Neck pain is a very common condition and most people will suffer pain in their neck at some point in their life. It can range from a mild discomfort to a more severe pain and be due to a sudden acute onset or be more of a chronic problem. Neck pain is more frequently seen in women than in men, and it can influence your ability to work, carry out day to day activities as well as effect your sleeping habits.
The neck is composed of 7 vertebrae housing and protecting the spinal cord. It has a complex arrangement of muscles, ligaments, and nerves which are enveloped, supported and strengthened by multiple layers of dense, fibrous tissue known as fascia. The vertebrae are connected to each other by joints which allow the neck to bend forwards, backwards, and side to side. In between the vertebrae are structures called discs. These have a much higher water content than bone and help to absorb pressure and load. When any one of these structures becomes worn, injured or inflammed, neck pain can occur.
When we are born the discs have a very high water content, but as we get older these discs become less hydrated and more fibrous. This is known as ‘degenerative disc disease’ (DDD). Just like grey hair and wrinkles, this is the normal ageing process and occurs at varying rates depending on the individual – it can start as early as your 20s!
With most acute neck pain the outlook is good with symptoms easing within a few days and gone after a few weeks.
Frequently there appears to be no specific reason for the onset of neck pain, however there are a number of possible causative factors:
• bad posture; it is very common in people who spend a lot of their day at their desk in front of a computer with a ‘poking chin’ posture
• trauma or injury; minor injuries or sprains to the muscles or ligaments usually caused by impact or contact with an object, surface or another person, or
• falling asleep in an awkward position; can cause a ‘wry neck’ where it becomes stuck to one side with a lot of muscles going into spasm. This can make it very difficult to move the neck back into an upright position
• worry or stress; tends to tense up the muscles of the neck and shoulders so that they become stiff and tight
• a disc problem; the intervertebral disc sits inbetween the bones of your neck and helps to provide shock absorption during movements. They can sometimes bulge beyond their normal borders causing an inflammatory reaction and pain. As the discs bulge or protrude to the side they can also irritate the nerve as it leaves the spine and travels down the arm. This can therefore cause arm pain with possible pins and needles or numbness. If the nerve’s ability to function starts to become affected you may suffer with weakness or changes in your sensation within the upper limb
• arthritis; degeneration or wear and tear of the joints between the vertebrae or the discs is a common cause of neck pain. Although you would expect this to only be present within the elderly, it can actually occur at much younger ages and progress at varying rates. It is important to remember that arthritis is the normal ageing process and although it is a common source of pain it can be managed well with exercises, advice and physiotherapy
• whiplash injury; This often occurs as a result of a road traffic accident. It involves a sudden forwards and then immediate backward movement of the neck. This can result in overstretching of the muscles, ligaments and nerves as well as irritation to the joints in the neck and therefore pain often results
For the most part, with general neck problems the pain feels like an ache with stiffness in the neck area, and pain on movement. However it can sometimes become a sharper or even burning sensation. It often radiates into the shoulder, or between the shoulder blades and can also go down the arm and into the hand. Sometimes it may cause pins and needles or a tingling sensation in the arm. The pain can also go up into the neck causing a headache and can produce a feeling of weakness in the shoulders and arms.
The spine is an ‘S’ shape and this helps to dissipate the load of your day to day activities. It is therefore important to maintain these natural curves in the neck, otherwise the ligaments, muscles, joints, nerves and discs can be put through abnormal stresses which can cause pain. We rely on the use of the deep neck muscles (‘core muscles’) to help maintain the ‘s’ curve and thus support the neck. The neck has multiple other responsibilities, including support of the head and face and coordination of movement between the head the upper body.
Posture is a key factor to neck pain. It is the way we hold and move our bodies. It is unique to each one of us and can be influenced by our mood, daily activities and environment. Certain posture types can cause muscle imbalances and again predispose us to an increase risk of poor core stability and neck pain.
However, at The Wyndham Centre the physiotherapists can guide you through both manual treatment techniques and rehabilitation in order to improve your postural habits as well as show you how to activate and strengthen the core muscles, with the aim of reducing your neck pain, and giving back the support your body needs.