We have all experienced neck pain to some degree- it may be brought on from sitting at a computer the whole day, from playing sports or possibly from an accident. Neck pain is a relatively common complaint, affecting up to 70% of individuals at some point during their life. Approximately 40-50% of the population suffer neck pain in any one year. Our Chartered Physiotherapist Niamh Connolly discusses the problem and some measures by which to reduce the chance of the problem occuring.
It tends to be a persistent and recurrent disorder where approximately 60% of individuals can expect to get some degree of on-going pain following their first episode.
The aim of physiotherapy rehabilitation of neck pain is to prevent a first episode from turning into chronic (>3 months) or recurrent pain.
The Neuromuscular system is one of the main reasons why people get a re-occurrence oftheir neck pain. The neuromuscular system is composed of nerves and muscles, these allow for innervation and movement of the muscles in the body. When a person undergoes pain and injury the strategies to control movement, posture and stability are compromised.
If neuromuscular function is altered this can cause:
- Delayed activation of neck muscle
- Changes in muscle size
- Changes in muscle composition
- Impaired postural endurance
- Altered muscle activation movement
All of which can lead to neck pain
Some examples of this type of altered function would be:
A reduced ability to maintain upright posture during a computer task, this reflects a low level of endurance in the muscles required to control the postural function of the spine, and over time if this is a repetitive position eg office / desk related job this may lead to neck/ shoulder pain.
How is Neck Pain Treated?
The key principles in treating neck pain involve
- Selectivity and specificity of exercise
- Early rehabilitation
- Pain-free rehabilitation
- Rehabilitation for prevention of reoccurrence
Numerous recent studies in neck pain+ headaches, chronic whiplash, chronic idiopathic (spontaneous) neck pain have shown relief of neck pain and disability when these principles have been used (Jull et al 2002, Jull et at 2007, Falla et al 2011).
How Can Exercises Help?
Exercise has been shown to improve neuromuscular impairments in people with neck pain however the type of exercise selected should be based on careful and precise physiotherapy assessment of these neuromuscular changes and therefore be specific to the impairments of the presenting patient.
This type of exercise usually commences early in the rehabilitation process and is used in combination with ‘hands on’/manual therapy if required; these exercises do not provoke pain and are designed to address the specific changes that have been identified via assessment in the muscle and neuromuscular system.
The types of exercises used
- target and activate the deep cervical muscles
- retraining the endurance capacity of deep neck muscles
- retrain the patterns of activation of the deep and superficial neck muscles
- re-educate the use of muscles in posture and in functional tasks
- address the strength and endurance for functional requirements
Education and explanation regarding the rationale behind the treatment approach are a large component of this physiotherapy treatment as the patient’s compliance and contribution to the exercise program is critical.
Have you been suffering with neck pain? If you have, we would love to help you your out, to book an appointment click here. Today’s author, Niamh Connolly works in our Drumcondra clinic, if you would like to read more about Niamh click here. Thanks for writing this piece!