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Neck Pain

The neck (cervical spine) is a complex structure made up of seven bones called vertebrae. Between the skull and top two vertebrae there are no discs, as a result this area accounts for nearly half the ability of the neck to turn. The remaining vertebrae are separated from each other by discs which are stabilised by joints and ligaments and moved by muscles.
The neck supports the relatively heavy head and is a very mobile structure. Good muscle strength and posture are important to maintain a healthy neck. Injuries and postural problems are the most common causes of neck pain; however arthritis and degeneration of the cervical spine can also cause neck pain.
Physiotherapists have excellent anatomical knowledge and are trained to understand the significance of common neck pathologies. They will question you thoroughly to establish whether your neck pain is mechanical in nature or whether it represents a more serious condition. When appropriate they will refer you for further investigation or medical review. A Physiotherapy examination will typically assess posture and movement. This will be used to provide an individualised strategy to reduce pain, restore function and prevent re-occurrence. Your Physiotherapist will also discuss a diagnosis and provide information on your prognosis.
The most common types of neck pain and their signs & symptoms are outlined below:
 

Acute Nerve Root Pain

When a nerve exiting from the spinal cord becomes compressed by a structure in the neck.

What are the Signs & Symptoms?
  • Gradual or sudden onset of pain usually in the arm.

  • With or without neck pain, frequently associated with pain around the shoulder blade.

  • May be associated with pins and needles, numbness or loss of strength/movement in the arm.

  • Typically worse with looking up and or with sustained postures such as sitting.

 What can Physiotherapy do?
  • Assess the severity of the condition and refer for Medical review as appropriate

  • Provide a prognosis

  • Provide management and treatment, this condition typically responds well to appropriate physical intervention and advice

  • Provide an understanding of the causes of the condition and provide strategies to prevent re-occurrence

 

Whiplash  

This is typically a result of a motor vehicle accident where the neck suffers an acceleration/deceleration injury - the head is thrown forward or backward.

What are the Signs & Symptoms?
  • In more severe cases pain is felt immediately, however in less severe cases there may be little or no pain at time of injury.

  • Gradual increase in intensity of pain in following 2-3 days

  • Pain in neck and sometimes radiating into head and shoulders/arms

  • May be a dull ache or sharp pain made worse with movement

  • Reduced range of motion of the neck

What can Physiotherapy do?
  •  Assess the severity of the condition to help exclude serious causes of pain and refer for Medical review as appropriate.

  •  Explain the mechanism of injury, however it is often difficult to know the exact structure injured.

  •  Provide individualised treatment as there are different types of whiplash injuries.

  •  Provide management and treatment, this condition typically responds well to appropriate physical intervention and advice.

  •  Rehabilitate you to enable a return to pre-injury function, pain doesn’t need to result in a loss of function.

  •  The Whiplash Injury Recovery – a self-management guide booklet is available for free download from the Queensland Motor Accident Insurance Commission and is recommended reading.

 

Wry Neck

Results in acute neck pain and stiffness, typically caused by sleeping in a poor posture or using an inappropriate pillow.

What are the Signs & Symptoms?
  • Strong or sharp pain in the neck resulting in difficulty moving the head.

  • Most often preventing full neck rotation to one side.

  • Commonly unilateral pain (involves one side of the neck).

 

 What can your Physiotherapist do?
  • Restore movement quickly

  • Provide neck and spine exercises

  • Advise on appropriate sleeping postures

  • Provide an appropriate pillow

 

Postural Neck Pain


What are the Signs & Symptoms?
  • Widespread aching pain in the neck
  • Typically worsens in repeated and sustained postures that are not optimal

  •  Pain increases as the day progresses

  •  Nearly all children now use computers and computer use increases over adolescene

  •  Musculoskeletal pain typically starts in adolescents


What can you do?
  • Move frequently, get up from a sitting position every 30 to 60 minutes and do an active task

  • Regular neck and spine exercises, your Physiotherapist can advise you on this

  • Use laptops at a desk

  • Decrease sedentary time, total sedentary time is a risk factor for developing musculoskeletal pain

What can your Physiotherapist do?
  •  Provide a thorough postural assessment that relates to your complaint

  •  Provide neck and spine exercises

  •  Advise on appropriate cardiovascular and gym exercises

  •  Assess and advise on occupational issues that could be contributing to the pain

  •  Improve movement in stiff joints

  •  Massage and prescribe exercises for tight and overworked muscles