Neck Pain

Introduction to neck pain

 

Like back pain, neck pain is very common, we’ve all experienced it at some point in our lives.

Some common causes of neck pain can include muscle strains, acute injuries such as whiplash from a motor vehicle accident, poor posture and bad work/desk ergonomics. Other causes of neck pain can include:

  • Facet joint  dysfunction/syndromes (“pinched nerves”)
  • Disc herniations
  • Degenerative disc disease
  • Osteoarthritis
  • Tight muscles and or Trigger points
  • Spondylolisthesis
  • Spinal stenosis 
  • Neck aches and pains from sitting in front of a computer all day (which I am experiencing right now 😅)

Symptoms of neck pain

The symptoms of neck pain can vary depending on the underlying condition or injury. Well break it down into 3 categories:

  1. Localised Pain
  2. Muscle Pain/tightness
  3. Referred Pain

Localised pain

In cases of muscle strains, facet dysfunction or degeneration, a person may experience pain in and around the neck. Neck pain can be experienced in the front (anterior) as well as at the back (posterior) of the neck. The pain is usually due to inflammation and aggravation of the joints, ligaments, intervertebral discs and muscles of the neck.

Muscle pain

When the muscles in the neck and shoulders become tight or inflamed, they can produce painful symptoms. These symptoms can be local to the affected area or they can refer pain as seen with myofascial trigger points. Trigger points are taut bands or “knots” that can be felt in the muscles. Trigger points refer pain in a predictable pattern, this can be pain referred around the neck and shoulders, to the head, down the back or into the arms and hands. Here are some examples:

Trapezius Muscle

Neck pain trapezius
Trapezius Muscle 1

 

Neck pain trapezius
Trapezius Muscle 2

Levator Scapulae Muscle

neck pain Levator scap

Scalene Muscles

Neck pain Scalenes

Sternocleidomastoid (SCM) Muscle

neck pain SCM

Referred pain

There are different kinds of referred pain that a person can experience, we have already covered the pain referral patterns of specific muscles above. A shooting, burning or electric shock-like pain felt going down the arm and sometimes into the arm is called radicular pain. Radicular pain occurs in cases of spinal stenosis, disc herniation with nerve root compression, cervical facet joint syndromes or degeneration, as well as thoracic outlet syndrome. Pins & needles, tingling, numbness and a loss of grip strength can also occur.

Neck pain cervical facet syndrome
Cervical facet syndrome referral patterns

 

 

 

 

Treatment for neck pain

Chiropractors may utilise several treatment methods and modalities to treat neck pain:

Spinal manipulation/Adjustments

Adjusting/manipulating the neck helps to relieve pain by reducing pressure on sensitive structures such as nerves, increases movement and flexibility, increases blood flow and reduces muscle tension. When an adjustment takes place, normal nerve function is restored to the joint and very often you will find that a muscle spasm that was previously there has subsided almost instantly.

Neck pain adjustment

Decompression techniques

Manual traction or door-traction units can be used to help relieve neck pain and radicular symptoms. Our spines are under constant pressure so these types of treatment modalities are extremely useful in treating neck pain.

Soft tissue therapy

A common response to pain in the body is a reactive muscle spasm to try and protect an aggravated area of the spine. Massage, fascial release and instrument-assisted soft tissue mobilisation (IASTM) are very effective in relieving muscle tightness.

Massage
IASTM – Instrument Assisted Soft Tissue Mobilisation

Dry needling

A very effective method for treating myofascial trigger points is Dry Needling. This involves the practitioner inserting an acupuncture needle into the muscle, which stimulates blood flow to the affected area and results in a reduction of pain, inflammation and muscle tension.

Dry Needling

Other modalities

Heat and cryotherapy can assist in pain relief and decrease inflammation. Electrotherapy such as interferential current or ultrasound may also be used.

 

Ultrasound

 

IFC

 

Exercise, Stretching and Ergonomics

A common pattern of muscle imbalance seen in the neck is something known as Upper Crossed syndrome. Here we’ll find that a person has tight upper trapezius, levator scapulae and pectoralis manor & minor muscles, with weak deep neck flexors, rhomboid, serratus posterior and lower trapezius muscles. When this occurs, it’s common to see a person has a rounded shoulders, hunched forward and with their head in the forward position. This also just happens to be the position most us are sitting in while we’re in front of a computer. 

Neck pain Upper cross
Upper Crossed Syndrome

To correct this there are a few factors:

  • Strengthen the weak muscles
  • Stretch the tight muscles
  • Make sure you are sitting correctly (see pictures below)
  • Take regular breaks while working at your desk to stand up and walk around. Over time we tend to slouch while sitting so it’s important to reposition yourself regularly.
Don’t sit slouched like this ☝️
This is also bad ☝️
This is good 👍