Neck Pain

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Physiotherapy is a very common and very effective way to manage neck pain. Our treatment approach will depend on each person’s situation: the type of symptoms you have, how these symptoms developed, how you have tried to manage your symptoms, and what your goals are with treatment. Our goal of treating neck problems is usually to reduce pain and stiffness, to get pain-free neck movement, to improve the strength of your neck and surrounding structures, and ultimately to prevent the problem from recurring.

Postural Neck Pain

Neck Pain

Probably the most common reason for neck pain is posture. Postural neck pain develops when we stay in poor or awkward positions for long periods of time. For example, when we work on our laptops or look down at our phones. Most commonly, it is a forward flexed posture.

Being in this position for extended periods of time places stress on the back of your neck, shoulders, and upper back. If the problem is not addressed, further muscle, fascia, bony, and nerve structures will be compromised, and you may develop additional symptoms such as headaches, dizziness, difficulty concentrating, vision problems, pins and needles, or weakness in your arms.

Postural neck pain responds very well to physiotherapy treatment. Our aim is to reduce pain and discomfort, ease muscle tension, restore normal, healthy movement and optimise posture to prevent worsening of symptoms. We will teach you ways to adapt and thus manage your postural pain, and how to perform daily tasks more optimally. Depending on your specific presentation, treatment may include massage, heat application, electrotherapy, manual spinal and nerve mobilisations, stretching and strengthening exercises, as well as education and advice on ergonomics.

Acute Wry Neck

A sudden onset, painful and stiff neck is called “Wry Neck”. It is usually caused by muscle spasm or a locked facet joint in the neck. It is very common in younger people. You typically wake up with a sore and stiff neck, and be “stuck” a one position. Attempts to move out of this “stuck” position will cause pain. Early movement must be encouraged but since movement of the neck can be very painful, we may need to perform passive, manual techniques to “unlock” the small joints of your neck and release the muscles. Early treatment (preferably within 12 hours of onset) is crucial to restore movement and function of your neck, and to prevent complications. Wry neck symptoms can resolve within 24 – 48 hours with early, effective treatment. Treatment typically involves applying heat, massage, dry needling, performing gentle passive joint mobilisations, and encouraging gentle stretches and movement. Once you are pain free and can move your neck through its full range of movement, it is a good idea to start a strengthening program to prevent recurrences in future. We create individual exercise programs for each patient, depending on your specific needs and abilities.

Whiplash-associated Disorders

Neck Pain

A common cause for neck pain is whiplash. These injuries are common in car accidents, but can also occur with work or sports incidents. The sudden, forceful head and neck movements that take place during the incident may cause damage to soft tissues and joints in the neck area. Mild injuries will cause some neck stiffness or discomfort for a few hours or days.

More severe injuries may cause significant neck pain, stiffness with restricted neck movements, headaches, problems with vision, nausea, dizziness, loss of balance, and tingling sensations in your arms. Everyone who sustains a whiplash injury should be medically examined to rule out any serious damage to ligaments or bony structures, even if their symptoms are not severe.

Most whiplash injuries won’t result in serious damage and can be successfully treated with physiotherapy. For best results and to prevent problems later on, early treatment is advised. During the initial, acute phase of treatment, our goal is to reduce pain and stiffness. This can be achieved through various techniques including ultrasound, electrotherapy, massage, heat application, gentle passive mobilisations, and relaxation techniques including breathing retraining. To ensure optimal pain management, we will discuss pain medication with your doctor, if needed. As you get better, treatment will become more active, where we will guide you through exercises and stretches. The aim of active treatment is to restore normal neck movement, strengthen your neck muscles, and improve your neck posture and function. We want to empower you to be able to self-manage your symptoms. Recovery from whiplash-associated injuries may take up to two years, and we understand that this lengthy period may cause some mental and emotional distress. Therefore, we will not only treat your symptoms but will guide and support you throughout your recovery.

Nerve Root Pain

Occasionally, neck pain may be caused by an injury or irritation of the nerve where it exits the spinal cord. Pain from a nerve root typically occurs on one side, although it can be both sides, and distant from the site of injury or irritation, such as down the arm or in the hand. Other symptoms of nerve root injury may include arm weakness, numbness, or pins and needles in the arms or hands. Nerve root injury/irritation can occur as a result of degeneration of the vertebrae or disc, such as in osteoarthritis, ligament injury, disc herniation, or due to a vertebra moving slightly out of place. Previous trauma to the spine can also cause nerve root pain either acutely, or later on.

Nerve root pain can be successfully treated without surgery. Your doctor may prescribe pain and anti-inflammatory medication. Physiotherapy treatment aims to resolve the root (excuse the pun) cause of the problem, and thus restore normal nerve function. Depending on your specific presentation, we will choose treatments to address your symptoms and functional deficits.

This may include pain management strategies such as ultrasound, electrotherapy, dry needling, massage, and heat therapy. To restore normal spinal movement, reduce spinal stiffness, and relieve pressure off the nerve root, we perform spinal and/or nerve mobilisations. We also teach you specific exercises to regain normal movement and strengthen the muscles around your neck, back, core, and shoulder girdle. Here, we may include postural retraining and advice if needed.

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