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A Pain in the Neck

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neck painAs a physical therapist, I know that neck injuries, whether caused by something as severe as an accident or as seemingly innocuous as a simple at-home task, are no laughing matter and can cause neck pain and strain that interferes with your daily routine.

When you injure your neck, the pain can present itself in many ways.  Symptoms may range from a dull ache to a sporadic sharp pain located anywhere from the base of the skull to the shoulders and upper back.  You may also have headaches and excessive muscle tension, a limited range of motion in your neck, and difficulty in swallowing. In more severe cases, you may experience radiating pain, numbness and/or tingling in your fingers or upper extremities.

Neck pain can be caused by numerous movements, from simple everyday activities to injuries to underlying medical conditions, such as:

  • Poor postural habits (slouched posture, forward head position)
  • Muscle strain from staying in a bad posture position for a long period of time
  • Inadequate core muscle strength for posture support
  • Poor body mechanics while performing overhead tasks (like painting a ceiling or fixing electrical fixtures)
  • Degenerative changes: disk bulge/herniation, foraminal narrowing (a compression of the spinal nerves), facet joint hypertrophy (enlargement of the spinal joints) or osteophytes (bone spurs)
  • Trauma: whiplash (motor vehicle accident), a fall, or a head injury (sports or other activity)
  • Inflammation from arthritis or rheumatoid arthritis
  • Infection (meningitis)

The duration of the symptoms of neck pain may vary significantly depending on the cause.  If the cause is muscle tension/spasm or facet joint immobility, the symptoms may resolve within a week.  Pain due to poor posture issues can be alleviated or eliminated by maintaining good posture and proper ergonomics or stopping tasks that aggravate neck pain, such as a repetitive overhead arm motion.  For the symptoms caused by degenerative changes, it may take several weeks until you start to feel better. Finally, in the case of severe trauma, symptoms may last several months.

Management

During the acute phase (usually the first 48 hours of injury or onset of the pain)

  • Ice
  • Be aware of posture and good body mechanics.
  • Change or adjust your pillow if symptoms occur primarily in the morning
  • Use medication as prescribed or recommended by your doctor

After the first 48 hours and to address more chronic problems, your doctor and/or a physical therapist may recommend the following:

  • A gentle cardio program, such as walking (focus on body/arm motion and correct breathing)
  • Muscle strengthening exercises focused on the neck, scapular muscles, and the upper extremities
  • Continued use of medication as recommended by your doctor

As you recover from neck pain or strain, you should avoid the following activities like reading or using the computer for a long period of time, overhead lifting or repetitive tasks, sleeping on your stomach, driving long distances, or staying in a prolonged, unsupported position that cause muscle strain, such as watching TV or crocheting.

You should call your doctor immediately if you:

  • Have numbness or tingling in your hands
  • Have been in a car accident, involved in a sports injury/have a concussion, or fell and are experiencing severe pain
  • Have a fever
  • Have severe pain and cannot turn your head more than 45 degrees
  • Feel dizziness or have difficulty swallowing

Most of the time, neck pain can be prevented by maintaining good cardiovascular health, improving postural strength and postural awareness, and focusing on using good body mechanics. Improvements can also occur from taking frequent breaks when working at the computer or performing repetitive tasks, using a good pillow that aligns your spine in the center of your body, and using proper protective gear when playing sports, driving, or working.

 


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