One of the most common and deliberating ailments that we treat at Central Health Physiotherapy is neck pain. Two out of three of us will have neck pain at some time in our life. In some instances, this can come on suddenly, for example, whiplash following a road traffic accident or suddenly but with no apparent reason such as an acute “wry neck”. Other times, it comes on gradually, often after working at a computer for too long. In this series of blogs I’m going to discuss different causes of neck pain, what you can do to treat it, and, more importantly, prevent it.

What are the different causes of neck pain?

• Simple or mechanical neck pain is probably the most common type. This is sometimes called non-specific neck pain. Bad posture is often a contributing factor. Neck pain is more common in people who spend a lot of time at a computer with a “poky chin” posture. This causes the muscles in the front of our neck to become lengthened and weak, and the muscles at the back to become shortened and tight. This alters our movement patterning and ultimately our biomechanics causing stresses and strains to muscles and joints.

• Acute torticollis. This is sometimes called a ‘wry neck’. A torticollis is when the head becomes twisted and locked to one side and it is very painful to move. The cause of this is often unknown. It may be due to a sprain to a muscle or ligament in the neck, or a joint getting stuck. It is common for people to go to bed feeling fine and to wake up the next morning with an acute torticollis. The pain usually eases and clears away over a few days but physiotherapy can be helpful to reduce the symptoms.

• Whiplash jolt to the neck, most commonly due to a car accident, may cause neck pain. This can be very distressing especially due to the nature of the trauma. Luckily, our necks are resilient and serious injury rarely occurs. Often there is considerable muscle spasm to protect your neck, which can be very painful and make it difficult to move. However, the research shows that early movement is the best treatment.

• Degeneration (‘wear and tear’) of the vertebrae (spinal bones) is a common cause of persistent neck pain in older people. This is sometimes called cervical spondylosis. Most people over the age of 50 have some degree of degeneration, often without any symptoms. One feature of the degeneration is that the edges of the vertebrae develop small, rough areas of bone called osteophytes. The joints become stiff, making normal movements painful and more difficult, particularly after a night’s rest. The pain tends to come and go with flare-ups from time to time often after unaccustomed use of your neck. Ensuring you keep your neck mobile and the muscles that support the joints and your shoulder blades is vital to prevent pain and disability.

•  Cervical radiculopathy is when the nerve is irritated in the cervical (neck) region. As well as neck pain, there may be symptoms such as numbness, pins and needles, pain and weakness in parts of and arm supplied by the nerve. This can be very concerning and the pain can be incredibly intense. Adequate pain control is extremely important in managing this pathology. Avoiding repetitive tasks or movements that aggravate the symptoms is also very important. A good physiotherapist can help address activity modifications. Manual therapy can also be of considerable benefit.

Ellie Dorman, Physiotherapist, The Hospital of St John and St Elizabeth and The Royal Hospital Chelsea

Photos © Aidan Jones and ©Reegmo