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Neck Pain

Neck pain is extremely common. Our expert Physiotherapists have years of experience in working with people to feel better, quicker, and reducing the impact of neck pain long term.

Anatomy of the Neck

skeletal anatomy of the neckThe neck (known as the cervical spine), comprises seven vertebrae stacked one on top of each other, at the very top of the spine. The bones in this region of the spine are the smallest, however the joints (referred to as “facet joints”) allow for some of the greatest range of movement.

A capsule surrounds each joint and strong ligaments (both at the front and back of the neck), connect bone-to-bone. These ligaments simultaneously allow for both movement and stability of the joints. A vital arrangement of ligaments at the skull/neck junction keep the skull stable at the top of the spine. Soft tissues including fascia, deep stabilising muscles and larger powerful muscles are responsible for working together to produce and control the intricacies of both head and neck movement.

Like in the other regions of the spine, discs lie between each of the vertebral bodies and help to shock absorb. These discs begin gel-like in nature in the first few decades of life, but as we get older, they become drier and can lose some height.

At each vertebral level in the neck, nerves exit the spine both on the right and left side, sending information about sensation and motor control along both arms to the finger tips, and also to the head/face. Injury to these nerves can cause changes in skin sensation (pins and needles, numbness) muscle weakness, and pain of varying intensity.

The spinal cord is an important structure and it runs through the middle of the entire length of the spine. Injury to the spinal cord in the neck region is particularly serious and can cause paralysis to vial muscles in the trunk, arms and legs.

The neck is also home to a network of blood vessels that contributes to vital blood supply to the brain and head. As such, migraines and headaches can be caused or contributed by issues in the neck region.

Common Conditions

Common factors that can lead to neck pain include postural strain (either muscle strains or joint sprain) and whiplash type injuries.

Mechanical neck pain is one of the most common injuries we see. It is an umbrella term, including pain originating from the facet joints and all other soft tissues in the neck area (muscles, ligaments, tendons, joint capsules).

Facet pain usually affects one side of the neck, is localised to the neck area (no arm pain) and is made worse with movements such as looking upwards, turning the neck or leaning the ear to the shoulder. People often wake up one morning with neck stiffness, and this can be due to a facet joint which has become stiff or “locked”. This usually settles down in a few days and with the right advice and Physiotherapy treatment, a full recovery is to be expected.

Muscle spasm, strains and sprains often occur around the neck region. These injuries could be caused by a specific movement (an awkward movement or heavy exercise in the gym), or they could come on more gradually due to postural changes or a repetitive strain activity (long hours spent at the computer or using an electronic device). These injuries respond well to Physiotherapy including hands-on treatment and rehabilitation of the affected muscles.

Like all spinal pain, the neck can very much be influenced by stress and other lifestyle factors. Lack of sleep, stressors in our personal and work lives, poor diet and lack of exercise can lead to the build up of tension and muscle imbalances in the neck region that can then manifest as pain. A holistic approach to this sort of pain is essential, and Physiotherapy interventions to help restore control of these issues (including mindfulness and meditation) can be hugely effective.

Cervical radiculopathy is the term used to describe pain referred from the neck into the arm. This could be due to either compression of a nerve, or inflammation around the nerves in the neck. This could be caused by normal, age related wear in the neck joints, or sometimes a disc bulge in the neck irritating a nearby nerve.

Symptoms include neck pain with pins & needle and / or numbness referred into the arm. The location of pain in the arm can help to identify the level in the neck where the nerve is being irritated.

The prognosis for cervical radiculopathy is good; up to 88% of cases resolve within 4-6 weeks. The management of symptoms includes continuing with daily activity as able, taking rest as required from activities that cause the symptoms to feel worse, using a firm pillow at night to support the neck and optimise sleep and using over the counter analgesia as required.

Physiotherapy treatment, including specific exercises, joint mobilisation, soft tissue treatments and acupuncture can also provide relief from neck and arm symptoms.

In some cases, an injection to the neck may help to settle pain symptoms and allow you to engage in your Physiotherapy treatment better.

How We Can Help You

A thorough examination comprised of specific questions and physical tests can help to diagnose the cause of your neck pain. A treatment plan would then be discussed and implemented, to help you towards being pain free and get you back to performing your desired activities. A fundamental part of the treatment plan is explaining the cause of pain and ways to manage it.

Treatment could include hands-on therapy (joint mobilisation/soft tissue massage), a programme of stretches or strength based exercises, Taping, Acupuncture, Ultrasound or perhaps Shockwave Therapy (if appropriate).

If further investigations such as MRI, Ultrasound scan, blood tests or X-rays are required, our Physiotherapists can point you in the right direction. If the Physiotherapist feels you need to see another health professional (such as an Orthopaedic Consultant or Rheumatologist), they will ensure you see the right person via our vast network and close links with consultants.

So, if you have been struggling recently with neck pain, click here to contact us so we can help you get better!

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