Neck Pain Treatment
The neck is a very important part of the body that allows for three-dimensional movement of the head, as well as providing an anchor for muscles of the shoulder region. The neck has many specialised muscles and its control is closely linked to vision, the control of balance and the initiation of movement of the head, upper limb and the whole body. The neck structures are very strong and are capable of tolerating large compressive forces via the upper limbs, such as lifting heavy weights. The neck structures also protect the spinal cord, exiting nerves that travel to the upper limbs as well as blood vessels that supply the head and brain. Because of this, there are lots of nerve receptors that inform and guard this important region of the body.
The health of the neck and surrounding structures is maintained through regular relaxed movement and maintaining the strength of the neck and upper limb muscles, as well as caring for general physical and psychological health. This includes, engaging in regular physical activity, maintaining healthy body weight, good sleep habits, as well as managing stress and mood.
What is neck pain?
Neck pain is a term that relates to pain around the front, sides and back of the neck. Neck pain can sometimes coincide with pain being referred between the shoulder blades and down the arm/s and into the head. It can affect up to 70% of people at some time in their lives. For some, neck pain can be scary and very disabling. It can negatively impact on many aspects of a person’s life, including activities of daily living such as dressing, sleeping, being physically active and working. It can also affect a person’s ability to concentrate, their balance and use of the upper limbs. This can in turn impact on a person’s psychological and physical health.
Common diagnostic labels for neck pain are whiplash, cervicogenic headache, degenerative disc disease, neck arthritis, disc bulges and prolapses, canal stenosis, cervical radiculopathy and cervico-brachial pain.
Risk factors for neck pain:
Neck pain can develop as a result of a strain/injury such as whiplash, sudden movement or a blow to the head. More commonly it can develop from sustained and or repeated postural loading of neck and shoulders in combination with other factors such as chronic stress, poor sleep, anxiety, depressed mood, deconditioning and inactivity. This can result in sensitive muscles, joints and/or nerves in the neck, muscle tension and neck stiffness.
Myths about neck pain:
✖ Neck pain is always caused by damage and wear and tear
✖ Neck pain means a scan is always required
✖ Neck pain is caused by poor posture
✖ Neck pain means a joint is out of place
✖ It’s dangerous to extend and twist the neck if it hurts
✖ Movements and activities that provoke neck pain should be avoided
✖ Disc protrusions and spinal stenosis need surgery
Facts about neck pain:
✔ Neck pain is rarely caused by tissue damage
✔ Unless there has been a traumatic injury or a loss of sensation and power in the arms, scanning for neck pain is not usually needed
✔ ‘Wear and tear” such as disc degeneration, arthritis, disc bulges is common in people without neck pain even in young people
✔ Necks don’t go out of place
✔ There is no one posture that prevents or reduces neck pain
✔ Neck pain is commonly caused by factors such as stress, muscle tension, a neck strain, poor sleep, inactivity and depressed mood. These factors can make the neck structures sensitive to touch and to move
✔ Learning to relax the neck and engage in neck movement in all directions is safe and can help reduce neck pain
✔ Managing stress, tension, mood and sleep as well as engaging in regular physical activity can reduce neck pain
✔ Surgery is rarely needed for neck pain and most disc protrusions shrink over time.
If neck pain is associated with a traumatic injury – such as a heavy blow to the head, scanning may be required.
When neck pain is associated with arm pain, arm weakness and numbness of the skin, medical attention and scanning may be required.
Most neck and arm pain episodes, even when severe, settle down within 2 to 12 weeks. For a small group neck pain +/- arm pain can become persistent, distressing and disabling. The causes for ongoing pain persistence usually relate to things such as becoming frightened and protective of the neck, movement and activity avoidance, ongoing stress, worry and a negative mindset towards the pain. These factors make the neck muscles tense and the neck structures hypersensitive.
Assessment of neck pain:
There is strong evidence that physiotherapy is effective as first-line treatment of most neck pain, neck and arm pain, neck-related headaches and persistent neck pain.
It is first important to undertake a comprehensive history in order to hear your story, how the pain began and how it impacts on all aspects of your life.
We screen for serious causes of neck pain.
We will then perform a comprehensive examination of your head, neck, upper limbs and surrounding structures. This includes assessment of: the sensitivity of the structures to touch, movement and load; the mobility of the neck, trunk and upper limbs; and the ability to relax the muscles of the neck and shoulder girdle. Assessment of balance, eye movement as well as strength and endurance of the neck and upper limbs may also be performed. We are most interested in the postures and activities that you find limiting.
Treatment of neck pain:
Based on all this information we will then explain to you in simple language, where the pain is coming from, the factors that are contributing to your neck pain, and discuss the best treatment options available to you.
If your pain is acute (sudden onset), the key is to help you to get comfortable and moving as this helps with recovery. This may involve some hands-on treatment and gentle home exercises. We will also identify the factors that caused neck pain and make a plan to prevent it in the future.
If your pain is persistent (longer than 6-12 weeks), we will work out a plan with you to help you take control of your pain and get back to living based on your goals.
Treatment often involves learning to relax tense muscles, regaining neck mobility if restricted, a graduated strengthening exercise program, and a plan to get you physically active based on your preference. It’s really important to get you fit, confident and strong as this results in pain relief and increased functional capacity.
Other strategies known to be effective in treating neck pain include improving sleep, stress management and engaging in regular physical activity. In some cases where neck pain is distressing and disabling, working with other health care practitioners is important.
We will identify your goals and ensure the treatment plan is directed towards these.
At Body Logic Physiotherapy we are not interested in ongoing “band-aid treatments”. We know that the best way to manage neck pain is to help you understand why you have pain, having a treatment plan to address these factors and get you back in control, moving, active and living again.
For some people this may take 2-3 sessions, however, for others this may take up to 7-10 sessions over a 3-4 month period. We also offer supervised exercise rehabilitation classes and one-to-one sessions to support this process if needed .