Neck Pain

Neck Pain

This information is not a definitive list but only a guide to possible causes of your pain which can be helped by your physiotherapist. There are a wide range of medical conditions that can cause your pain. An assessment by one of our physiotherapists will allow them to take a detailed history and perform a thorough examination to give a diagnosis. They can then treat you effectively or recommend a medical referral if it is required.

Osteoarthritis in the spine

Osteoarthritis is the process of degeneration of the joints which occurs over time and leads to wearing down of the joint surfaces. There are several joints in the neck that can be affected. There are 7 different cervical vertebrae in the neck known as C1 through to C7. The process of degeneration can start earlier in some people. Common symptoms include stiffness and pain.

Physiotherapy can help with manual therapy techniques and setting exercises to help increase the strength around the joints and improving your flexibility. Acupuncture can also provide pain relief.

Postural pain

Often people can adapt certain postures where the chin pokes forwards and the shoulders become rounded. These postures may develop from certain muscles around the neck and upper back and shoulders becoming weak or tight. Sitting at work in front of a desk for long periods can lead to people developing a certain posture. More information can be found through the workstation assessment information. Osteoporosis can also lead to developing a poor posture. The pain experienced may be aching around the neck and shoulders and tends to become worse when continue in the same posture for a period of time.

Physiotherapy can help by using manual therapy to loosen any stiff joints and muscles. Massage and trigger point release can help muscle pain. Exercises can be set to improve your posture and strengthen muscles than have become weak and stretch muscles that have become tight. If you are sitting at a desk for long periods of time we can come to you and assess your workstation and make the required changes to help you keep a desired position when working. If your posture is changing due to osteoporosis we can provide osteoporosis programmes at home to help this.

Sharp sudden neck pain

Pain can develop suddenly either within the joints when a piece of soft tissue known as meniscoid can become trapped or because of problem has developed within one of the discs between each of the verterbrae within the neck. Sudden pain from the joints tends to be felt higher up in the neck whereas pain from the discs lower down in the neck. Stiffness of the neck may also be present as a result where you can feel locked and unable to turn the head or bend the head in one direction.

Physiotherapy can help by working on the joints and restoring any movement lost in the neck. Massage can help relax any tense muscles and exercises can be set to retrain posture and stability around your neck.

Whiplash

This can happen in a road traffic accident, sport or hobbie such as dancing. It involves the head moving forwards fast and then back. Symptoms often include neck pain and headaches and this can start up to 48 hours after the injury. There is more information on this condition and how physiotherapy can help under whiplash programmes. It is important to regain the movement in your neck as soon as possible to prevent the symptoms becoming chronic (long term).

Nerve root pain

Nerve roots exit between you cervical vertebrae before forming the nerves that run down your arms. Where the nerve root exits the neck it can become compressed or irritated by inflammation, bulging of the disc, growth of bone (osteophytes) or other spine conditions. Symptoms that can arise when this happens are arm pain, tingling or loss of feeling in the arm and pain in the neck.

Physiotherapy can help with manual techniques, massage, advice on posture, sleeping position and reducing any inflammation. Stabilising exercises for the neck and exercises for the nerves can be set.

Muscle spasm

There are many muscles around the spine. These can be strained, torn or just become in spasm trying to protect the spine. Trigger points can develop in muscles in spasm. These are specific tender spots that develop that give rise to pain and can also cause pain in other areas of the body.

Physiotherapy techniques that can help to reduce pain and spasm in muscles include massage, advice, manual therapy and acupuncture.

Prolapsed disc

This is when one of the discs slightly bulges. It can happen over time or suddenly as a result of a sudden movement or an accident. The pain is normally quite deep and achey. Sometimes activities such as coughing, sneezing or bending forwards can make the pain worse. If the bulge of the disc causes pressure on the nerve exiting the spine then there can be arm pain or tingling and loss of feeling in the arm also.

Physiotherapy techniques which can help include manual therapy, massage, specific exercises, advice and acupuncture.

Instability

Stability of the spine comes from the spine itself (joints and ligaments), the muscles around attached to the spine and responses from the nerves and brain. Symptoms of the spine not being as stable is a sense of the neck feeling weak and a feeling of a painful catch or lock.

Physiotherapy has been proved to help by working on retraining the strength of the muscles around the spine and the brain and nerves contribution to controlling the stability around the spine.

Osteoporosis

This is when the inner part of the vertebrae of the spine breaks down. It happens with age and is a lot more common in females.

Physiocomestoyou has devised a specific programme for people suffering with osteoporosis to help improve their posture and strengthen the body to reduce the impact of osteoporosis. Refer to our osteoporosis programmes for more information.

‘Stinger’ or ‘burner’

This can occasionally happen in sport when one shoulder is pushed down and the head is bent towards the other shoulder at the same time. It causes a injury to the nerves as they exit the cervical spine (neck). Symptoms normally include a burning type pain, pins and needles, numbness and weakness in the arm.

est from sport is required and the symptoms usually resolve relatively quickly or over a few days.

Rheumatoid Arthritis

Rheumatoid Arthritis is when the immune system goes haywire and attacks the body rather than defending it causing inflammation of the lining of the joints and tendons of the muscles. Affected joints in the body that have the arthritis become swollen, painful and stiff. Morning stiffness on waking is very common. Muscles around the joints often become weaker and doing certain activities of daily living can become more difficult.

We can provide experienced physiotherapists to see you at home and work you to help manage your condition. The first time the physiotherapist visits they will carry out a thorough assessment which includes looking at your mobility and walking aids, muscle strength, joint movement, posture and function. Following the assessment the physiotherapist will discuss any treatments they can provide and set goals with you to improve your general function and mobility and achieve the maximum potential in your home, work and social life. These treatments can include advice on ice, exercise programmes, massage, taping, acupuncture and mobility programmes.

We can also provide occupational therapists to come to your home. They help people to regain the ability to carry out activities that have purpose and meaning to them and become or remain as independent as possible. Some of the services they can offer include:

• Home assessments including modifications such as rearranging furniture, building ramps, widening doorways, grab bars, special toilet seats etc
• Wheelchair assessments
• splinting

Fibromyalgia

This condition does not involve inflammation but affects the fibrous tissues in many parts of the body ie. tendons, muscles, connective tissue etc. There can be a large number of tender points and a feel of generalized aching. One of the common tender points is muscles either side of the neck. There a number of other symptoms including fatigue, sleep disturbances, sensitivity to temperature, morning stiffness, numbness and tingling, irritable bowel, depression and dry eyes and mouth.

Physiotherapy can help people with this condition. There are pain relieving techniques that can be used and they are experienced in pacing you back to being able to exercise again and return to activities whether sport, work or hobbies that you were able to do before the condition started. They also are able to provide advice on how to cope with your condition and manage flare ups of pain.

Chronic Pain

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related. We can also recommend top Singapore pain consultants to help you.

Other possible causes

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

• cardiovascular symptoms
• respiratory (breathing) symptoms
• gynaecological symptoms
• urinary or genital symptoms
• digestive symptoms
• immune system symptoms
• lymph system symptoms
• hormonal symptoms
• neurological symptomsv
• dermatological (skin) symptoms
• medication side-effects
• virus
• infection
• cancer
• disease process
• psychological problem ie. depression, anxiety