Everybody talks about lower back pain, despite the number of people I see that I see in my clinic with neck pain. It is estimated that around 15% of people have suffered neck pain in the UK, although I suspect this is much higher. Neck pain can be excruciating just as much as low back pain. It can also create (radicular) symptoms similar to ‘sciatica’, tracking down the arm and can cause pain, pins and needles and numbness. People also report funny sensations, headaches and jaw ache. It can also masquerade as shoulder. People often come into clinic with what they think is a shoulder issue. Much like ‘sciatica’ the cervical nerves can be irritated for a number reasons. People commonly call this a ‘trapped’ nerve, although that’s not what really happens. The neck is also very prone to muscle spasm. Most of us have woken thinking we have ‘slept funny’ causing pain and reduced range of movement. You’ll notice this especially trying to look over your shoulder for example, whilst driving.

Most neck pain self limits within a couple of weeks, but it can become troublesome beyond that and some people struggle indefinitely turning into persistent pain. The causes of neck pain are much the same as most other musculoskeletal issues, muscle strains, postural issues such as sitting at computer or any other posture or movements that are sustained for long periods of time and other general conditions such as osteoarthritis. Neck pain can also be the result of trauma such as whip lash injuries, although we mainly think of this as a result from car accidents it can be from any incident that ‘hyper extend’ the neck such as a fall or sporting injury. 

Cervical (Neck) Anatomy

The cervical spine (neck) consists of 7 vertebrae between which lay inter-vertebral discs. The anatomy of the cervical spine differs from the mid and lower back vertebrae in shape and the way the vertebrae move against each other. Their primary function is to allow rotation of the head, while supporting the neck and head also protecting the spinal cord and vertebral artery. The cervical muscles are small and operate in the opposite way to other muscles.

Red Flags

Most neck pain is a result of straightforward musculoskeletal issues. On occasion, there can be a more serious underlying cause. It is always best to get checked out immediately by a doctor if you experience headaches that don’t resolve, pain and or weakness down both arms, dizziness, drop attacks, nausea, visual disturbances, loss of sensation in the saddle area, faecal incontinence, trouble emptying your bladder, infection type symptoms such as night fever, redness or heat in the area. Or if your pain has been the result of a trauma.

Treating Neck Pain

I actually love seeing a poorly neck in the clinic! They respond really well to physiotherapy, of course, there are always exceptions to the rule. The sooner you seek help the better. Physiotherapy can get your neck moving much quicker and reduces the chance of abnormal movement patterns and more persistent pain in the longer term. Movement is your friend trust me! See below for some simple stretches.

A physiotherapist can thoroughly assess your neck, they should also be looking at the whole of your back and upper limb. Often the thoracic spine (mid back) has some involvement and may need to be treated also. We can offer reassurance and a treatment plan. In my clinic, this usually involves hands-on treatment and a self-management plan. We can also advise if any onward referral that maybe required to a doctor. 

Initially, you want to manage your pain, don’t be afraid to take some pain medication that suits yourself, managing pain enables you to move and improve function, heat and ice can also help. If you’re unsure about medication speak to your pharmacist or Doctor. Simple stretches and movements need to be introduced, this maybe uncomfortable to start with but this will help pain and stiffness reduce more quickly. Of course, it is always best to see a physiotherapist or other qualified clinician prior to embarking on self-management especially if your symptoms are particularly worrisome and definitely if you are experiencing radicular symptoms that don’t quickly resolve. Avoid self-diagnosis! Doctor Google is not always your friend. Physiotherapists and other clinicians are qualified in the use of clinical reasoning and have a much deeper understanding of medical matters! You don’t want to miss an important diagnosis or make things worse by embarking on an inappropriate treatment. 

At Twist Physiotherapy we always ensure that your treatment plan is bespoke to yourself. This can depend on the severity and nature of symptoms and lifestyle, amongst other factors. The number of sessions can vary depending on the individual. As every other injury there can be ups and downs and can recur over time. Don’t stop doing your exercises just because you feel better! Neck exercises can be really simple and be done at your desk or incorporated into your daily routine.

Simple range of movement exercises include bringing your head forward, backwards, side to side and looking over each shoulder. You can also tuck your chin like you are making a double chin. If you’d like to know more it is best to consult and qualified physiotherapist.

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