Neck pain, also referred to as cervical pain, describes painful symptoms which derive from the upper region of the spine. It may be felt locally, at the source of the pain, or may radiate to other areas of the body such as the shoulders or into the arms – this is known as referred pain.
The neck supports the weight of the head. The average human head weighs around 5kg, a surprisingly heavy load for the neck to carry. Any type of inflammation or injury to its structure creates a significant strain on the neck causing pain and even discomfort. This is not only highly unpleasant but can interfere with everyday life considerably, making day to day tasks such as getting dressed, a challenge. Neck pain is a common complaint at the physiotherapy clinic and one that often responds well to physiotherapy treatment.
There are many different possible causes of neck pain, the most common of which are listed here.
Direct trauma to the neck can cause a variety of neck related issues varying in severity, from soft tissue damage, fractured vertebrae to nerve damage or even the spinal cord in more severe cases.
One commonly cited type of trauma is whiplash. This is a type of direct injury to the neck and is often associated with road traffic accidents where the sudden impact of a collision causes the tendons and ligaments of the neck to severely overstretch as a result of a sudden movement to the head, either forwards or backwards. In road accidents, this happens when a car brakes suddenly, although whiplash can also be caused by a sudden slip or fall, from a direct blow to the head, or by high contact sports such as rugby.
Posture & Lifestyle
General poor posture can cause a range of neck and back-related complaints; causing inflammation and swelling to soft tissue structures. Postural related neck problems are often associated with sitting at a desk for extended periods of time, poor ergonomics, driving a vehicle or poor sleeping positions.
Correct posture at all times can help considerably towards the prevention of neck and general back-related issues. This includes not only whilst sitting, standing, lying down, or driving, but also when performing physical exercise, in particular, lifting heavy weights.
Smoking, poor diet and lack of exercise can also contribute towards neck problems as well as other wider health issues.
Degenerative Wear and Tear
Medically referred to as Spondylosis, degenerative wear and tear typically occurs as a result of the body’s natural ageing process where the wear and repair cycle begins to slow down, causing the musculoskeletal system to deteriorate. When this occurs in the neck, it can result in a number of painful conditions.
Cervical Disc Issues
Nerve compression in the cervical region is often caused by disc-related issues. Along the spine length, from the top of the neck all the way down to the coccyx, intervertebral discs, made from gel-like material with a tough outer case, separate the spinal vertebrae. This prevents them from coming into contact with one another, whilst providing padding to absorb any shocks or jolts when the body is moving. Any type of damage or cracks to the exterior of the intervertebral discs can allow the gel-like substance of the centre to seep out and encroach on nearby structures. In some cases, an individual may not be aware of a herniated disc, as there may be no symptoms. For others, however, the disc centre may come into contact with nearby nerve roots exiting the spinal column, causing very painful symptoms.
In the cervical region, nerve compression is often termed “radiculopathy” and may cause referred pain, felt in the shoulders or into the arm and hand, for example, depending on the nerve affected. Pain and discomfort may also be felt locally in the neck and associated headaches may be present.
Disc herniation often occurs as a result of degeneration, as we age the discs begin to dry out causing them to shrink and making them more prone to cracks and tears. Poor posture and unhealthy habits such as smoking are directly associated with disc herniation.
Bone spurs (osteophytes) are another possible cause of nerve compression in the cervical region. Degeneration to the intervertebral discs or the break-down of cartilage at the edge of the spinal vertebrae can allow bones to rub against one another, resulting in inflammation. In response to this process, the body sometimes creates more bone to try and repair the damage, this additional bone, however, forms irregularly at the edges of the vertebrae. The bony growth alone is not painful and adverse symptoms typically only occur if it impinges on any nearby nerve roots, or more rarely in extreme cases, it may be sufficient to compress the spinal cord itself resulting in spinal stenosis.
Red Flag Indicators
When accompanied by specific other symptoms, neck pain may be indicative of a more serious underlying pathology, such as infection or a tumour. Symptoms such as high temperature/fever, unexplained weight loss, difficulty walking, problems with coordination, issues with bladder or bowel control, speech difficulties, dizziness and fainting, blurred vision, and nausea are all red flag indicators and should be taken very seriously. It is important to contact your GP as soon as possible if you experience any such symptoms.
Initial treatment for neck pain is typically conservative treatment, involving a course of physiotherapy combined with pain relief medication if necessary. Physiotherapy can assist with safe recuperative mobilisation strategies including hands-on manipulation, massage, exercise programmes, teaching correct posture and self-management.
Pain Relief Medication
Over the counter medication, analgesics (paracetamol) and anti-inflammatories (ibuprofen), provide effective pain relief for many. Pain caused by nerve compression, however, may require stronger prescription medication.
If the source of the pain is a direct result of lifestyle habits, e.g. poor sleeping position, poor ergonomics, disc herniation associated with heavy smoking etc. then these habits will need to be addressed. A well-trained physiotherapist can help provide useful advice on how to improve posture and ergonomics, as well as general fitness advice. They may also be able to show you useful literature on giving up smoking. Dietary advice can be provided by a dietitian or nutritionist.
Surgical intervention may be considered for forms of severe neck pain relating to nerve compression if all other treatment methods have failed. Rehabilitation will typically consist of rest and physiotherapy.
Physiotherapy for Neck Pain
ProPhysiotherapy offers a range of physiotherapy and related services which include the treatment of neck pain. Our highly experienced physiotherapists will carry out a detailed assessment in order to identify if the cause of the pain is of musculoskeletal origin. In most cases, neck pain can be successfully treated with physiotherapy alone, however, depending on the cause of the pain, referral to your GP or a pain management clinic for further assessment may be required, as well as diagnostic testing, such as MRI, CT scan or Xray – in which case, we can advise on an appropriate course of action.
Feel free to get in touch today to discuss our treatment options further.