Neck pain is a common complaint that we see in physical therapy. Our posture as a society has continued to decline with the increased use of phones and computers. Poor posture can lead to many neck injuries that can be addressed with physical therapy.
Common Neck Injuries:
Cervical radiculopathy is a term that means radiating pain down into your arms/hands or upper back due to nerve compression in the neck. Most people will complain of numbness down into their hand or posterior shoulder pain with moving the neck into a certain position. These symptoms can often be alleviated by light traction of the neck/spine or changing your posture. Cervical radiculopathy is commonly caused by disc pathology in the cervical spine causing nerve root compression.
Cervical arthritis and stenosis is common to develop as we age and can be accelerated with previous injury or prolonged poor posture. Arthritic changes occur within the facet joints of the neck which are required to slide and glide to allow full cervical ROM. The facet joints are what allow the cervical vertebrae to be stacked on top of each other and provide us the ability to move our head. Stenosis is categorized as a narrowing of the small holes that the cervical spinal nerve roots exit the spine causing nerve compression or pain. The narrowing can be caused by bone spurs, scar tissue, inflammation, or disc material from an old disc herniation.
Whiplash injuries most commonly occur due to a motor vehicle accident however can also occur from a fall or concussion. Whiplash results in a sprain of the muscles and ligaments of the neck and result in the spine becoming more unstable. One will often experience sudden pain in their neck and muscle spasming making any active motion of the head difficult and painful. You may also experience a sensation of the head being heavy and need to lie down to alleviate pain. The pain will also commonly cause headaches or radiating pain into the shoulder blades and upper back.
Cervical Instability is a term that is used to describe excessive motion of the neck and muscle weakness which results in poor spinal mechanics and pain. If you have cervical instability you are at risk for overuse injuries, headaches, and chronic neck pain due to inflammation. It is common to have shearing in the spine which is when several of the vertebrae move too much while others don’t move enough causing overuse and inflammation at certain segments. Symptoms of cervical instability commonly include headaches, a feeling that your head is too heavy, pressure through the neck, difficulty sitting or standing for prolonged period of time, and a constant feeling of muscles being tight and ‘spasming.’
Posture and its effect on neck pain
Posture is extremely important, especially when it comes to preventing neck related injuries. As a society we tend to spend large amounts of time sitting at computers, reading e-mails and texts on our phones, and watching TV which will all result in abnormal stress in our neck if performed with poor posture. Poor posture often develops from bad habits and weakness in a key muscle groups, your scapular muscles. The scapular muscles are the muscles that surround the shoulder blade and help you sit up straight. The middle trapezius, lower trapezius, and rhomboids are the 3 major muscles that help us sit up straight. We tend to sit with our backs rounded and shoulders forward (slouched) which results in the scapular muscles to become over stretched. An over stretched muscle is a weak muscle which results in complaints of neck and upper back pain or “it’s too tiring to sit up straight.” A slouched posture also causes our head to jut out forward called a forward head posture and is a common cause of headaches and significant muscle tightness in the muscles at the base of the skull. By training these muscles to work optimally we are able to sit up straight for long periods of time and take all the stress off our neck. It will also decrease the frequency and intensity of headaches and can even decrease low back pain. Physical therapy will teach you how to effectively use your scapular muscles, teach you proper postures for daily activities, and improve your overall neck and upper back health to allow you complete all daily tasks pain free.
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