Neck pain is debilitating. Whether we use our necks to talk to people in meetings, play with our children, blind spot checking while driving or playing sport. We use our neck to do important tasks.
30% of patients with neck pain will develop chronic symptoms
37% of individuals who experience neck pain will report persistent problems for at least 12 months.
What is it?
When terming neck pain, there is a myriad of neck pathologies that may be present. Some severe and others less sinister, however have the potential of transpiring into something more severe and painful. Some of the common specific injuries include Pseudo-Torticollis, facet sprains, Cervical Radiculopathy (Pinched Nerve) and whiplash.
However, it is convenient to generalise mechanical neck pain to a dysfunctional muscle (or chain of muscles) an/or a facet joint issue. Muscle and the skeletal range of motion are complimentary. Often, if there is a chronic limitation and pain due to restricted neck range of motion, there is also adaptive shortening of the muscle which may exacerbate the pain. Conversely, if there is an adaptively shortened muscle, it may lead to a reduced range of motion and facet arthropathy (degenerative changes in the facet joint due to an uneven distribution of weight)
In short, the core of the problem needs to be identified and remedied before the pain progresses any further.
Signs and Symptoms
- Reduced range of motion or pain at end range movements
- Intense localised pain
- Radiating pain
- Neurological pain (sharp, pins and needles/lancinating pain, weakness, numbness down arm)
- Referred headaches
- > 35 years old.
- Postural deficit – 10 to 21% greater by being an office worker!
- Living in metropolitan urban areas
- Heavy lifting and repetitive movements
- Stress, lacking job support/control and job insecurity
The solution to neck pain and specifically chronic mechanical neck pain often an arduous process. It isn’t just rectifying and giving temporary relief to the muscle and skeletally the facet joints of the neck. But there also has to be an implementation of the education on what actions or tasks are precipitating the problem.
At the clinic, we will need to understand:
- A thorough neck history
- Assessment of the neck and surrounding areas for range of motion
- restrictions and muscle tension
- provocation special testing to establish which structure is causing your pain
We will then:
- Offer management strategies and prophylactic strengthening programs specific to your injury
- Education and advice on modification of activities of daily living to ensure that the pain is solved and does not reoccur.
One early strategy for acute neck pain of muscular origin includes:
Chin tucks 1 x 10 every hour
Levator scapulae stretch (holding for 10 seconds) 1 x 5 every hour
Active left and right head turns to end of range 1 x 10 every 2 hours (within painless limits)
Medication and icing within the early days of acute pain if pain is consistently >7/10
Although all patients will have a different degree of neck pain and will improve at their own pace, neck pain is a complicated injury that requires investment and time to completely rectify. In order to holistically treat your neck pain, it is ideal that professional help and advice is sought to address maladaptive issues and dysfunctional tasks that may lead to chronic neck pain.
Article by Joshua Shum (Physiotherapist)