Neck Pain

By Osteopath Ella Meehan

Neck pain can be a painful, frustrating and even frightening experience. It can be acute (sudden) or chronic (long lasting) and can occur for various reasons. There are many treatment options available to help you overcome your pain, and restore your mobility and function. This blog will discuss the reasons we experience neck pain, and the strategies we can employ to overcome it.  

Anatomy of the neck:

The neck, also known as cervical spine, is made up of 7 vertebrae. Between each vertebrae there are discs. Surrounding and supporting the joints are various ligaments. Muscles attach to various parts of the cervical spine, creating movement of the neck. Weaving in and around the cervical spine are important blood vessels and nerves.  

Why should I get my neck pain checked?

It is important to get neck pain investigated by a trained health professional, as sometimes serious pathologies present as musculoskeletal problems. Sometimes problems with the heart, lungs, blood vessels and other organs can produce neck pain symptoms, therefore it is important to have serious conditions screened for and excluded before you assume the neck pain is harmless.  

 

What musculoskeletal elements are causing my neck pain?

Neck pain can be caused by injury to the discs, joints, ligaments, nerves, and muscles. 

Acute (sudden) neck pain can be caused by minor or major trauma. Chronic (long lasting) neck pain is when the complaint has persisted for 6 or more months. Chronic neck pain can be caused by prior injury (i.e minor or major trauma) that is maintained by lifestyle factors (for example: lack of regular exercise, long work hours, repetitive movements). Pain can also be caused by degeneration where the structure of the bones and joints change as a result of wear and tear due to overuse or older age. 

Minor trauma refers to situations where the neck is under strain, for example: 

  • Sitting at a desk or in a car for prolonged periods 
  • Sleeping in an awkward or uncomfortable position 
  • Trying a new exercise or job where the body is unaccustomed to the movement 

Major trauma refers to situations where the neck is more seriously damaged, for example: 

  • Motor vehicle accident 
  • Diving accident – hitting the bottom of a pool or rock  
  • High speed contact sports where head collisions occur 

The mechanism of injury (i.e. the way the injury came about) as well as the nature and pattern of your pain provides clues as to what structures could possibly be affected. Sometimes neck pain can also radiate into the upper back, shoulders and arms, can contribute to headaches, and can cause numbness and tingling in the upper limbs. The source of the pain may be due to muscle spasm, joint sprain, disc bulge, disc degeneration, arthritis, nerve impingement, and other spinal conditions. Assessment of your range of motion and tenderness adds to the clinical picture to form a diagnosis. Sometimes imaging is necessary to examine the neck more closely, but this is not always the case.  

How do I overcome neck pain?

Exercise 

Research from Sterling and colleagues (2019) suggests exercise is an effective way to manage neck pain. Strengthening the neck and upper back, improving muscle control, and engaging in aerobic exercise (such as brisk walking, jogging, cycling, and swimming) are all beneficial in the treatment of neck pain to help improve mobility and function. Importantly, exercise has a hypo-analgesic effect, meaning it decreases our sensation and perception of pain.  

Manual therapy 

Research from Verhaeghe and colleagues (2018) demonstrates osteopathic treatment has been shown to help improve pain and function in patients suffering from neck pain. Further, research from Sterling and colleagues (2019) suggests combining physiotherapy with psychological interventions is effective in helping patients recover from whiplash associated disorders (more on this later). Importantly, their evidence also suggests combining manual therapy with exercise interventions is more effective than exercise alone in treating neck pain.  

Lifestyle factors 

Sterling and colleagues (2019) explore how physical inactivity, a high body mass index (BMI), and sleeping problems are associated with an increased risk of chronic pain. Therefore it is suggested improvements in weight and sleep, and increased engagement in physical activity may be effective in managing neck pain. 

Ergonomic interventions  

Research from Sterling and colleagues (2019) states office workers have the highest annual prevalence of neck pain, and it is often a recurring problem. Their research suggests ergonomic modifications in the workplace in conjunction with exercise are helpful. Strengthening exercises targeting the neck and shoulders are most beneficial. Combining exercise with ergonomic modifications as well as relaxation, regular breaks, and activity modification are all helpful in reducing neck pain and improving quality of life.  

Psychological interventions 

Sterling and colleagues (2019) state neck pain is associated with psychological factors such as cognitive distress, anxiety, depressed mood, and fear of pain and/or movement. Additionally, people suffering from whiplash can experience post traumatic stress symptoms. These psychological factors increase the likelihood of someone experiencing acute neck pain to continue to experience chronic neck pain. Some research suggests psychological intervention, particularly the use of cognitive behavioural therapy (CBT), may be an effective treatment for neck pain. This technique helps patients overcome unhelpful thoughts (such as being scared of movement or thinking the worst is going to happen), and improves mood (alleviating symptoms of anxiety and depression), which can contribute to an improvement in neck pain.  

 

Take home message:

  • A combination of interventions is more effective than one intervention alone.  
  • Exercise, manual therapy, lifestyle changes, ergonomic changes, and psychological support can all help you overcome your neck pain. 
  • Our osteopaths and physiotherapists at 13th Beach Health Services are trained in assessing and treating neck complaints. We are skilled in a wide range of hands-on techniques to suit your needs, as well as having a deep understanding of appropriate rehabilitation exercises. We aim to get you feeling and moving better! Book in for an appointment online or phone 03 5254 2668.  

 

References: 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214527/ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723111/ 

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