PHYSIOTHERAPY FOR NECK PAIN
Muscles of the Neck
Anatomy of the Neck
IS THE NECK A FRAGILE STRUCTURE?
This question often comes up a lot when people ask about their neck pain. The neck is a strong yet flexible structure that is made up of seven vertebrae (think of these as platforms that can glide and rotate over one another) and a plethora of muscles and ligaments that ensure the stability of the region. However, this inherent stability and flexibility does not make it immune to pain or stiffness.
Neck Pain HOW DOES NECK PAIN START? An initial occurrence of neck pain with no previous neck pain is an acute episode. These acute episodes could be from sleeping a certain way, or trauma to the neck. If pain persists for longer than 12 weeks, then it becomes chronic neck pain. Studies show that 30% of people with neck pain end up developing chronic symptoms. A similar proportion of people will have persistent problems with their neck pain for at least a year onwards. WHAT ARE THE RISK FACTORS FOR NECK PAIN? There are many risk factors for neck pain which are outlined below: Poor Posture
Poor Posture compared to Good Posture Regardless of whether when sitting, standing or lifting, poor postures can cause extra strain on other parts of the body. The anatomy of the neck and spine is strong and flexible, but there is a limit to how much loading the muscles and ligaments will allow before pain is the main response. Office Ergonomics
Office Ergonomics In this current economic climate, there is much more working from home or in different office spaces than normal. More than ever, it is extremely important to focus on good ergonomics. Factors such as appropriate chair height, elbows at 90° and eyes horizontally lined with the top of the screen are vital for good ergonomics. Poor Habits
Source: https://www.spine-health.com/conditions/neck-pain/text-neck-treatment-and-prevention
Another development that has been steadily increasing its reach is the use of smartphones and the subsequent impact it has on our postures. It has become all too common to see the right-most posture almost everywhere. Our preference should be to raise the phone in favour of our neck, rather than what is comfortable for our hands in our lap. Repetitive Movements
Source: https://aminoapps.com/c/metal/page/item/headbang/PJjC_3I48m8dEpZemPGdWP5GrZV5V3
High volumes of repeated actions can cause strain and therefore pain in the neck. It doesn't even have to be headbanging (pictured). It can be as simple as turning the head when swimming or sports related repetition such as looking up with volleyball or badminton. Sleeping in Awkward Positions
Source: https://health.clevelandclinic.org/back-side-stomach-sleep-position-best/
Sleeping is an extensive topic that will be covered in detail in the next section. Wherever possible however, try not to sleep on your stomach. This is mainly due to the prolonged period of time the neck might be in a rotated position. This can lead to all manner of stiffness and pain onset upon waking. For perspective, recall the last time your foot went numb and then was painful after sitting on it for a while. The neck also dislikes being stuck in a fixed position for extended periods. Trauma
Source: https://www.welcomebackclinic.com/blog/Whiplash---Neck-Injury.htm
Trauma to the neck can occur from contact sports or car accidents. In either case, the neck goes through a series of hyperextension and hyperflexion movements. This results in the stretching of ligaments and soft tissue around the neck, ultimately causing pain after the event.
Source: https://orthopedicandbalancetherapy.com/7-times-bad-posture-caused-your-headaches-and-neck-pain/
Two simple fixes that we advocate for good posture:- Move chin back towards throat
- Tuck shoulder blades in
Source: https://www.health.harvard.edu/staying-healthy/3-surprising-risks-of-poor-posture
- Feet flat on the ground
- Knees bent to 90°
- Entire back against backrest of chair
- Head and shoulders in line with hips
- Elbows bent to around 90°
- Eye lines up with the top of screen
Source: https://www.spine-health.com/conditions/neck-pain/text-neck-treatment-and-prevention
- Sit up straight
- Elevate phone to level of face
- Take regular breaks
Source: https://www.healthline.com/health/neck-tension#treatments
- Regular stretching of the neck especially in the less travelled directions.
Source: https://health.clevelandclinic.org/sleep-position-causing-back-pain/
- The use of a supportive pillow is paramount for side sleepers to maintain good neck posture
- For back sleepers, a flatter pillow to cushion the neck might be necessary to maintain good neck posture
- Strengthening exercises to promote correct activation of neck musculature
- Covered in more detail below
HOW CAN PHYSIOPHI HELP?
Source: https://golfdashblog.com/neck-strength-golf/
- Exercise Therapy: Pain causes the deep postural muscles of the neck to switch off. This results in other muscles compensating. These compensatory muscles are not designed to take over for a long period. Exercises aimed at reactivating deep postural muscles of the neck will reduce pain and improve function.
Source: https://learnmuscles.com/blog/2017/11/10/treat-spinal-joint-dysfunction-manual-therapy/
- Manual Therapy: Segments of the neck that allow for proper movement can be stiff. Manual therapy reduces the stiffness of these segments and restores range of movement, which can also reduce pain with movement.
- Dry Needling: Tension from overuse can be global in the neck, and dry needling is an effective method that can reduce tension. It also works well at the base of the skull for neck pain which is accompanied by headaches.
Source: https://www.physio.co.uk/images/advice-and-education/advice-and-education1.jpg
- Advice and Education: Getting to the source of the neck pain, whether chronic or acute, is the most important aspect of treatment. If the origin of the pain can be identified and modified, then prevention of future occurrences is possible. Several aforementioned strategies such as phone habits, ergonomic modifications and sleeping postures may seem minor, but these factors have significant contributions to neck pain globally.
At Physiophi, our years of experience with the different types of neck pain allows us to treat neck pain with great effectiveness. If you have either woken up with neck pain and stiffness or have been experiencing neck pain for a long time, book an appointment to see us. We pride ourselves on being able to reduce your neck pain and stiffness.
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REFERENCES
- Fernández-De-Las-Peñas, C., Plaza-Manzano, G., Sanchez-Infante, J., Gómez-Chiguano, G. F., Cleland, J. A., Arias-Buría, J. L., . . . Navarro-Santana, M. J. (2021). Is Dry Needling Effective When Combined with Other Therapies for Myofascial Trigger Points Associated with Neck Pain Symptoms? A Systematic Review and Meta-Analysis. Pain Res Manag, 2021, 8836427. https://doi.org/10.1155/2021/8836427
- Jahre, H., Grotle, M., Smedbråten, K., Dunn, K. M., &Øiestad, B. E. (2020). Risk factors for non-specific neck pain in young adults. A systematic review. BMC MusculoskeletDisord, 21(1), 366. https://doi.org/10.1186/s12891-020-03379-y
- Mahmoud, N. F., Hassan, K. A., Abdelmajeed, S. F., Moustafa, I. M., & Silva, A. G. (2019). The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis. Curr Rev Musculoskelet Med, 12(4), 562-577. https://doi.org/10.1007/s12178-019-09594-y
- Miranda, I. F., Wagner Neto, E. S., Dhein, W., Brodt, G. A., & Loss, J. F. (2019). Individuals With Chronic Neck Pain Have Lower Neck Strength Than Healthy Controls: A Systematic Review With Meta-Analysis. J Manipulative PhysiolTher, 42(8), 608-622. https://doi.org/10.1016/j.jmpt.2018.12.008
- Navarro-Santana, M. J., Sanchez-Infante, J., Gómez-Chiguano, G. F., Cleland, J. A., Fernández-de-Las-Peñas, C., Martín-Casas, P., & Plaza-Manzano, G. (2021). Dry Needling versus Trigger Point Injection for Neck Pain Symptoms Associated with Myofascial Trigger Points: A Systematic Review and Meta-analysis. Pain Med. https://doi.org/10.1093/pm/pnab188
- Price, J., Rushton, A., Tyros, I., & Heneghan, N. R. (2019). Effectiveness and optimal dosage of resistance training for chronic non-specific neck pain: a protocol for a systematic review with a qualitative synthesis and meta-analysis. BMJ Open, 9(2), e025158. https://doi.org/10.1136/bmjopen-2018-025158
- Seo, Y. G., Park, W. H., Lee, C. S., Kang, K. C., Min, K. B., Lee, S. M., &Yoo, J. C. (2020). Is Scapular Stabilization Exercise Effective for Managing Nonspecific Chronic Neck Pain?: A Systematic Review. Asian Spine J, 14(1), 122-129. https://doi.org/10.31616/asj.2019.0055