are originating from your neck, we use two primary clinical tools:

Cervical Flexion-Rotation Test (FRT): This is the gold standard for CGH diagnosis. Your therapist will gently move your neck into specific angles to check mobility at the C1–C2 level. This test has a 92% sensitivity rate, making it highly accurate for identifying neck-related headaches. In a recent study of 175 students, 136 participants (over 77%) tested positive on the FRT, showcasing how common this issue has become.
Numeric Pain Rating Scale (NPRS): We use this 0–10 scale to track your progress and understand the severity of your symptoms during daily activities.

Practical Strategies for Prevention and Management

Recovery involves more than just “sitting up straight.” It requires a dedicated approach to how you interact with technology:

Monitor Accumulated Time: Use “Screen Time” apps to track your daily usage. Aim to keep your total phone use below the 3-hour mark whenever possible.
Raise the Device, Not the Neck: Bring your phone up to eye level. It is much easier to move your arms than it is to repair a strained cervical spine.
Correct the Imbalance: Focus on exercises that strengthen the deep neck flexors while stretching the stiff superficial muscles like the trapezius.
Seek Targeted Intervention: Consult a physical therapist for manual therapy. Specialized techniques, such as C1-C2 mobilization, can restore lost movement and provide immediate relief from referred head pain.

Summary Checklist for Spinal Health

Use this checklist daily to protect your neck and reduce the frequency of your headaches:

[ ] Limit cumulative smartphone use to under 3 hours per day.
[ ] Perform an eye-level check: Is my device at eye level, or am I looking down?
[ ] Reset your posture every 15 minutes by aligning your ears over your shoulders.
[ ] Discuss manual therapy and C1-C2 mobilization with your physical therapist.
[ ] Strengthen deep stabilizers and stretch the superficial neck muscles daily.

For Further Reading (References)

The evidence provided in this guide is based on recent clinical research. You are encouraged to share these findings with your primary care provider:

Arshad, J., Faisal, S., Safdar, N., Aslam, S., & Farwa, M. (2025). Association between Smartphone Screen Time and Cervicogenic Headache Severity in Young Adults, a Cervical Flexion-Rotation Test-Based: A Cross-Sectional Study. Journal Riphah College of Rehabilitation Science (JRCRS).

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Can Running Actually “Heal” Your Spine? The Truth About Running and Disc Degeneration

Dr Notley Chiropractor and Athletic Therapist in Winnipeg — Sun, 08 Mar 2026 15:22:03 +0000

If you have been told you have degenerative disc disease in your lower back, your first instinct was likely to stop running. For years, the common wisdom, even among some healthcare providers, was that running is “high impact” and therefore “bad” for your back. The image of your vertebrae “hammering” away at your spinal discs is a powerful one, and it’s led thousands of people to give up the sport they love in search of back pain relief in Winnipeg.

But what if that image is entirely wrong?

New research from a 2026 analysis of the ASTEROID Trial suggests a startling paradox: running may not just be “safe” for a worn-out spine—it might actually be the very thing that helps hydrate and “feed” your discs. In fact, the study found that those with the most significant disc degeneration saw the greatest benefits from a specific running program.

At my clinics in St. Vital and Downtown Winnipeg, I help patients navigate the gap between a scary-looking MRI report and the active lifestyle they want to lead. Let’s look at why your “worn” discs might actually need to hit the pavement.

The “Pumping” Effect: How Discs Stay Healthy

To understand why running and disc degeneration aren’t mutually exclusive, we have to understand how a disc works. Unlike your muscles, which have a rich blood supply, your intervertebral discs are “avascular.” They don’t have their own internal pump to bring in nutrients and flush out waste.

Instead, they rely on diffusion. They act like a sponge. When you apply pressure and then release it, you create a “pumping” action that moves fluid in and out of the disc.

Why Impact is a “Nutrient”

This is where running comes in. The rhythmic “loading and unloading” of your spine during a run creates a pulsatile pressure. This isn’t “damage”—it’s a mechanical signal to the cells inside your disc to start producing the proteins that hold onto water. In the world of MSK health, we call this mechanotransduction.

Without this mechanical “nudge,” the disc can become stagnant, leading to the dehydration and thinning we call degeneration.

The Paradox: Why “Worn” Discs Responded Best

The most significant finding of the ASTEROID Trial was the moderation effect of baseline health. Researchers used T2 Mapping (a specialized MRI technique) to measure disc hydration in 40 adults with chronic low back pain over 12 weeks.

They found that participants with high levels of disc degeneration (Pfirrmann Grade 3 or 4) actually saw a 3.42 ms increase in disc hydration compared to a control group.

Why the “Healthy” Spine Responded Differently

Interestingly, those with “perfect” or healthy discs didn’t see the same immediate spike in hydration. This suggests that a degenerated disc might be more sensitive to mechanical signals. It’s as if the “worn” disc is starving for the right kind of movement, and once provided with a specific “dose” of running, it begins to adapt and rehydrate more aggressively than a disc that is already in top shape.

Finding the “Sweet Spot”: The 3 Key Variables

The research didn’t suggest that all running is created equal. There is a “Sweet Spot” where running moves from being a stressor to being a “medicine.” If you are seeking back pain relief in Winnipeg, you need to understand these three variables:

1. The Speed Threshold (10.5 km/h)

The study found that a moderate running speed (approximately 10.5 km/h) was significantly more effective than a slow “shuffle” or power walk.

Why? At 10.5 km/h, most people enter a true “flight phase,” where both feet leave the ground. This creates the specific magnitude of impact needed to trigger the disc cells.
The Takeaway: If you’re just “jogging in place,” you might not be giving your discs the “pump” they need.

2. The Weekly Volume (The “Goldilocks” Zone)

The most benefit was seen in people who ran between 28 km and 46 km total over the 12-week study.

Too Little: Less than 2.5 km per week didn’t provide enough stimulus.
Too Much: Going significantly over 4 km per session, three times a week, didn’t necessarily lead to better results.
The Takeaway: Consistency and moderate volume beat “weekend warrior” marathons every time.

3. The Running Surface (The Grass Advantage)

This is a big one for our Winnipeg community. The study found that running on grass was a massive moderator of success.

The Science: Hard surfaces like concrete reflect more force back into the joints. Grass provides enough compliance to “muffle” the peak impact while still allowing for the rhythmic loading the disc needs.
The Takeaway: Spend more time at St. Vital Park or the trails Downtown and less time on the sidewalk.

The “6-Week Dip”: A Warning for the Patient

One of the most important things we discuss is the adaptation phase. The ASTEROID data showed that many runners actually had a decrease in disc hydration at the 6-week mark before it rebounded at 12 weeks.

This is where most people quit. They start a program, feel a bit of “new stiffness” or a slight flare-up at the one-month mark, and assume they are “damaging” their back. In reality, your body is likely in the middle of a remodeling phase. Just like your muscles feel sore after a new gym routine, your spinal tissues need time to adjust to the new mechanical load.

How a Winnipeg Chiropractor Helps You Start Safely

If you have been diagnosed with degenerative disc disease, you shouldn’t just sprint out the door tomorrow. You need a bridge between your current pain and the “Sweet Spot.”

As a Chiropractor in St. Vital and Downtown Winnipeg, my role is to act as your “mechanic.” When a patient comes to see me for back pain relief in Winnipeg, we don’t just look at the MRI; we look at the movement.

Our “Impact Readiness” Process:

Get assessed: Are you over-striding? High-impact “heel striking” on a straight leg can send a jarring force to the lower back. We help you find a cadence that protects the spine.
The “Run-Walk” Interval: We often start patients with a 30-second run / 2-minute walk ratio. This allows you to hit the 10.5 km/h speed threshold for short bursts without overtaxing your system.
Core Resilience: We ensure your deep stabilizers are “turning on” before your foot hits the ground.

Conclusion: Stop Protecting, Start Living

The diagnosis of degenerative disc disease is not a life sentence to the couch. While it’s natural to want to protect your spine, the latest science tells us that running—when done at the right speed, on the right surface, and in the right volume—is one of the best ways to keep your back resilient.

If you’re tired of being told what you can’t do and you’re looking for back pain relief in Winnipeg that actually gets you back to your favorite activities, let’s talk. Whether you visit us in St. Vital or Downtown, we can help you find your “Sweet Spot.”

Book at Gelley Chiropractic

Book at Precision movement & therapies

The post Can Running Actually “Heal” Your Spine? The Truth About Running and Disc Degeneration appeared first on Dr Notley Chiropractic & Athletic Therapy | Winnipeg.

Doorway Stretch: Improve Shoulder Mobility and Reduce Chest Tightness

Dr Notley Chiropractor & Athletic Therapist in Winnipeg — Wed, 04 Mar 2026 16:25:00 +0000

We often hear that “bad posture” is the cause of our aches, but the reality is more about a lack of movement variability. My philosophy is that our body is incredibly adaptable; it becomes efficient at the positions you inhabit most often. If you spend your day at a computer or performing repetitive lifting, your body isn’t “failing”—it is simply adapting to a stationary demand.

The discomfort you feel in your shoulders isn’t necessarily because you are “slouching.” It is because your nervous system has lost the habit of accessing its full range of motion. The doorway stretch is a simple, effective tool to reintroduce that lost variety, reducing tightness through the chest and making daily activities feel smoother.

How to Perform the Doorway Stretch

To get the most out of this movement, focus on quality positioning rather than intensity.

Setup: Stand in a doorway or corner with one forearm placed against the frame.
Position: Place your elbow around shoulder height (about 90°).
The Move: Step forward gently with the leg on the same side until you feel a stretch across the chest and front of the shoulder.
Refinement: Keep your chest tall and avoid arching your lower back.
Note: You should feel gentle to moderate tension—never sharp pain or pinching in the shoulder.

How Often Should You Perform the Doorway Stretch?

For general mobility:

1–2 times daily
2–3 repetitions per side
20–30 second holds

Athletes or individuals with significant tightness may benefit from integrating it into warm-ups or post-training recovery routines depending on goals and symptoms.

Why This Movement Matters

Modern research shows that shoulder discomfort is rarely caused by a single structure or a lack of “space” in the joint. Instead, your symptoms are influenced by how your muscles, joints, and nervous system work together.

The doorway stretch mainly targets the pectoralis major and minor muscles. When these tissues become sensitized from prolonged sitting or repetitive overhead activity, you might notice:

Tightness when reaching overhead or lifting.
Shoulder fatigue during sports or work.
Neck or upper-back tension as your body compensates for restricted front-body mobility.

Rather than “fixing” a posture, this stretch creates a more comfortable starting point for movement. By reducing feelings of stiffness, it prepares the body for strengthening and activity.

Progressions and Clinical Variations

Different arm positions change which tissues receive the greatest stimulus. By varying your angles, you provide the “movement snacks” your joints crave:

Low-Angle Stretch: Elbow slightly below shoulder height. This is excellent for sensitive shoulders or early rehabilitation.
90° Abduction: The classic position targeting the bulk of the pectoral muscles.
Higher Arm Position: Places greater emphasis on the lower chest fibers but should be used cautiously if you have existing shoulder irritation.

Integrating Stretching Into Your Care

While stretching is a fantastic tool for temporary relief, lasting change comes from a broader approach. In my Winnipeg practice, I use a joint-by-joint philosophy to ensure the shoulder isn’t just the “victim” of a stiff mid-back or weak scapular stabilizers.

We often combine this stretch with:

Chiropractic Care: To restore joint motion in the thoracic spine and shoulder girdle.
Athletic Therapy: For movement retraining and strengthening of the scapular stabilizers.
Ergonomic Modification: To change the environmental stressors that lead to the feeling of “tightness” in the first place.

Common Mistakes

Arching the back: This shifts the tension away from the chest and into the lumbar spine.
Forcing intensity: Over-stretching can cause the nervous system to “guard” or tighten up more.
Forward shoulder glide: Ensure the shoulder stays back and down; don’t let the head of the humerus dump forward.

Who Should NOT Do This Stretch?

Although the doorway stretch is safe for most people, it is not appropriate in every situation. Stretching should feel comfortable and controlled but not painful.

You should avoid or modify this stretch if you experience:

Sharp or Pinching Shoulder Pain

If lifting your arm or moving into the stretch causes sharp pain, catching, or pinching sensations, forcing the stretch may irritate sensitive tissues rather than help them.

Recent Shoulder Injury

Individuals recovering from a recent fall, dislocation, fracture, or acute injury should wait until movement has been assessed and guided appropriately.

Shoulder Instability or Repeated Dislocations

People who feel their shoulder is loose, unstable, or prone to slipping out of place may need strengthening and control exercises before performing chest stretches.

Numbness, Tingling, or Arm Symptoms

If the stretch causes tingling, numbness, or symptoms travelling down the arm, stop and seek assessment. These symptoms may indicate nerve sensitivity rather than muscle tightness.

Increasing Pain After Stretching

Mild stretching discomfort is normal, but symptoms should settle shortly afterwards. If pain worsens later in the day or the next morning, the stretch may need adjustment.

If you are unsure whether this exercise is appropriate, an assessment can help determine which movements are most beneficial for your specific situation.

When Stretching Isn’t Enough

Stretching alone may not resolve symptoms if underlying movement dysfunction exists.

Consider assessment if you notice:

Pain during the stretch
Persistent shoulder discomfort
Recurrent tightness despite stretching
Strength loss or instability
Limited overhead motion

A structured evaluation can identify whether joint restriction, motor control deficits, or loading patterns are contributing factors. Learn more about my available services or schedule an assessment if symptoms persist.

Book at Gelley Chiropractic

Book at Precision movement & therapies

Frequently Asked Questions

Does the doorway stretch help posture?

Yes. By reducing anterior chest tightness, the stretch can allow improved shoulder blade positioning, which supports more neutral posture when combined with strengthening exercises.

Can the doorway stretch cause shoulder pain?

It should not cause sharp or pinching pain. Discomfort may indicate improper positioning or an underlying shoulder condition requiring evaluation.

Should I stretch before or after exercise?

Both can be appropriate. Gentle mobility before activity prepares movement, while longer holds afterwards may assist recovery.

What muscles feel tight during this stretch?

Most people feel tension across the chest and front of the shoulder, particularly the pectoralis major and minor muscles.

Who should avoid this stretch?

Individuals with acute shoulder injuries or instability should modify or perform the stretch under professional guidance. Shoulder dislocations can occur in the position in those with a previously dislocated shoulder or shoulder instability

Summary

The doorway stretch is a simple yet powerful tool for improving shoulder mobility, reducing chest tightness, and supporting healthier movement patterns. When integrated into a comprehensive rehabilitation or training program, it can help restore balance between mobility and stability throughout the upper body.

Consistent performance combined with proper assessment and strengthening often produces the best long-term outcomes.

The post Doorway Stretch: Improve Shoulder Mobility and Reduce Chest Tightness appeared first on Dr Notley Chiropractic & Athletic Therapy | Winnipeg.

How to Get Off the Toilet With Back Pain (Without Making It Worse)

Dr Notley Chiropractor & Athletic Therapist in Winnipeg — Tue, 03 Mar 2026 15:27:00 +0000

Lower back pain when getting off the toilet is one of the most common movement complaints we see. If standing up from sitting triggers sharp pain or stiffness, the issue is usually mechanical — not that something is “out of place.”

The way you move during the sit-to-stand transition determines how much stress goes through your lumbar spine.

Understanding that mechanism makes it easier to correct.

Why Back Pain Happens When Getting Off the Toilet

When you sit on a low surface, your lower back moves into flexion (forward bending). To stand up, you lean forward, shift your weight over your feet, and extend through the hips and spine.

That transition moves the lumbar spine from flexion into extension under load.

Sitting increases disc pressure compared to standing, and deeper bending increases strain on posterior disc structures and surrounding tissues. If those tissues are sensitive, pain getting up from the toilet or a chair is common.

Many people notice lower back pain when standing up from sitting that eases after walking. When symptoms improve with movement, load sensitivity — often called flexion intolerance — is frequently involved.

Could It Be Something Else?

Not all sit-to-stand back pain is disc-related.

If pain increases when fully upright, extension-sensitive or facet-related irritation may contribute.

If pain is strongly one-sided and aggravated by uneven weight shifting, the sacroiliac joint can play a role.

A proper movement assessment differentiates lumbar disc irritation, facet sensitivity, sacroiliac involvement, and hip mobility restrictions.

How to Get On and Off the Toilet With Back Pain (Without Making It Worse)

How to Get Off the Toilet With Back Pain Safely

The problem is usually movement strategy, not the toilet itself. Rounding the lower back and pushing straight up increases shear and compression stress.Instead, use a controlled hip hinge to shift load into your legs.

Why the Hip Hinge Works

Reduces lumbar flexion stress
Shifts load into glutes and quadriceps
Improves balance and control
Decreases pain during sit-to-stand

This is the same strategy used in proper squatting and dead-lifting.

How to Sit Down With Lower Back Pain

Stand with feet slightly wider than hip-width
Push your hips back (not straight down)
Keep a neutral spine
Place hands on your thighs for support
Lower yourself slowly
Use a grab bar or counter if needed

Avoid collapsing into a rounded posture.

How to Stand Up Without Aggravating Your Back

Bring your feet underneath you
Shift your weight forward onto your feet
Maintain a neutral spine
Place hands on your thighs
Drive through your legs
Use a rail or support if needed

Shift the movement onto your hips. Control the transition. Drive through your legs.

Common Mistake

Rounding forward and pushing straight up from the lower back increases shear and compression forces on sensitized tissues.

Small Changes That Help Immediately

Raising the toilet seat reduces required flexion.
Using arm support decreases spinal load.
Slowing the movement improves control.
Avoid prolonged slouched sitting before standing.
If gentle extension movements reduce symptoms, perform them after longer sitting periods.

These adjustments do not resolve the underlying tolerance issue, but they reduce aggravation while capacity improves.

When to Seek Care

Seek urgent medical evaluation if you experience progressive leg weakness, significant numbness, loss of bowel or bladder control, fever, unexplained weight loss, or recent trauma.

If your back pain when getting off the toilet persists, a structured movement assessment can determine whether the driver is discogenic, facet-related, sacroiliac, or hip-based.

At our clinic, we combine chiropractic and athletic therapy to correct movement strategy and progressively rebuild load tolerance so daily transitions like standing from sitting are no longer painful. Learn more about our approach to low back pain treatment in Winnipeg here: [internal link].

The Bottom Line

Back pain when standing up from the toilet most often reflects reduced tolerance to flexion under load. It does not automatically mean your spine is unstable or damaged.

Modify the movement strategy.
Shift load into the hips.
Build capacity.

If symptoms persist, they can be assessed and improved.

Book an evaluation and we will identify the pain driver, correct the pattern, and progressively rebuild your tolerance.

Book at Gelley Chiropractic

Book at Precision movement & therapies

FAQ

Is it bad to sit on the toilet with back pain?

Sitting puts more stress on the irritated tissues. Lessening how long you are sitting helps reduce the irritation. This is not limited to sitting on toilets.

What if I don’t have strong legs?

sing hand support (grab bars, counter, sink) reduces load while you build strength. Progressive strengthening of glutes and quads is recommended.

Should I lean forward when standing up?

Yes — but from the hips, not the spine. Leaning forward shifts your centre of mass over your feet, making standing easier and safer.

Does a raised toilet seat help?

Yes. Increasing seat height reduces required hip and knee flexion, decreasing lumbar stress — especially helpful in acute pain phases.

Is this safe for disc injuries?

Neutral spine hip hinging typically reduces disc irritation compared to lumbar flexion. However, tolerance varies by individual presentation.

The post How to Get Off the Toilet With Back Pain (Without Making It Worse) appeared first on Dr Notley Chiropractic & Athletic Therapy | Winnipeg.

Cervical Radiculopathy Treatment Guide

Dr Notley Chiropractor and Athletic Therapist in Winnipeg — Mon, 19 Jan 2026 04:41:41 +0000

Cervical Radiculopathy Treatment in Winnipeg: Your Complete Recovery Guide

Expert Chiropractic Care for Pinched Nerves & Neck Pain Radiating Down the Arm

If you’re dealing with neck pain that shoots down your arm, numbness in your fingers, or weakness in your hand, you might have cervical radiculopathy—a pinched nerve in the neck. At our Winnipeg chiropractic clinic, Dr. Christopher Notley provides treatment based on current research that helps most patients recover without needing surgery.

Local Cervical Radiculopathy Treatment

Serving Winnipeg, Manitoba and surrounding areas, our clinic combines gentle chiropractic adjustments, cervical traction therapy, targeted exercises, and patient education to help you recover faster and prevent your symptoms from coming back.

Location: Winnipeg, MB | Serving: Greater Winnipeg area including St. Vital, Fort Garry, River Heights, Transcona, and surrounding communities

Here’s something that might surprise you: The size of your disc herniation on an MRI doesn’t predict how bad your symptoms will be or how well you’ll recover. New research from December 2025 shows that inflammation matters far more than the size of the bulge. This is good news—it means you can get significantly better with the right treatment, even if your MRI looks concerning.

What’s Happening in Your Neck?

A pinched nerve in the neck (cervical radiculopathy) happens when one of the nerve roots in your cervical spine becomes irritated or compressed. About 5-6 people per 1,000 experience this condition, most commonly from a disc herniation or age-related changes in the spine.

Common symptoms include:

Sharp or burning neck pain
Pain traveling down your shoulder and arm (following a specific pathway)
Numbness, tingling, or “pins and needles” in your arm, hand, or fingers
Weakness in your arm, shoulder, or hand
Reduced grip strength
Symptoms that get worse with certain neck positions

The Inflammation Connection: Why Your MRI Might Not Tell the Whole Story

For years, doctors assumed that larger disc herniations caused worse symptoms. A big bulge on your MRI meant severe pain. A small one meant mild symptoms. This seemed to make sense.

But recent research shows this isn’t true.

December 2025 Study: Researchers examined 206 patients with cervical radiculopathy and found no connection between the size of their disc herniation on MRI and the severity of their symptoms. More importantly, herniation size didn’t predict recovery—regardless of whether patients chose surgery or conservative treatment. The key finding? Inflammation, not just mechanical pressure, is what drives your symptoms.

We often think of nerve pain as purely mechanical—like stepping on a garden hose. But research shows that inflammation and your immune system’s response cause most of your symptoms. This is actually great news for patients seeking conservative treatment. It means therapies that reduce inflammation and help nerves heal can work extremely well, even if your MRI “looks bad.”

Key Takeaway: Your symptoms can improve dramatically even if a follow-up MRI still shows a disc herniation. The size of the bulge doesn’t determine your outcome—proper treatment and your body’s healing response do.

Recovery Timeline: What to Expect

Good news: With appropriate care, most cervical radiculopathy patients improve without surgery

Initial improvement: Many patients notice meaningful relief within 6-12 weeks

Continued recovery: Significant improvement typically happens within 4-6 months

Full recovery: Can take up to 24-36 months, but most daily activities can resume much sooner

Reality check: Recovery isn’t a straight line. Some days will be better than others—this is completely normal. Setbacks don’t mean you’re back to square one.

📋 Your Recovery Action Plan: Start Here

Try the arm-on-head test: Rest your affected arm on top of your head. Does this reduce your arm pain? If yes, you’re likely a good candidate for traction therapy.
Fix your desk setup TODAY: Screen at eye level, supportive chair, keyboard close enough to avoid reaching
Use ONE supportive pillow tonight—not too high, not too flat
Take movement breaks every 30-45 minutes if you work at a desk
Keep your neck warm during cold Winnipeg weather
Book your assessment with Dr. Notley to get a personalized treatment plan

What Affects Your Recovery?

Recovery isn’t just about your spine—it’s about you as a whole person. Understanding what influences healing helps you take an active role in getting better.

Your Body

How long you’ve had symptoms: Earlier treatment generally means faster recovery
Overall health: General fitness and other health conditions
Sleep quality: Poor sleep slows healing and increases pain sensitivity
Smoking: Impairs disc healing and reduces blood flow to nerves
Physical conditioning: Strength, flexibility, and movement habits

Your Mind

Understanding your condition: Knowledge reduces fear, which directly improves outcomes
Positive expectations: Believing you can get better correlates with actually getting better
Stress management: Chronic stress increases inflammation and pain
Movement confidence: Fear of movement can prolong recovery
Coping strategies: How you respond to pain and setbacks matters significantly

Your Life

Work demands: Physical requirements and ability to modify tasks temporarily
Workplace setup: Desk height, screen position, chair support
Social support: Support from family, friends, and healthcare providers
Activity pacing: Balancing activity with rest
Winter considerations: Cold weather can affect activity levels and pain

Why this matters: Many of the most important factors are within your control. You’re not passive in this process. Dr. Notley addresses all these factors when creating your personalized treatment plan.

Managing Your Symptoms Daily

What Usually Makes Symptoms Worse?

Looking up: Tilting your head back for prolonged periods (painting ceilings, changing light bulbs)
Overhead activities: Reaching above shoulder height
Forward head posture: Common during desk work, computer use, phone scrolling
Increased spinal pressure: Coughing, sneezing, straining, heavy lifting
Poor sleep positions: Too many pillows, stomach sleeping
Staying in one position too long: Even “good” positions become problematic
Cold exposure: Cold weather increases muscle tension—dress warmly
High stress: Stress tenses muscles and sensitizes pain pathways

What Usually Provides Relief?

Quick Self-Test: Rest your affected arm on top of your head, or gently pull upward on your neck (like giving yourself a gentle stretch). Does this reduce your arm symptoms? If yes, decompression treatments like cervical traction will likely help you.

Arm positioning: Resting your arm on your head or in an elevated, supported position
Gentle stretching: Light decompression that creates space for the irritated nerve
Optimal sleep posture: One supportive pillow that keeps your neck neutral
Movement within comfort: Gentle movement in pain-free directions
Activity pacing: Balancing activity with rest
Stress reduction: Deep breathing, meditation, progressive muscle relaxation
Heat therapy: Especially helpful during winter for muscle tension
Ice therapy: For acute flare-ups, apply 15-20 minutes
Posture awareness: Maintaining neutral neck alignment during daily activities

Treatment Options That Actually Work

Multiple treatment approaches have strong research support for cervical radiculopathy. At Dr. Notley’s clinic, we combine several proven therapies tailored to your specific condition. Research shows that with appropriate care, outcomes can be very favorable.

Clinical Guidelines Support Conservative Care

Our treatment approach follows established guidelines from leading organizations:

North American Spine Society: Recommends conservative care including manual therapy, exercise, and patient education as first-line treatment
American College of Radiology: Emphasizes clinical diagnosis and conservative care before imaging or surgery
International Evidence: Systematic reviews consistently support multimodal conservative treatment

Recommended Timeline: Guidelines suggest 6-12 weeks of appropriate conservative care before considering more invasive options. Most Winnipeg patients see meaningful improvement within this timeframe.

1. Chiropractic Manual Therapy

Gentle hands-on techniques restore normal movement to your neck and upper back, reduce muscle tension, and may help decrease inflammation around the affected nerve.

Research Evidence: Studies show significant improvement in appropriately selected cervical radiculopathy cases with gentle spinal manipulation and soft tissue therapy, particularly when combined with exercise. Recent 2025 reviews confirm that manual therapy produces statistically significant improvements in both pain and disability.

Treatment Includes:

Gentle cervical adjustments: Restores normal joint movement and reduces nerve irritation
Soft tissue therapy: Addresses muscle tension and trigger points in neck and shoulder muscles
Joint mobilization: Gentle movement techniques for stiff joints
Myofascial release: Releases tension in muscles and connective tissue

Typical Plan:

Initially 2-3 visits per week for 2-4 weeks, then reducing as you improve. Most patients see meaningful improvement within 6-12 visits when combined with home exercises.

2. Cervical Traction Therapy

Mechanical cervical traction gently stretches your neck, creating space between vertebrae. This reduces pressure on the affected nerve and decreases inflammation. Particularly effective for disc-related problems.

Clinical Indicator: If the self-test mentioned earlier (resting arm on head or gentle upward neck pull) provides relief, you’re likely a good candidate for traction therapy.

Research Evidence:

Recent Reviews: Multiple 2024-2025 analyses show that mechanical cervical traction produces statistically significant improvements in pain and function. Benefits are most pronounced when traction combines with other therapies (manual therapy and exercise) rather than being used alone. The multimodal approach we use maximizes your outcomes.

How It Works:

Mechanical cervical traction: Gentle, controlled decompression of your neck
Typical protocol: 10-20 minutes per session, 2-3 times per week
Progressive approach: Starting with light force (10-15 pounds) and adjusting based on your response
Home traction options: Sometimes recommended for continued improvement

What to Expect:

Many patients feel “taller” or experience a sense of relief during and after treatment. Effects are typically cumulative—you’ll notice gradual improvement over several sessions rather than instant dramatic relief.

3. Therapeutic Exercise

Targeted exercise therapy is the most important component for long-term recovery and preventing recurrence. Exercise reduces inflammation, improves nerve mobility, strengthens supporting muscles, corrects posture, and builds confidence in your neck’s ability to move normally.

Research Evidence: Exercise therapy consistently shows superior outcomes for neck pain and cervical radiculopathy in systematic reviews and clinical trials. Benefits include significant pain reduction, functional improvement, and long-term prevention of recurrence. Exercise receives the highest level of evidence rating from the North American Spine Society and demonstrates not only statistical significance but clinical significance—meaning patients notice real, meaningful improvements in their daily lives.

Types of Exercise Dr. Notley Prescribes:

Deep Neck Flexor Strengthening

Targets the small stabilizing muscles in the front of your neck
Helps maintain proper neck posture and reduces strain on discs
Often performed lying down with gentle chin tucks and progressive holds
Critical for long-term neck health, especially for office workers
Learn more about our rehabilitation exercise programs

Nerve Mobility (Neural Gliding) Exercises

Gentle movements that help the nerve slide freely through surrounding tissues
Reduces nerve adhesions and improves mobility
Must be performed gently within pain-free ranges
Should not increase arm symptoms—if they do, stop and consult Dr. Notley

Postural Correction Exercises

Addresses forward head posture and rounded shoulders common in desk workers
Includes upper back extension exercises
Shoulder blade retraction and stabilization drills
Reduces chronic strain on the neck

Scapular Stabilization & Strengthening

Strengthens shoulder blade muscles to support proper neck mechanics
Includes exercises like rows, “W” exercises, and shoulder blade squeezes
Creates a stable foundation that reduces compensatory neck strain

Exercise Guidelines:

Frequency: 3-5 times per week for best results
Duration: Minimum 4-6 weeks, with progressive advancement
Repetitions: Typically 10-15 reps per exercise, or time-based holds (10-30 seconds)
Progression: Start gently and gradually increase difficulty as symptoms improve
Golden rule: Exercises should not significantly increase arm pain. Some muscle soreness is normal, but sharp or radiating pain means you need to modify

4. Patient Education & Self-Management

Understanding your condition and having practical strategies to manage it empowers you and directly improves outcomes. This isn’t just about feeling informed—research shows that education actually improves clinical results.

Research Evidence: Active self-management strategies combined with professional care produce the best long-term outcomes. Education reduces fear-avoidance behaviors and improves treatment compliance.

Self-Management Strategies:

Sleep Optimization

Use one supportive pillow that keeps your neck neutral (not too high, not too flat)
Side sleeping or back sleeping preferred (avoid stomach sleeping)
Consider a cervical pillow with contoured support
Mattress should provide adequate support without being too firm

Workplace Ergonomics

Computer screen at eye level (top of screen at or slightly below eye level)
Chair with proper lumbar and upper back support
Keyboard and mouse positioned to avoid reaching
Take regular breaks every 30-45 minutes to move and stretch
Consider a document holder if you reference papers frequently
Phone headset or speakerphone to avoid cradling phone between ear and shoulder

Activity Pacing

Balance activity with rest to avoid symptom flare-ups
Break larger tasks into smaller segments with rest breaks
Avoid prolonged positions (even “good” positions can become problematic)
Gradually increase activity tolerance rather than boom-bust cycles

Winter Self-Care

Keep your neck warm with scarves during cold weather
Be cautious on icy surfaces—falls can aggravate symptoms
Maintain activity levels despite shorter days
Consider indoor exercise options during extreme cold

5. Additional Therapies

Acupuncture

Research Evidence: Systematic reviews show that acupuncture provides statistically significant pain relief for neck pain and cervical radiculopathy, with effects that can last several months.

Typically performed 1-2 times per week for 4-6 weeks initially
Often combined with electroacupuncture for enhanced effect
May help reduce the need for pain medications
Generally well-tolerated with minimal side effects

Anti-Inflammatory Approaches

Since inflammation plays a dominant role in cervical radiculopathy:

Medications: NSAIDs (ibuprofen, naproxen) or other anti-inflammatories as recommended by your doctor
Lifestyle factors: Sleep quality, stress management, and diet all influence inflammation
Anti-inflammatory diet: Omega-3 fatty acids, colorful vegetables, fruits, limiting processed foods
Natural approaches: Curcumin, ginger, and other natural anti-inflammatory compounds (discuss with Dr. Notley)

Why Combining Treatments Works Best

One of the most consistent findings in cervical radiculopathy research is that combining several proven therapies produces better outcomes than any single treatment used alone.

Research-Backed Combinations

What the Evidence Shows:

Manual therapy + Exercise = Superior outcomes to either alone
Cervical traction + Manual therapy + Exercise = Optimal pain and functional improvement
Patient education + Active treatment = Better long-term outcomes and lower recurrence
Early intervention with multimodal care = Faster recovery and reduced chronicity risk

Dr. Notley’s Approach: We combine gentle chiropractic adjustments, targeted soft tissue work, cervical traction when indicated, progressive therapeutic exercises, and comprehensive patient education. This aligns with the highest quality evidence and clinical practice guidelines.

Clinical Guideline Recommendation: The North American Spine Society and international guidelines recommend 6-12 weeks of appropriate multimodal conservative care before considering more invasive interventions. Research shows that most patients experience meaningful improvement within this timeframe, and many achieve complete or near-complete resolution.

When to Consider Additional Medical Help

While most cervical radiculopathy cases respond well to conservative chiropractic care, it’s important to recognize when additional medical evaluation may be appropriate.

Red Flags Requiring Immediate Medical Attention

Seek immediate medical evaluation if you experience:

Progressive or sudden severe weakness in your arm or hand (inability to lift arm, grip objects, or perform basic movements)
Loss of bowel or bladder control
Difficulty walking or loss of coordination
Symptoms in both arms simultaneously
Severe, unrelenting pain not relieved by any position or treatment
Fever, unexplained weight loss, or night sweats accompanying neck/arm pain
History of cancer, recent significant trauma, or IV drug use

These symptoms may indicate more serious conditions requiring urgent medical intervention.

When Conservative Care May Not Be Enough

Consider consultation with a spine specialist or orthopedic surgeon if:

No improvement after 6-12 weeks: Guidelines suggest this timeframe for appropriate conservative care trial
Functional disability: Inability to perform essential work or daily activities despite treatment
Progressive neurological deficit: Gradual worsening of weakness or numbness despite treatment
Severe, disabling pain: Pain that significantly impairs quality of life and doesn’t respond to conservative measures

Dr. Notley’s Approach: We maintain collaborative relationships with orthopedic specialists and neurosurgeons. If your condition requires additional evaluation or intervention beyond conservative care, we’ll ensure you receive appropriate referrals and coordinate your care.

Advanced Treatment Options (Provided by Medical Specialists)

If conservative chiropractic care doesn’t provide adequate relief, your medical doctor or spine specialist may consider:

Cervical epidural steroid injections: Performed by pain management specialists, these can provide temporary relief for some patients with persistent symptoms
Surgical decompression: Performed by orthopedic surgeons or neurosurgeons for cases with progressive weakness, severe unrelenting symptoms, or failure of comprehensive conservative care
Advanced imaging: MRI to better visualize disc herniations, nerve compression, or other structural issues
Prescription medications: Stronger pain medications, muscle relaxants, or nerve pain medications

Important Note: These advanced interventions are provided by medical doctors, not chiropractors. Dr. Notley maintains collaborative relationships with specialists to ensure you receive appropriate referrals when needed. However, research shows conservative chiropractic care is successful for the majority of patients, and more invasive interventions are typically reserved for the small percentage who don’t respond to non-surgical treatment.

Ready to Start Your Recovery?

Dr. Christopher Notley’s clinic specializes in research-backed treatment for cervical radiculopathy and pinched nerves. Using proven approaches including gentle chiropractic care, cervical traction, therapeutic exercise, and comprehensive patient education, we help you recover faster and prevent recurrence.

Don’t let neck and arm pain control your life. Schedule your consultation today.

Book Your Appointment Learn More About Dr. Notley

What to Expect at Your First Visit

Comprehensive Assessment: Dr. Notley will perform a thorough clinical examination to accurately assess your condition and determine if chiropractic care is appropriate for you
Personalized Treatment Plan: Based on your examination findings, goals, and lifestyle, we’ll create a customized treatment approach
Clear Education: You’ll understand your condition, what’s causing your symptoms, and realistic recovery timelines
Same-Day Treatment: In most cases, we’ll begin gentle treatment during your first visit
Home Exercise Guidance: You’ll receive specific exercises and self-management strategies to accelerate your recovery
Collaborative Care: If additional medical evaluation is needed, Dr. Notley will provide appropriate referrals to medical specialists

Can a pinched nerve in my neck cause permanent damage if I don’t treat it?

In most cases, no. A pinched nerve in the neck usually improves with the right care. For many people, the nerve is irritated by inflammation rather than being permanently damaged. That said, symptoms that keep getting worse, especially increasing weakness, loss of grip strength, or ongoing numbness, should be checked sooner rather than later. Getting assessed early in Winnipeg allows you to start treatment that supports nerve healing and reduces the risk of long-term problems.

Can I keep working or exercising with cervical radiculopathy?

Yes, most people can and should stay active. Complete rest often slows recovery. The goal is to modify what you do, not stop moving altogether. Many Winnipeg patients continue working, training, or exercising with adjustments to posture, loads, and positions. Activities should not significantly worsen arm pain or numbness. Dr. Notley helps you figure out what is safe to keep doing and what needs to be temporarily changed while you heal.

Why does my arm hurt more than my neck?

This is very common with a pinched nerve in the neck. Even though the problem starts in the cervical spine, pain is often felt in the shoulder, arm, or fingers. This happens because the irritated nerve sends pain signals along its pathway. For many people, arm pain improves before neck stiffness fully settles, which is a normal part of recovery.

Scientific References

Gül A, Yang X, Goedmakers CMW, Vleggeert-Lankamp C. Does the Size of Cervical Disc Herniation Affect Clinical Parameters in Cervical Radiculopathy? J Clin Med. 2025;14(24):8900. doi:10.3390/jcm14248900. PMID: 41464802. https://pubmed.ncbi.nlm.nih.gov/41464802/
Radhakrishnan K, Litchy WJ, O’Fallon WM, Kurland LT. Epidemiology of cervical radiculopathy. A population-based study from Rochester, Minnesota, 1976 through 1990. Brain. 1994;117(2):325-335. doi:10.1093/brain/117.2.325. PMID: 8186959. https://pubmed.ncbi.nlm.nih.gov/8186959/
Kjaer P, Kongsted A, Ris I, et al. National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy. Eur Spine J. 2020;26(9):2242-2257. doi:10.1007/s00586-017-5121-8. PMID: 32710604. https://pubmed.ncbi.nlm.nih.gov/32710604/
Bono CM, Ghiselli G, Gilbert TJ, et al. An evidence-based clinical guideline for the diagnosis and treatment of cervical radiculopathy from degenerative disorders. Spine J. 2011;11(1):64-72. doi:10.1016/j.spinee.2010.10.023. PMID: 21168100. https://pubmed.ncbi.nlm.nih.gov/21168100/
Iyer S, Kim HJ. Cervical radiculopathy. Curr Rev Musculoskelet Med. 2016;9(3):272-280. doi:10.1007/s12178-016-9349-4. PMID: 26971891. https://pubmed.ncbi.nlm.nih.gov/26971891/
Engquist M, Löfgren H, Öberg B, et al. Surgery versus nonsurgical treatment of cervical radiculopathy: a prospective randomized study comparing surgery plus physiotherapy with physiotherapy alone with a 2-year follow-up. Spine. 2013;38(20):1715-1722. doi:10.1097/BRS.0b013e31829ff095. PMID: 30583108. https://pubmed.ncbi.nlm.nih.gov/30583108/
Woods BI, Hilibrand AS. Cervical radiculopathy: epidemiology, etiology, diagnosis, and treatment. J Spinal Disord Tech. 2015;28(5):E251-E259. doi:10.1097/BSD.0000000000000284. PMID: 24614255. https://pubmed.ncbi.nlm.nih.gov/24614255/
Caridi JM, Pumberger M, Hughes AP. Cervical radiculopathy: a review. HSS J. 2011;7(3):265-272. doi:10.1007/s11420-011-9218-z. PMID: 21886529. https://pubmed.ncbi.nlm.nih.gov/21886529/
Abbed KM, Coumans JV. Cervical radiculopathy: pathophysiology, presentation, and clinical evaluation. Neurosurgery. 2007;60(1 Supp1 1):S28-S34. doi:10.1227/01.NEU.0000249223.51871.C2. PMID: 17204882. https://pubmed.ncbi.nlm.nih.gov/17204882/

Note: All references have been verified through PubMed and include PMID (PubMed ID) numbers for verification. This ensures the accuracy and reliability of the scientific evidence cited in this guide.

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