Neck Pain

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Non Specific Neck Pain
  • Symptoms
    Neck pain is a very common problem affecting 60-70% of the population at some point in their lives. These symptoms can vary from very sharp pain with restricted movement to dull, aching and burning in the surrounding shoulder and shoulder blade muscles. In some cases, symptoms may travel down the arm to the hand causing pain or numbness and tingling. In more severe cases significant weakness is noted in the arm or hand.
  • Causes
    The neck is a very mobile structure allowing for movement in many directions. Because of this mobility, the neck can be vulnerable to injury and disorders that produce pain and restrict motion. The cause of neck pain can occur from poor computer posture, falls, whiplash or often for unknown reasons. Common neck problems can consist of facet syndromes, herniated discs, osteoarthritis as well as muscular pain and tension. For many people, neck pain is a temporary condition that disappears within several days, but for others underlying stiffness and weakness can predispose the neck to further injury and prolong the painful situation.
  • Relief
    Manual therapy interventions are found to be very beneficial in treatment of the cervical spine. Techniques of joint mobilization, deep tissue mobilization and muscular retraining are proven to be significantly effective treatments. Manual and mechanical traction is found to be effective in cases of nerve compression. An individualized exercise program is developed for each patient’s specific problem often focusing on the deep neck muscles and the postural muscles of the shoulders and shoulder blades. Education on proper techniques and postures for work, athletic and daily activity is an essential component of treatment.
Acute Cervical Sprain/Strain
  • Symptoms
    Acute neck pain is usually described as a sudden locking while turning the head or following sustained periods of looking up or down. Occasionally, patients awake with a “crick” or a “wry neck” for no particular reason. Both of these situations can cause very sharp, specific pain especially in one particular direction. Very often turning the head to look over either shoulder is the most painful and is usually very limited. Frequently, there is a moderate amount muscle spasm associated with these specific movements. This can significantly limit the ability to perform normal activity such as driving, looking up, looking over your shoulder or raising your arms overhead. There are usually no symptoms in the arms or hands.
  • Causes
    The onset of an acute cervical sprain or locking can have several underlying causes. Obviously any type of trauma such as sporting activity or a minor whiplash type injury can cause these joints to become swollen and inflamed. Often, the onset of this condition is unexplained which can suggest there is too much movement (hypermobility) in the specific joints in the neck called facet joints. Poor muscular control of the movement in the neck is called instability. When instability is the cause, patients will often have a frequent history of this same condition. Poor sitting postures can be an underlying cause to this condition due to the improper use of the neck and shoulder muscles.
  • Relief
    Manual therapy is found to provide a significant reduction in pain and increased ability to move in a very short time frame, usually no more than 1-2 visits. Techniques of joint mobilization, deep tissue mobilization and muscular retraining are proven to be significantly effective treatments for this condition. Assessment and treatment of the underlying cause for this condition such as poor sleeping habits, neck weakness, postural stresses and associated areas of stiffness are the key to long term relief and reduction in re-injury. A key component for this condition is patient education. An individualized exercise program is developed for each patient’s specific problem often focusing on the deep neck muscles and the postural muscles of the shoulders and shoulder blades. Modalities such as ice and electrical stimulation are utilized to reduce the acute inflammation and pain.
Cervical Radiculopathy
  • Symptoms
    Cervical radiculopathy is a term to describe compression or irritation of the nerves that supply the arm. When these nerves are compressed or irritated they cause pain and feelings of numbness and tingling down the arm and occasionally into the hand. Occasionally there is no neck pain associated with this condition and only arm or hand symptoms. Movement of the neck will reproduce the arm/hand symptoms in this case. The pain from this can be excruciating due to the involvement of the nerve. In more severe cases, significant weakness and/or numbness in the shoulder, arm or hand may occur.
  • Causes
    The cause of radiating symptoms in the arm or hand from the neck is due to the compression or irritation of the nerve that supplies the arm and hand. These nerves begin in the neck and can be compressed by a ruptured or herniated disc, bone spurs or an irritated facet joint. This can occur from normal wear and tear, degenerative or arthritic changes, or from acute traumatic activities such as athletics or a whiplash type injury. Areas of stiffness above or below the problem area frequently lead to abnormal stress at the level of the nerve involvement.
  • Relief
    A course of manual therapy in conjunction with mechanical or manual traction is found to be the most relieving and effective treatment for this condition. As the pressure begins to reduce on the nerve, treatment to the associated areas of muscle spasm and joint stiffness frequently helps reduce the remaining symptoms. As in all cases, the underlying muscle weakness and tightness is addressed with a specific exercise program to help reduce the likelihood of this condition returning. Exercise training to assist in returning to normal activity is the primary goal. Modalities such as ice and electrical stimulation are utilized to reduce the acute inflammation and pain as well.
Muscle Spasm/Myofascial Pain Syndrome
  • Symptoms
    Symptoms associated with this condition include aching, burning, tightness, and tender trigger points of the muscles surrounding the neck, usually in the upper trapezius muscle. Often, pain is felt between the shoulder blades as well. These symptoms usually worsen as the day progresses and feel better in the morning or with rest.
  • Causes
    The muscle itself is rarely the cause of this condition. There is usually an underlying cause for the muscle pain that is causing the muscle to contract at a low level. When this occurs, the muscle never has a chance to relax and becomes very painful. This can be due to undue stress from prolonged sitting, poor posture, psychological stress, or any number of neck conditions such as instability or low level inflammatory processes. Occasionally patients who overuse their neck muscles while performing normal breathing can have these myofascial pain syndromes.
  • Relief
    Manual therapy interventions are found to be very beneficial in treatment of this condition. Techniques of joint mobilization, deep tissue mobilization and muscular retraining are proven to be significantly effective treatments. Specific exercises to improve blood flow through the muscles are beneficial. An individualized exercise program is developed for each patient’s specific problem often focusing on the deep neck muscles and the postural muscles of the shoulders and shoulder blades. Re-education of breathing patterns is also found to be helpful. Relaxation techniques and assistance in stress management are key components of the treatment when stress is noted to be a significant source of the symptoms. Education on proper techniques and postures for work, athletic and daily activity is an essential component of treatment.
Other Neck/Cervical Spine Conditions

Other cervical spine conditions include postural syndrome, whiplash, degenerative disc disease, thoracic outlet syndrome, and cervical instability. Physical Therapy is indicated in all these conditions.