Neck pain is a relatively common condition, yet it reacts favourably to non-invasive and conservative treatment. Initial management is aimed at resolving the initial neck pain and restoring function.
Aims of Treatment
Decrease recurrence rates
A multimodal approach has been found to be the most effective this may include manual therapies, exercise, dry needling and functional or sensory training.
Assessment should include the neck, shoulders and spine eliminating any possible Red Flags.
Treatment is based on a multimodal approach and may include, manual therapies, myofascial trigger points, dry needling, functional soft tissue work, exercise, postural analysis and sensory training in the case of whiplash (WAD)
Neck pain affects both athletic and the general population, it is a relatively common complaint affecting a large percentage of the population each year.
Epidemiological studies show that approximately 70% of the population is affected at some stage in their lives, with 40% suffering neck pain in any given year. With up to 60% suffering episodic bouts after the initial presentation.
Neck degeneration is highly age dependent with a linear pattern.
There is a very strong genetic component 70-80% with degeneration and 30% idiopathic.
There is a positive association with heavy work and some sport (dose response).
Neck degeneration does not necessarily correlate with pain.
Pain may be local, referred upwards towards the head or down towards the shoulder girdle.
This may be due to dysfunction within joints, discs, dura, vascular tissues, ligaments or muscles.
Dysfunction of the upper cervical complex may lead to headaches these may be felt in the occiput and frontal region of the head and face.
Pain being referred to head and face may also be commonly attributed to Trigger Points emanating from the neck and shoulder girdle muscles.
Upper Shoulder Girdle Pain
The lower cervical region may refer pain to the shoulders, scapula, upper thoracic area and the chest.
Radicular pain is pain radiating into the upper limb that may be deep or sharp in nature. Usually emanating from the nerves of the Brachial Plexus or vascular tissues.
N Bogduk, B McGuirk. 2006. Management of Acute and Chronic Neck Pain. Pain Research and Clinical Management. An evidence based approach. Elsevier.
G Jull, M Sterling, D Falla, J Treleaven, S O’Leary. 2008. Whiplash Headache and Neck Pain. Research-based directions for physical therapies. Churchill Livingstone.
J A Porterfield, C DeRosa. 1995.Mechanical Neck Pain. Perspectives in Functional Anatomy. W.B.Saunders Company.
Simons D, Travell JG, Simons LS.1999. Myofascial pain and dysfunction. The trigger point manual. Upper half of body. 2.: Lippincott, Williams and Wilkins.
Neck treatments are available with Raymond Smith, Chiropractor, 114 Alexander Street, Crows Nest, NSW 2065