Physiotherapy for neck pain

The nerves that supply strength and sensation to the arms come out of small circular spaces between the vertebrae. Good mobility in the joints of the neck is essential for normal neck movement. Neck pain can come from a number of disorders in the neck. Examples of common conditions producing neck pain are disc degeneration, neck injury such as in whiplash or a pinched nerve. Poor sitting posture can also lead to neck pain

Disc degeneration in the neck is much less common than disc degeneration in the lower back (lumbar spine) because the neck generally is subjected to less torque and force. However, a fall or a twisting injury to the cervical discs space can lead to degeneration. Over time wear and tear to the disc or joints of the neck can lead to pain and stiffness.

Symptoms of disc degeneration are:

• Low grade neck pain and stiffness
• Restriction at the end of movements e.g. difficulty turning to look over your shoulder
• Muscle tightness and tenderness around the neck and between the shoulder blades
• Pain may also radiate up into the back of the neck, causing a headache

Whiplash is due to a traumatic event that causes the head to move suddenly (“whip”) in one direction and then recoil in the other direction. The most common cause of whiplash is a motor vehicle accident in which one vehicle is struck from behind by another. Whiplash can also occur in sports e.g. if someone is tackled from the back and their neck whips back. Unexpected falls can also cause a whiplash-type effect to the neck. This abnormal motion causes damage to the soft tissues that hold the cervical vertebrae together (ligaments, facet joint capsules, muscles).

Symptoms of whiplash are:

• Pain, restricted movement and tightness in the neck.
• The muscles around the neck and shoulders may feel hard or knotted.
• Pain when moving your head from side to side or backward and forward.
• Headaches at the base of the neck that radiate towards the forehead.
• Dizziness which can be from disturbance of the balance receptors in the neck or ears.

A pinched nerve in the neck occurs when there is compression on the nerve from the surrounding vertebrae or disc. This can occur when there is degeneration of the cervical discs. As a result of this degeneration, the circular spaces between the vertebrae where the nerves exit the spine, get smaller and compress the nerve. In vertebrae where there is wear and tear, the vertebrae can develop little spurs which are like little spikes that grow on the bone. These spurs can also push or compress the nerves in the neck. Pressure on the nerve can also occur when there is inflammation around the nerve which then causes irritation of the nerve. This inflammation can occur in acute injuries such neck strains and whiplash.

Symptoms of a pinched/compressed nerve are:

• Pain as usually described as sharp or burning
• There can also be a “pins and needles” sensation or even numbness in the arm or hand. There may also be a feeling of weakness with certain activities.
• Pain usually travels down the arm in the area of the involved nerve.
• Symptoms can be worsened with certain movements, like looking down.
• When certain nerves are affected, symptoms are often made better by either placing the hand on the head or bending the elbow and bracing the arm up against the body.

Poor posture like slouching from the shoulders and poking the chin out (like a lot of us do while working on computers) will cause the muscles in the back of the neck to become shortened and tight. Sitting with the chin poking out will result in the joints in the neck to become compressed and stiff. This will most likely cause pain and stiffness in the neck joints, reducing neck mobility. Tightness of the muscles in the neck can cause muscular pain and tension headaches. It is therefore very important to sit correctly and take regular short breaks from prolonged sitting during the day.

Poor posture can result in:

• Reduced neck mobility, especially forwards and side to side movement
• Dull headaches across the base of the skull
• Pain across the neck and shoulders
• Shortened/tight muscles at the back of the neck, and weakened/lengthened muscles at the front of the neck

Physiotherapy for neck pain involves first diagnosing the cause of the neck pain, as well as identifying intrinsic (e.g. posture) and extrinsic factors. (E.g. type of chair being used or position of computer screen). Once the cause has been identified, e.g.  joint stiffness or a trapped nerve, treatment will be aimed at relieving pain and restoring full mobility. Extrinsic and intrinsic factors will also need to be addressed to minimise the chance of the symptoms returning. Physiotherapy consists of joint mobilisations, soft tissue release, dry needling, strapping and postural re-education.

If you have any queries, please don’t hesitate to call 011 064 5670 or enquire online.