Neck Pain

Neck pain (cervicalgia) is pain in or around your upper spine, base of skull, and surrounding musculature.  A variety of medical conditions and injuries can lead to neck pain and in any given year, it can affect 20%-40% of adults. The chances of developing it increases with age and can be acute or chronic, local or radicular, and can interfere with your daily activities. Potential causes of neck pain include aging, physical strain, stress, and injury.  Physical therapy can help reduce your pain, muscle tightness, headaches, and radicular pain while restoring normal range of motion and function to your spine so you can return to prior level of function.

Prevalence

Neck pain is more common in women than men and the likelihood of experiencing neck pain increases with age. It has been reported that between 50%-85% of people who experience neck pain will report pain again within 1-5 years and 30% will develop chronic symptoms.  Pain can be acute (lasting days up to 6 weeks) or chronic (lasting longer than 3 months).  Symptoms can be local or axial (felt mostly in the neck) or radicular (pain that shoots into other areas  like into your arms). 

Common Risk Factors

Age: As you age, parts of your cervical spine begin to deteriorate from nature wear and tear causing pain. This degeneration can lead to conditions such as osteoarthritis, spinal stenosis, pinched nerves, and compression fractures. Discs can also weaken over time due to repeated stress and motion leading to herniation.

 

Physical Strain/Poor Posture: Overuse, such as leaning over a computer or smartphone for too many hours can lead to muscle strains and tightness. In addition to poor posture, weak abdominal muscles and increased body weight can affect the alignment of the spine, contributing towards neck pain. 

 

Stress: Many people who tighten their neck muscles when they are stressed don’t even realize they are doing it until they feel pain.  This constant tightening of neck muscles lead to neck pain and stiffness/tightness and headaches. 

 

Injuries: Physical injuries can to muscles, ligaments, disc, and spinal cord can lead to neck pain. Injuries can range from less common athletic injury to more common whiplash type injury from an automobile accident. 

 

Anatomical Structures: Bone spurs, cysts, herniated discs, masses such as tumors can place pressure on the nerves leading to more intense, radiating, and sometimes an electrical shock type feeling into one or both of your arms.

Signs and Symptoms

Pain: Pain may be localized or radiate into one or both upper extremities. It may worsen in certain positions and may be a dull ache or sharp shooting sensation.

 

Stiffness: Difficulty moving the neck with reduced range of motion and flexibility.

 

Muscle Spasms/Tightness: Involuntary contraction of the muscle that may produce sudden, intense pain resulting in more consistent muscle tightness. Spasms may also occur when trying to protect itself from further pain.

 

Numbness/Tingling: Typically involves a nerve and can extend into either upper extremity and into the hands. Pressure on the nerve can result in weakness into the affected upper extremity as well as grip strength. 

 

Headaches: Often occur from muscle tension and tightness from the surrounding neck muscles. 

 

Common Conditions

Muscle Strain/Tightness:  A common cause of neck pain.  You can injure muscles, tendons, or ligaments by lifting something too heavy or by improper lifting technique.  However, poor posture is a major cause of neck pain and muscle tightness. 

 

Disc Issues:  Discs provide cushion and height between the vertebrae.  Discs can either bulge or tear/herniate from their position in the spine and press on a nerve, resulting in radicular symptoms such as upper extremity pain, burning, numbness, or tingling.  With age, discs degenerate and become flattened, offering less protection and resulting in degenerative disc disease (DDD) with possible nerve involvement and associated radicular symptoms.

 

 Structural Problems

  • Spinal Stenosis: a condition when the spinal column is too narrow for the spinal cord, potentially causing severe sciatic nerve pain and lower back pain.
  • Scoliosis: a curvature of the spine that can lead to pain, stiffness, and difficulty moving
  • Spondylolithesis: a condition that causes the vertebrae in the spine to slip out of place, either anteriorly or posteriorly.  It leads to low back pain and often leg pain as well as it can place pressure on a nerve as it moves out of place. 

Fractures:  The bones in the spine can break during an accident like a car crash or a fall.  Certain conditions such as spondylolysis or osteoporosis increase the risk of fractures and compression fractures.

  

  • Spondylolysis:  a small crack between two vertebrae.  Can also be considered as a pars fracture.  It is more common in kids and teens, especially children who play contact sports.  Most common causes are overuse, growth spurts, and genetics.  Most people do not need surgery to treat it.  Rest, medication, and physical therapy are most successful when started early. 
  • Osteoporosis:  condition that silently weakens your bones, which can make you more likely to experience a bone fracture. 

Arthritis: Osteoarthritis can lead to neck pain. Ankylosing spondylitis is a type of arthritis that affects joints in the spine, causing neck pain, inflammation, and stiffness.  

 

Prevention

Maintain Good Posture: Keep your shoulders aligned with your hips and your ears over your shoulders.  Use the chair’s armrests and keep your knees slightly lower than your hips. Avoid straining to read the computer or phone screen. 

 

Maintain Good Sleeping Positions:  Use a small pillow to support your neck and keep your head and neck aligned with the rest of your body.  If sleeping on your back, you may place a pillow under the knees to take additional pressure of the low back. 

 

Adjust Your Workspace: Position your monitor at eye level while adjusting your mouse and keyboard to a comfortable height. An Ergonomist may be beneficial assessing your work station. 

 

Take Breaks: Taking frequent breaks every 30 min to one hour can be beneficial to reduce neck pain.  Set an alarm every 30 minutes and briefly stand and “wake” up your muscles and straining your muscles.

 

Manage Stress: Try to lower or manage your stress levels by performing deep breathing, yoga, meditation, or other relaxation techniques.

Elite Physical Therapy & Sports Medicine Treatment for Neck Pain

Whether acute, chronic or post-operative, we can help get you back to doing the things you want to do.

 

Reducing pain and muscle tightness is typically our initial focus along with techniques such as traction to reduce neurological and radiating symptoms.  Once range of motion and flexibility is improved, focus shifts towards stabilizing the spine and strengthening the peri-scapular musculature.

 

Manual therapy, Mechanical Traction, Dry Needling, Kinesio Taping, and applied functional science are just some of the techniques that can be helpful in getting you back to what your want to do.