Do you have neck pain? Well, you are not alone! Studies show that about 2/3 of the population will experience neck pain at some point in their lives. Neck pain is second to only back pain in the frequency of musculoskeletal consultation in primary care. Neck pain usually goes away on its own within a few days or weeks, but can recur or become chronic (3 months or greater). The prognosis for acute neck pain is very good, but can become more unpredictable once it becomes chronic.
Neck pain is a very common problem affecting 60-70% of the population at some point in their lives. These symptoms can vary from very sharp pain with restricted movement to dull, aching and burning in the surrounding shoulder and shoulder blade muscles. In some cases, symptoms may travel down the arm to the hand causing pain or numbness and tingling. In more severe cases significant weakness is noted in the arm or hand.
Neck pain with no known cause is called “non-specific” neck pain. Despite the prevalence of this condition, there remains a poor understanding of the underlying causes in many of these cases. We believe that many of our daily stresses can be the cause for most of this category of neck pain. Examples of these stressors are poor posture, anxiety, depression, neck strength/endurance, stiffness in the vertebral segments, and altered motor patterns of stability. In reality, and in most cases, it is a combination of several of these factors that often lead to this type of neck pain.
The neck is a very mobile structure allowing for movement in many directions. Because of this mobility, the neck can be vulnerable to injury and disorders that produce pain and restrict motion. The cause of neck pain can occur from poor computer posture, falls, whiplash or often for unknown reasons. Common neck problems can consist of facet syndromes, herniated discs, osteoarthritis as well as muscular pain and tension.
For many people, neck pain is a temporary condition that disappears within several days, but for others underlying stiffness and weakness can predispose the neck to further injury and prolong the painful situation.
The most common symptoms associated with non-specific neck pain can vary from very sharp pain with restricted movements, to dull/aching and burning in the surrounding shoulder and shoulder blade muscles. There will often also be the association of trigger points, or knots, in many of the muscles of the neck and shoulder regions. You may even notice some radiation of the pain extending into the arms.
As we get older, degenerative changes in the spine become very common. Most of this is considered “wrinkles on the inside” and do not indicate further pathology. It is very common in fact to see degenerative changes in the cervical discs with osteophyte (spurs) formation and involvement of adjacent soft tissue structures in many people over the age of 30. There is actually a poor correlation between pain and radiological findings. Non-specific neck pain is typically diagnosed on clinical grounds alone, provided there are no features to suggest more serious conditions.
Exercise in combination with manual therapy interventions are found to be very beneficial in the treatment of non-specific neck pain. Techniques of joint mobilization, soft tissue mobilization, dry needling, and muscular retraining are proven to be significantly effective treatments in many these cases. There is evidence that early “hands-on” treatments and a return to normal function can hasten recovery and may prevent the likelihood of the condition from becoming chronic.
An individualized exercise program is developed for each patient’s specific problem, often focusing on the deep neck muscles and the postural muscles of the shoulders and shoulder blade regions. Education on proper techniques and postures for work, athletic, and daily activity is an essential component of successful treatment.
Working with a physical therapist to improve neck strength, movement, and supporting structures can help to alleviate future non-specific neck pain. In addition, patients should strive to stay active and be healthy and eliminate stressors in their life that could potentially contribute to the non-specific neck pain.