A recent review article has highlighted the importance of physiotherapy management of neck pain. Globally neck pain ranks fourth highest in the Global Burden of Disease study in terms of overall disability. There are at any one-time 3551 per 100,000 people suffering from neck pain and 70% of us will have neck pain during our lifetime. Unfortunately, there seems to be more female than male sufferers and the incidence increases as age wears on. Rest assured not all incidents of neck pain will seriously affect your ability to function and participate in things that matter to you and only 2% of neck pain sufferers have a major pathology.
So how do we distinguish neck pain?
The definition provided by Verhagen (2020) is “pain in the neck with or without pain referred into one or both upper limbs that lasts for at least 1 day”. A task force on neck pain concluded this definition based on 300 separate definitions found in the literature. That is a lot of different ways to describe what seems rather straight forward but is important to clinicians and keeps us all reading from the same ‘song sheet’. We then separate this broad category into 4 subgroups based on neurological deficits and serious pathology, fortunately the worse the symptoms, the smaller the number of sufferers.
Who is most at risk?
Low back pain research vastly outweighs neck pain research so there is a lot we are yet to learn. We do know that you are more likely to suffer neck pain if you meet any of the following criteria however:
- Involved in a trauma (car crash, falls, sports collision etc.)
- Increased work-related stress, low job satisfaction or poor perceived work support
- Poor perceived psychological health or depression
- Smoking
Interestingly degenerative discs are not a risk factor for neck pain.
What does a typical Physiotherapy consult involve?
All our consultations at Bend + Mend start with history taking or hearing your story. This helps us learn what it is that is affecting you, how your neck pain impacts on things important to you and what we need to address. As Physiotherapists we use your story to create hypothesis on what may be the underlying cause and what is contributing to your pain anatomically, biomechanically, and environmentally. We are also listening out for underlying cues of serious pathology.
Physical examination of the neck involves a safety screen for serious pathology, movement tests and can include postural assessment. We may also test strength, reflexes, sensation and use special tests to confirm or rule out our hypothesis and give us your diagnosis. We can refer for a scan if this is needed.
How do we treat your neck?
There are three major treatment methods we employ and many adjuncts to your treatment. The three main methods are;
- Education
- Exercise
- Manual therapy (mobilisations and manipulation)
Education can be anything from understanding your diagnosis and prognosis, what you can do to enhance your recovery and enable you to make informed decisions in your own management.
Exercises can be wide ranging depending on your diagnosis. It could be as simple as postural correcting, or stretches, or could include a detailed ongoing strength and conditioning program.
Manual therapy is the hands on part. This helps reduce pain and restore movement through various direct and indirect physiotherapy mobilisation, manipulation, movement correction or massage techniques.
If you have any questions on how we can help with your neck pain please come in and see one of our highly skilled and friendly staff members at Bend + Mend in Sydney’s CBD.
