3 Common Causes Of Neck Pain And How to Successfully Manage Them

Hello everybody and welcome, welcome, welcome to the health and sport show! My name’s Tom Butterfield and in this episode we're going to talk about the three most common causes of neck pain and the best ways to manage them. I've been spending some time looking through and answering questions in a variety of different Facebook groups and it became clear to me that a lot of people are confused, frustrated and concerned about their condition. The first step should always be to get a clear, solid diagnosis first. This is where a well trained clinician or therapist is needed.  It’s ok to ask other group members questions, and learn from their experiences but bear in mind that everybody is different, and just because somebody got a certain outcome, it doesn’t mean that you will.  Ok, here are the three most common causes of neck pain;   Joint Dysfunction - There are lots of joints in the neck, and just like any piece of machinery, if it’s not maintained well or serviced regularly it’s only a matter of time before a problem occurs. The mistake people make is thinking that in order for there to be pain there MUST be some ‘damage’….. and that causes people to worry….. but fear not…. Unless there’s been some form of trauma this is very unlikely. Clients will often say things like;   I didn’t do anything…. I just woke up like this… I must have slept funny… All I did was look over my shoulder….     None of these are traumatic movements, therefore, very unlikely to have caused any tissue damage such as muscle strains, ligament sprains, disc injuries or fractures.    The brain receives messages from the body constantly, trillions of messages every second letting our brain know exactly what's going on at all times. Are we hot, are we cold, all our hormone levels correct, are we in danger, are we hungry et cetera et cetera. As Chiropractor's we deal with the parts of the body that enable us to move or hold ourselves up against gravity. That includes the joints, muscles, ligaments, tendons, and other associated soft tissues or contains special receptors send messages to the brain licking letting it know whether things are functioning optimally. If a joint stops working correctly, causing joint dysfunction the brain will protect this area by causing local muscle spasm. This results in neck stiffness and pain if you try to move your neck past this reduced range of motion.   We've put together a YouTube video which explains this in a bit more detail, there is a link to this in the show notes if you're interested.    Typical features of this problem are;   Dull ache ( can be sharp on certain movements) Can radiate to the head or top top of the shoulder blade. Pain aggravated by movement, improved with rest. Neck stiffness is common - but movement can at times be normal Tilting head backwards, tilting towards the painful side and neck rotation are commonly painful.  Tender when palpating (pressing) over the joints and muscles of the neck on affected side.     If there’s been no history of trauma then we have no need to take any form of imaging at this stage - X-ray, MRI etc. Clients love a scan, but in cases where we feel the cause is from joint dysfunction I very rarely ever feel it provides any extra information to change the treatment and management of the case.  From a management perspective, seek out a solid diagnosis from a well trained professional first! Don’t buy lots of gadgets off Amazon before you even know what the problem is.    A typical treatment plan for a client with neck joint dysfunction would look like this;   Soft tissue massage to the neck and shoulder muscles Neck joint manipulation/mobilisation to regain joint function. Once function has been restored start an exercise program to aid good posture, and efficient function of the neck. Key to reduce the risk of recurrence.  Use paracetamol if appropriate for the individual (Ibuprofen may not be effective due to the lack of inflammation in this type of condition).    Frequency of treatment is key too. I would generally see a client with this type of problem a couple of times a week for 2 weeks in order to make some sustained functional changes, but this will differ from person to person.      2) Muscle Strains / Ligament Sprains - These can present in a very similar way to a joint dysfunction. The major difference, however, is in how the problem occurred. With a strain or sprain there will be a clear traumatic event that happened, and the individual will experience pain immediately, or very shortly after the trauma has occurred.    In these cases the first thing is to rule out any serious damage to the neck. The risk of this increases with the severity of the trauma…. If the neck feels unstable, or you lose strength or sensation in any of your limbs then best to get things checked out ASAP by a trained professional. This might be a suitable time for X-rays or MRI’s if the clinician sees fit.    Once serious injury has been ruled out the client can be more confident in moving their neck without causing further injury. Reassurance is extremely important. That’s the first step in managing this type of neck problem.    Muscles and ligaments take time to heal, and the length of time will depend upon the severity of the damage, it could be anything from a couple of weeks, to several months. But we would expect a slow, gradual improvement over time. Once the client is able, I would then recommend starting a treatment plan very similar to that for neck joint dysfunction.    3) Cervical Spondylosis - Very common in the lower neck C5-C7 levels especially. The discs dehydrate naturally over time - which is one of the reasons why we become shorter as we get older… When the disc dehydrates it flattens causing the facet joint surfaces to be under greater pressure, and reduces the space for the nerves to pass through - this increases the risk of both joint dysfunction and nerve irritation/entrapment. Both of which can cause pain.    There will be an absence of trauma as this is a condition that will progress very slowly over decades in most cases. Commonly clients will report;   dull aching pain  Improves with warmth/heat and activity Worse with prolonged extension of the neck (looking up) Usually unilateral (one side) - but can be both sides.  Can refer into the head, arms or shoulder blade.  Can wake you from sleep with pain or numbness in the arm. Joints tender on palpation Restricted movement of the neck. Acute attacks over a chronic baseline of aching and neck stiffness.   Are X-rays useful here? Spondylosis is extremely common in anyone over the age of 50. But not everybody over the age of 50 has neck pain, therefore, we have to assume that spondylosis on its own does not ALWAYS cause neck pain. So in clients suspected of having spondylosis I wouldn’t bother referring for x-rays unless they had multi level neurological symptoms (involved more than one nerve level), suspicion of pressure on the spinal cord, if they weren’t improving s expected with treatment, or if their condition was getting worse.  Treatment in these cases can be slightly different to a simple hint dysfunction. I like to start with simple neck traction to help decompress the joints of the neck, and mix in some soft tissue massage alongside.  That might be enough to start providing some relief, however, if not then we can use joint manipulation/mobilisation techniques. Those that don’t improve we could refer for imaging IF we felt it would change the treatment plan.  So there you have it, these are the three most common causes of neck pain. The key takeaways are;   Get diagnosed by a well trained professional X-rays and MRI’s are rarely needed.  Treatment is a process, not an event….don’t expect an instant fix! So make sure you talk through your expectations with your therapist and make sure you’re both on the same page.  Thank you for listening or watching I hope that you found it useful and answered some of your questions. If you have any further questions either get in contact with us on [email protected] or leave a comment on the YouTube video. We’ll be more than happy to answer them for you. We want to try and help as many of you as possible experience some kind of progress.  Reviewing and sharing the episode would be great and please do subscribe to our podcast and our YouTube channel it really does help. 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