“It’s my neck”

Neck pain is a widespread problem across most Western societies. Most neck pain occurs in association with a sense of tightness that spreads to the shoulders and upper back region. Or it may be associated with a headache or other symptoms such as dizziness, lightheadedness or a sense of feeling vague or a little “out of it”. In addition to variance in the location of symptoms on the back, we also tend to see variation in the intensity of symptoms. Some people experience neck pain as a mild annoyance that they can generally live with. While for others neck pain and other associated symptoms can be life changing in terms of the impact it can have on one’s occupation, recreational activities, social life, family life and mental health status.

Common Treatments for Neck Pain

Below you will find information on some of the more common treatment options for back pain. The decision to use one, some, all or none of these interventions is guided by a careful assessment of the relevant scientific literature and an analysis of your specific circumstances and case history.

Activity Modification
Graded Strength & Conditioning
Joint Mobilisation
Joint (thrust) Manipulation
Remedial Massage
Sports Massage
Trigger Point Therapy

Types of Neck Pain

Acute neck pain

Acute neck pain often begins “out of the blue” without there being any obvious cause or precipitating event… the type of neck pain that one might just wake up with one day. Similar to this type of neck pain is the type that is triggered by a fairly innocuous event. Just last week a patient reported that she flick her head back while brushing her hair and felt a very sudden onset of pain. Typically, in these scenarios where very intense neck pain / stiffness / tightness emerge suddenly, for no obvious reason, I tend not to be too concerned that the problem is going to long lasting. Most often the “bark” of acute neck pain is worse than its “bite”.

Although knowing that won’t make this type of neck pain hurt any less right now… it is useful to know that this sort of pain tends to follow a certain recovery trajectory and resolve in a fairly predictable time frame. Very intense pain is not necessarily a sign of very serious injury. You can learn more about how to manage the acute phase of this type of neck pain in the following videos and accompanying text.

 

Longstanding and Chronic Neck Pain
Whiplash Injuries

A whiplash injury is the term used to broadly classify injuries resulting from a sudden acceleration / deceleration of the head and neck. The common example is the whiplash motion of the head in motor vehicle accident. Other common scenarios that involve a whiplash motion of the head and neck include a heavy fall onto one’s buttocks or back, resulting in sudden jerking back motion of the head. Similarly, sports involving high force body collisions can create whiplash scenarios.

If you have suffered a whiplash injury, particularly a high force injury such as a car crash, it is important to have the injury assessed by a doctor or physio. We can assess your condition to determine whether or not it is necessary for you to have diagnostic imaging such as an x-ray carried out. The purpose of the x-ray would be to rule out the presence of a suspected fracture to one of your neck bones. In the event that a fractures is present, you will likely be admitted to hospital for monitoring and treatment. Depending on the severity of the fracture, you could require surgery.

When the assessment reveals that there is no fracture, or no clinical signs of a fracture or other serious structural pathology, conservative (meaning non medical, non surgical) management is indicated. This is where our role as physios is really important. If you’ve had a whiplash, and we know that there is no scary damage that has occurred to your neck, it is really important to commence a guided and graded return to your normal occupational and recreational activities.

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Common Neck Pain Diagnoses

You may have already received a formal diagnosis for your neck pain by a Health Professional or Doctor. Or perhaps you’ve been googling about in an attempt to find a solution to your neck problem. We’ve included a list of common diagnoses that are often provided to patients to explain their neck pain. It can be very helpful to place these structural diagnoses within the broader context of the physiology from which neck pain emerges.

Herniated / Bulging Disc / Annular Tear

A herniated or bulging disc would by far be the most common answer I receive when I ask patients the question- “what do you understand to be the cause of your pain?” When we are discussing disc related neck or back pain, it is really important that we place the herniated or bulging disc within the broader physiological context from which symptoms emerge. Put simply, the presence of a disc bulge or disc herniation is only part of the story of neck or back pain. It may be a big part of the story, or a small part of story… as time goes by, the bulging or herniated disc should become a smaller part of the story.

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Compressed / Pinched Nerveroot

This diagnosis often goes hand in hand with a diagnosis of a bulging or herniated disc. Very often patients will explain to me that their pain is a product of a disc bulge squashing a nerve root in their spine, with their pain spreading down the leg or arm. It is quite common for an MRI study to reveal contact between a bulging / herniated disc and a spinal nerveroot. But again, these findings also turn up in MRI results of people with no pain. So I think it is worth reiterating the concept of nerve sensitivity.

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Scoliosis

Scoliosis was originally a Greek word meaning curved or bent. Today it is a word used to describe the most common type of spinal curvature. Scoliosis is simply a descriptive term, like headache- it is not a precise diagnosis. In other words, if you have had some imaging like an x-ray, or some other form of assessment that indicates that you have a spine that curves laterally, the next step is to work out why your spine is curved in such a manner.

There is some useful information about the various “types” of scoliosis on www.scoliosis-australia.org.

Small lateral curves in the spine a common and are of no particular consequence to an individual. For most people, a mild scoliosis is not something that warrants any specific treatment. We (people in general) are not perfectly symmetrical beings. We are capable of adapting to a mild scoliosis and performing our preferred occupational and recreational activities over a lifetime.

There is however, a smaller group of the population who develop more pronounced or prominent curves in their spines. And since every pronounced or severe case of scoliosis starts off at some point as a mild case, it does make sense to take measures to identify those who might be at a higher risk, as this will provide the best opportunity to commence effective treatment.

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Spondylitis, Spondylolysis, Spondylolisthesis, Anklylosing Spondylitis

Call us today to chat about your neck pain. 9665 9667. Or book an appointment online.

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