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By Gita Mikal, Registered Physiotherapist
Neck pain is one of the most common complaints in people who work in an office or had a car accident. It is a musculoskeletal symptom that most experience to some degree at one point or another. The condition has a high prevalence among adults and may affect the physical and psychological aspects of the person’s health.
Most neck pain is triggered by external causes like muscular trauma or whiplash. When the acute neck pain is caused by long work hours or uncomfortable sleeping positions, it is easier to treat and can be healed relatively faster.
Chronic neck pain can seriously impair an individual ability to work. Although not common, but constant neck pain lingering for longer than 3 months may be indicative of some underlying condition. This kind of pain usually requires care from a physiotherapist or chiropractor attention from a doctor as opposed to just taking an over-the-counter pain medication and other non-surgical remedies.
Why So Many People Have Neck Pain
Our necks comprise of vertebrae that begin at the bottom of our skull and extend to upper torso, ligaments and muscles as well as Cervical discs which are located in between each vertebra. Cervical discs and muscles and ligaments of neck absorb most of the shock that the spinal column endures.
Ligaments and muscles work together to hold your head up. If these structures suffer strain, sprain and inflammation, injury or overbearing pressure, it can cause pain or stiffness in the neck. This type of neck pain is called mechanical neck pain.
Mechanical neck pain is one of the most common reasons why people seek physiotherapists and chiropractors’ help. Intervening early and getting the cause diagnosed determines how long it will potentially take to heal. Like other aches and pains, neck pain also has the tendency to last longer if it is not treated at properly and in a timely manner.
Some of the signs and symptoms of neck pain include:
One of the most common symptom of neck pain includes radiating pain that can extend from the neck to the shoulders and/or arms. Radiating pain usually feels like a burning sensation that is usually not localized to one spot.
The second common symptom people suffer in their neck is a sharp kind of pain localized to a single spot. Sharp pains are often described by people to be similar to a stinging or stabbing feeling. In most cases, sharp neck pain is usually located in the lower part of the neck.
Stiffness in the neck is a common symptom that usually accompanies neck pain. The muscles stabilizing and moving neck are sore and the associated tightness limits the neck movement, making it difficult to turn and move your head from side to side or front to back.
Holding your neck in a poor posture for long periods of time, an injury or stress can cause the muscles in your neck to contract involuntarily. When neck muscles spasm, they get tight and hard, causing more pain and discomfort. Spasms can also trigger other symptoms like headaches.
Tingling in the Arms
Tingling sensations that go beyond the neck into the arm or shoulders is indicative of a more serious issue that might need immediate attention. In most cases, the tingles occur in either the left or right arm, not the both. The sensation in itself is similar to the pins and needles you feel when your leg falls asleep.
Injury or compression on nerves can sometimes triggers numbness in the neck and down the arms, shoulders, hands, and fingers. This symptom is often accompanied by a tingling sensation and muscle weakness.
Neck Pain with Headaches
Neck pain can often be accompanied by a headache. These headaches are called Cervicogenic or tension headaches and cause tension that radiates from the neck to the head. Stress headaches are caused when a group of muscles in the neck sustain pressure or injury and get tense, resulting in a headache.
These muscles are called suboccipital muscles which are located between the base of the skull and top of the neck. They are responsible for the movement between the two vertebrae in the neck and the skull. Poor ergonomics, poor posture or injury can make these muscles tender and trigger a headache that feels similar to a tight and wrapped around the head.
At times, the tension and tightness in the suboccipital muscles can compress a nerve present at the base of the skull. This pressure on the nerve can intensify the pain and shift the headache to over the head and right above the eyes.
When to see a Physical Therapist or Doctor
Most neck pain subsides with time. If your neck pain persists or gains intensity, see your Physiotherapist. Also, if your neck pain is caused by an injury like an accident or fall, seek immediate medical care.
You should contact a doctor and seek immediate medical attention if:
- The pain increases in severity
- Persists for several days
- Radiates in your arms, fingers, or legs
- You experience numbness, tingling sensations or severe weakness along with the neck pain
The etiology for neck pain includes a number of different factors including mechanical, physical or ergonomic, psychological, behavioral, and individual. Some of the common causes of acute neck pain include:
Nerve Impingement or Nerve Compression
Nerve impingement or a pinched nerve is also called cervical radiculopathy. This condition occurs when a nerve in the neck is irritated or pressed and branches away from the spinal cord. This compression causes a pain that radiates from the neck to the shoulder or arms. Along with neck pain, it can also cause tingles and/or numbness that travel from the arms down to the hand and fingers.
Wear and tear in our spine caused by aging and conditions like arthritis can lead to nerve impingement. Other than that, injuries and sudden movements in the neck can cause herniated discs, leading them to pinch down nerves and cause pain.
Rear-end car accident, falls or sports injury can cause a strain in your neck, which is also called whiplash. The injury occurs when the muscles and tendons in the neck either get strained beyond their capacity or sustains tears when the head is jerked back and forth with force.
This a common cause of neck pain in athletes as they are more susceptible to an injury.
Neck sprains are often confused with whiplash or neck strain. Neck sprains occur when the ligaments that connect bones sustain a pull, tear or other damages. Neck pain symptoms from a sprain might not appear right after the injury. Sometimes, it can take 1-2 days for the pain to settle in.
Temporomandibular Joint (TMJ) Disorders or TMD can also cause neck pain along with stiffness, numbness, and can also hinder your ability to turn your head easily. TMJ is a joint that connects your jaw to the temporal bones of the skull. Injury, arthritis in the joint, clenched teeth, or stress can cause TMD. This, in turn, causes pain, tenderness, and stiffness in the neck and shoulders.
There have been many studies in support of stress being the cause of musculoskeletal pain in various areas of the body but more commonly in neck. It can put tension in your muscles and put a strain on the neck, causing pain.
Underlying health conditions and several diseases have also been associated with neck pain. For example, rheumatoid arthritis can cause swelling and inflammation in the joints along with bone spurs. Although Osteoporosis does not cause pain by itself, but the condition can weaken the bones and cause fractures in the vertebrae, spinal stenosis can put pressure on the spinal cord etc.
Other causes of neck pain include poor ergonomics and overuse of the neck. With many people working in jobs that require the use of computers, wrong postures while doing so can lead to neck pain. If you tilt your head forward for hours at an uncomfortable position, the muscles and tendons of your neck will get sore and cause pain.
Also, holding your neck at an uncomfortable position while sleeping or looking at something above your eye level can cause strains or sprains in your neck.
Treatment and Therapy
The treatment for your neck pain depends on the cause. A certified and trained professional or doctor can ascertain the reason your neck is in pain.
Depending on your medical history and the intensity of your diagnosis, the doctor might prescribe you some over-the-counter pain medicine, muscle relaxants or tricyclic antidepressants to relieve the pain. The value of medication is that, it can assist in managing pain while you can address the root cause of neck pain.
Mild to modern neck pain is relatively easy to treat as it responds well to therapeutic-care within few weeks. A licensed chiropractor, masseuse or physical therapist will help you ease the pain with physical exercise and correcting your muscle alignment.
Physiotherapy is one of the most effective treatments for acute and chronic neck pain. It is used mainly for correcting mechanical neck pain, i.e. pain caused by weak joints or muscles. It realigns muscles and joints and improves flexibility in them.
Physical therapists use manual therapy and exercise to move stiff neck joints, stretch the neck muscles in the right manner to strengthen them and reduce the stiffness and/or pain. Along with that, the exercises also improve your neck muscles’ endurance. This helps in correcting posture and maintaining it so your neck has optimal movement. The therapist will call you in for session periodically over the course of a week or more (depending on your case) and will exercise each joint to help ease the pain.
Another natural treatment for neck pain is massage therapy. Massages therapy uses physical manipulation of the affected area to release the tension in muscles, deep tissues, tendons, and joints. Since pinched nerves and tight muscles are common causes of neck pain, it can alleviate it by applying counter pressure and improving circulation.
Massage therapy, specifically deep tissue massage, is also used to release tension in muscles caused by sports injuries. Therapists target trigger points and use their motions to release tension, increase blood supply to tissues and prevent scar tissue formation. The intensity of the pressure applied during the massage will depend on the severity of your injury and your sensitivity to pain.
Chiropractic treatment is a non-invasive approach to pain relief. Chiropractors first find out the source of your neck pain and then use their hands to address them. Chiropractors work with the joints and muscles in the spine and neck to treat the pain.
They use controlled sudden movements to bring a joint back to its original range. These are called cervical manipulations and are done to loosen joints in the cervical vertebrae to release pinched nerves and ease the pain.
If your neck pain is on the mild side, neck exercises might be able to help get rid of it. After checking in with your doctor, he might prescribe you do simple neck exercises to relieve the pain and reduce the stiffness in your neck. With daily practice, these exercises are also helpful in keeping your neck’s movement fluid and preventing injuries.
Some of the common exercises include:
Begin by straightening your back and neck and then pushing your chin forward and holding it there for 5 seconds. Then push your chin backward towards your throat and hold it there for another 5 seconds. Repeat the step 5 times.
Sit with your back and neck straight and drop your chin forward so it touches your chest. Hold it there for 5 seconds then bring it back to the original position and repeat.
From the same sitting position, tilt your neck towards your left shoulder with your ear leading it. Hold for 5 seconds then repeat on the other side.
With your neck straight, look forward and slowly turn your head to the side. Hold for seconds and repeat 5 times on both sides.
Remember that these exercises are helpful if your pain is mild. If you start experiencing more pain, stop immediately and consult a professional.
Using a head mounted laser pointer, the physiotherapist teaches you to strengthen deep neck muscles to increase endurance and stability.