Neck pain is a common condition that presents to physiotherapy clinics. 54% of the population have experienced neck pain in the last six months and the incidence of neck pain is increasing due to more sedentary occupations.
Most patients with neck pain are classified as being non-specific, where no structural cause can be identified. Dysfunction of the joints in the neck can cause referred pain. For example, dysfunction in the upper three joints in the neck can cause pain referral into the head (known as a cervicogenic headache). The lower three joints can cause pain referral into the shoulder blade or across the top of the shoulder.
In severe neck conditions, compression of the nerves in the neck can result which causes arm pain and tingling/numbness into the arm or hand. This condition is called a cervical radiculopathy and commonly occurs in the lower neck nerves as this area is vulnerable to wear and tear.
Research has shown that people with neck pain have deficits in the deep muscles at the front and back of the neck and clinical trials support re-training these muscles in patients with neck pain. Research has also confirmed that due to the deep muscles becoming weak the superficial muscles become overactive.
Imaging such as x-rays or MRI scans may be warranted but the majority of neck conditions do not require investigations.
Physiotherapy management consists of firstly assessing the cause of the neck pain. Mobilisation or manipulation of the neck joints may be used to restore normal movement. The muscles around the neck are assessed for strength and endurance and may need strengthening with specific exercises. Neck traction is often used for nerve root compression or radiculopathy to offload the irritated nerve and this can be very effective at relieving arm pain. Poor posture can be a major contributor to neck pain, hence postural re-training is often used to correct spinal alignment. Other techniques such as Mulligan techniques and taping are often used as additional treatment options.
All Physica staff receive extra training on the assessment and management of neck pain. We will perform a function specific assessment and address all contributing factors related to your neck pain. This allows us to develop an individualised management programme and return you to optimal health as soon as possible.
5 tips you must know about neck pain;
- Poor posture is a major contributor to neck pain. When sitting at your desk ensure your ears are aligned with your shoulders to prevent excess strain on the neck. Your lower back shoulder be slightly arch and having your resting on arm supports further helps to reduce neck strain
- Check your pillow. An old pillow will not support your neck. In side-lying, if your nose is not aligned with your sternum, your pillow is not supporting your neck.
- Check your work-station. Incorrect work station set-up can contribute to neck pain. You should look directly ahead at your screen, prolonged looking down or cervical protraction (poking your chin forward) can adversely load the neck.
- Consider neck strengthening. As mentioned in the previous article, there is a large body of evidence demonstrating changes within the neck muscles in patients with neck pain and headache
- Physical activity and Pause Gymnastics. The more you move the better your neck will function. We are designed to move and hence long periods of sustained sitting at a desk places abnormal stress on the neck. ‘Motion is lotion’, think about doing a three minute neck routine to break up prolonged sitting, such as – neck rotations, shoulder rolls and trunk twists.