Cervical (or neck) pain is a common medical problem today, affecting women more than men of the same age.
The most common cause contributing to cervical pain is prolonged-sitting with fixed, incorrect and constrained posture (eg forward-head posture). Mechanical disorders of the cervical spine lead to degeneration of the surrounding joints, muscles and ligaments.
Neck pain can sometimes radiate into the head, presenting as a headache. This is called a cervico-genic headache.
Neck pain of less than 6 weeks is termed ‘acute’, and usually may be attributable to a specific event. Pain longer than 6 months is termed ‘chronic’. Any pain duration between 6 weeks and 6 months is classified as ‘sub-acute’ neck pain.
Around 10% of the adult population at any one time is suffering from a stiff neck.
Do you experience any one of these symptoms?
- Neck pain or restriction of head and neck movement
- Pain that is spreading to the upper back or back of arms
- Neck stiffness or muscle spasms
- Sensory changes, such as numbness, tingling or burning sensation in the forearm, hands or fingers
Causes of neck pain
There are many causes of neck pain. Most neck problems happen after years of wear and tear on the parts of the cervical spine. At first these small injuries are not painful. But over time they can add up. As the degeneration and subluxation continues, bone spurs develop in the joint. These bone spurs can cause problems by pressing on the nerves of the spine. This pressure around the irritated nerve roots can cause pain, numbness, and weakness in the neck, arms, and hands.
Another reason for people experience neck pain is muscle strain. The muscles have been pulled or injured may cause neck pain due to repetitive motion of neck muscles. Other than that, the problem may be coming from irritation or injury in other spine tissues, such as the disc or ligaments. When this happens, the neck muscles may go into spasm and patient might feel pain and sore in these areas.
In one study, 70% of patients with neck pain who sought medical consultation have their symptoms greatly reduced within one month
A cervicogenic headache is a headache that originates from your neck.
Clinical studies have shown that pain from the upper cervical joints and muscles can often refer pain into the head. Strangely, if these pain sensitive structures become irritated we can often feel pain that is more prominent in the head than it is in the neck.
In the general population, about 20% of those who have chronic headaches are diagnosed as having the cervicogenic type. With a cervicogenic headache, pain will often start of in the neck region first, whereas it normally starts in the head with Migraine’s and tension-type headache sufferers. Cervicogenic headaches are also side-specific and do not change from side to side like a migraine headache can.
A trained physiotherapist is able to employ appropriate manual therapy techniques to the cervical spine and associated soft tissue structures to regain range of motion and restore normal joint mechanics to the cervical spine. A physio can also instruct you with specific and evidence based exercise program that addresses the deep neck flexors and the stabilising muscles of the scapular area. This will also help to stimulate the process of healing and repair by facilitating normal movement and loading stresses around the symptomatic joints.
Studies have shown a 76% success rate with a combination of the above treatment interventions, and patients reported a more than 50% decrease in headache frequency, with 35% achieving complete resolution of symptoms following seven weeks of treatment.
How can a physiotherapist help?
Your physiotherapists are specifically trained to identify possible lesions and manage them accordingly. Through a physical examination, they may assess your posture, muscle and skeletal symmetry, and movement restrictions. A neurological examination of the upper limb may also need to be carried out.
In most cases, your neck pain will respond well to a multi-modal treatment approach, which can include manual therapy, electrotherapy, acupuncture, and targeted therapeutic exercises.