Physiotherapy – Neck

Neck pain is very common and many people will experience this at some point in their life. The neck is a very important structure allowing us to move our head through a wide range of movement, enabling daily tasks to be performed with ease. Our neck is particularly vulnerable to strain and injury, often involving the soft tissues (muscles, ligaments, discs and nerves) and joints which surround it.

There are numerous types of neck injuries. Some of these injuries occur after straining the soft tissue by placing too much strain on the neck. This could be due to sleeping in a bad posture or after painting a ceiling. This type of pain can be associated with a stiff neck.

Alternatively an injury can occur over a longer period of time if the neck is held in a bad posture where the load on the neck exceeded its capacity to support the weight. Remember the weight of a head is around 4-5 kg.

Unfortunately our joints degenerate as we age, the level of degeneration depends upon genetic factors, occupation, previous injury and level of previous activity. These joint changes can cause narrowing of the spinal canal (spinal stenosis) where the spinal cord sits, or through the canal at the side of the neck where the nerves lie. These changes can cause compression of the nerves which can radiate pain along their path. This is why some people complain of arm pain and altered sensation in their fingers and pins and needles. If the nerve is significantly compressed then this can lead to muscle weakness.

Prolapses can occur in the neck but are less common than in the lumbar spine. If the inner part of the disc pushes far enough out then this can also compress the nerve root and reproduce the symptoms mentioned above.

We know stress is a big trigger of muscle tightness and altered posture around the shoulder, neck and head. This increased tension can cause neck pain, headaches and sometimes visual disturbances.

Whiplash occurs when the soft tissue in the spine is stretched and strained after the body is thrown in a sudden, forceful jerk. The injury most commonly occurs in car crashes involving sudden deceleration, but the injury can also occur in other strenuous physical activities such as driving.

Signs and symptoms

Depending upon the cause of neck pain the symptoms may vary. Most neck disorders present with stiffness along the side of the neck, especially at the end of movements like turning your head. This stiffness can be present even when sitting. Sometimes the neck muscles can go into spasm making head movement extremely painful or difficult. If you notice pain travelling into the arms and down to the fingers, this can be a result of the pain in the neck. In more extreme cases you may lose the ability to lift an arm or feel pins and needles and pain in both arms. If this is the case then it is advisable to see your GP.

How physiotherapy can help

Providing the right diagnosis is important to providing the correct treatment. After a thorough assessment of your neck and arms your physiotherapist will look to restore normal neck movement, strength and reduce pain. As every neck injury presents in a unique way your physiotherapist will individually tailor your treatment to your circumstance. This usually includes postural advice and muscle strengthening, joint mobilisations, massage, acupuncture, traction, and core stability.

The term ‘whiplash’ describes a sudden accident involving the neck, such as in a car accident.

The symptoms often take a while to develop after an accident. Any inflammation (swelling) and bruising in the neck muscles won’t usually be obvious at the time of the accident. It may take 6-12 hours for the symptoms to become apparent.

Symptoms include neck pain and stiffness, headaches, pins and needles or numbness in the arms and hands, blurred vision, nausea, tinnitus (ringing in the ears) and difficulty swallowing.

Taking anti-inflammatory medication can reduce the inflammation and painkillers should help to ease the pain.

It is very important to move the neck as normally as possible after the accident. If the pain is severe, it may be necessary to rest for a day or so initially. As the pain eases, the neck should be exercised gently to avoid stiffness.

It’s also beneficial to maintain a good neck posture when standing, sitting or walking, and to have a supportive pillow in bed.

Physiotherapy is helpful in speeding up the recovery from whiplash with advice and specific exercises to help to regain neck movement.