neck pain Archives - Page 2 of 2

A Pain in the Neck?

April 6, 2020 By Wendy Webb Schoenewald, PT, OCS Leave a Comment

Do you remember sitting in front of your laptop for hours without realizing your head is way too far forward or browsing on your phone with your neck bent and this eventually results in getting stiffness in your neck with a mild headache?

With the onset of the Coronavirus, COVID-19, many of us are working from home with our mobile laptops or even completing classwork online, it as important as ever to remember to be aware of good posture to prevent neck and thoracic pain.

We have all experienced neck stiffness and neck pain once in a while. Neck pain can also accompany by headache, TMJ pain, shoulder pain or pain radiating in arms. Headache which is coming from your neck is known as cervicogenic headache. The roots of the upper 3 cervical spinal nerves (located at C1, C2, and C3) share a pain nucleus (which routes pain signals to the brain) with the trigeminal nerve. Because of the shared nerve tracts, pain is misunderstood and thus “felt” by the brain as being located in the head. This headache sometimes can be misdiagnosed as migraine or cluster headaches.

By far the most common cause of neck pain is poor posture, which can lead to soft tissue or muscle strain in the neck area. The most common muscle gets involved with this strain is levator scapulae muscle which is located in your back and side of the neck. This muscle connects your shoulder (scapula) and your cervical spine (first four vertebrae).

Levator scapulae can be strained due to, sleeping with the neck in an awkward position or holding the neck in an abnormal position for longer periods. Sports or motor vehicle injuries were getting a sudden impact that pushes the head to the side or repeated activity which involves turning head side to side can also cause levator scapulae strain. Many times, experiencing excessive stress or anxiety can lead to tension in the neck.

Neck pain and related headaches can be prevented by having good postural awareness. Supporting your lower back with a rolled pillow while sitting corrects lumbar and cervical (neck) curvature. Some important tips to prevent pain:

•Always keeping your screen or your book at your eye level helps to prevent any extra strain while bending your neck.
•Moving neck in all different directions and stretching every couple of hours prevents it from getting stiff. Chin Tuck exercises are very important since we tend to protrude forward when working and this corrects your alignment.
•Squeezing shoulder blades together and keeping ears in line with your shoulders prevents it from getting forward head posture.
•Get up move around and do a couple of minutes of general stretching at least every hour.

If this isn’t working and you are having neck pain, your Physical Therapist can help. We can provide telehealth or clinic visits to help you.

Be Well!

Wendy W. Schoenewald PT, OCS

When’s the right time to see a PT?

July 16, 2019 By Gregory Synnestvedt PT, DPT Leave a Comment

Time to see a Physical Therapist, PT?
By Dr. Greg Synnestvedt PT DPT

Have you ever had physical therapy? Some people picture typical physical therapy as the rehabilitative process that a person goes through after joint replacement surgery. While this is one important time to participate in therapy, most people in a physical therapy clinic are coming for very common pains. The most common areas people seek PT for are 1) low back pain 2) shoulder pain and 3) knee pain. There are also people who are not in any pain at all (lucky them!) but want to improve their balance, walking, mobility, or ability to do daily tasks.

When is the right time to see a physical therapist? If you are trying other treatments for an ache or pain, it is worth seeing a physical therapist to get their opinion before going to other specialists. A recent study found that seeing a physical therapist first for low back pain reduced the overall healthcare costs and also reduced the chances of opioid prescription down the road. Whoever you see first in the healthcare system has a large impact on your path through the system—this is not the way it should be, but this is how it is. You can see a physical therapist with a direct access license for 30 days before requiring a referral from your physician, and this could give you enough time to see that you will be okay without an injection, procedure, or expensive MRI right off the bat. If your physical therapist thinks that your situation requires your physician’s attention, they will refer you to the physician for consultation.

A similar study to the one mentioned above found that early physical therapy for people with neck pain reduced the rate of imaging, opioid prescriptions, and overall costs. Early was defined as people who saw a physical therapist within 3 months. If you have an issue for more than a few weeks that isn’t getting better, it could be useful to consider trying PT.
As patients, we usually seek the “silver bullet” treatment, though this rarely exists. Ture healing and improving are nearly always processes involving time and effort. Take, for example, knee pain from arthritis, which is a very common problem. The clinical practice guidelines put out by the Academy of Orthopedic Surgeons recommends physical therapy as a primary treatment for knee arthritis, with strong evidence. Despite this recommendation, non-recommended treatments such as hyaluronic acid injections, corticosteroid injections, and opioids remain among the most commonly utilized treatments for patients in the year leading up to joint replacement (Bedard et al., 2017). This study estimated a 45% healthcare savings if only the recommended treatments were used. This is not to say that injection is never useful, but that it is worth trying physical therapy.
As a patient, you are your best advocate. If you have a joint or muscle pain or difficulty moving, ask your doctor for a referral to physical therapy and see what PT can do for you.

Bedard, Nicholas A., et al. “The AAHKS Clinical Research Award: what are the costs of knee osteoarthritis in the year prior to total knee arthroplasty?.” The Journal of arthroplasty32.9 (2017): S8-S10.
1: Frogner BK, Harwood K, Andrilla CHA, Schwartz M, Pines JM. Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Health Serv Res. 2018 Dec;53(6):4629-4646. DOI: 10.1111/1475-6773.12984.
Epub 2018 May 23. PubMed PMID: 29790166; PubMed Central PMCID: PMC6232429.

Horn, Maggie E., and Julie M. Fritz. “Timing of physical therapy consultation on 1-year healthcare utilization and costs in patients seeking care for neck pain: a retrospective cohort.” BMC health services research 18.1 (2018): 887.
Study: Seeing a PT First for LBP Lowers Overall Costs, Reduces Chances of Later Opioid Prescription

https://www.apta.org/PTinMotion/News/2018/05/24/PTFirstForLBP/

Study: Early Physical Therapy for Neck Pain Associated With Lower Imaging Rates, Opioid Prescriptions, and Overall Cost
https://www.apta.org/PTinMotion/News/2018/12/04/EarlyPTNeckPain/

My shoulder and neck hurt, why are you looking at my back?

December 8, 2017 By Amanda Nguyen PT, DPT Leave a Comment

Neck and shoulder pain are all common reasons people see physical therapists. Pain is usually dependent on your activities. For example, many people who work in an office and use a computer tend to have neck or shoulder pain. So naturally, when you go to a physical therapist for your pains, they will most certainly assess and address your problem area. In addition, they may also look at your upper back or thoracic spine.

There are 12 vertebrae that make up your thoracic spine. They lie in between your cervical spine (neck) and your lumbar spine (low back). They allow you to bend forward, extend back, and bend to one side or the other. They also have articulations to your ribs and your shoulder blades as well. There are also many muscles that attach from the thoracic spine to the cervical spine and shoulder. So moving your neck and shoulder will indirectly cause movement of your thoracic spine.

When you have pain, it is most likely due to a dysfunctional movement. When you perform a specific activity, you use certain muscle groups. However if you are weaker, have less range of motion, or less flexible in certain areas, then your body automatically compensates for those muscles and movements. Due to abnormal movement patterns, pain may occur. For instance, the office worker working at their desk is probably sitting with poor posture; they exhibit a forward head and rounded shoulders. As a result, the scapular muscles in the back that hold you in an upright posture are stretched out and not as strong. Your neck is also in an outstretched position it should not be in. Due to the weakness and abnormal flexibility of the muscles, this individual may present with neck, head, or upper extremity pain as a result.

So while you may not have any pain in your thoracic spine, addressing the spine can help with your complaints in your neck or shoulder. Your thoracic spine is connected to your neck and shoulder through the bony articulations and muscle connections. If the affected joints are moving improperly, then other areas of the body like thoracic spine will compensate for the movements as well. Therefore treatment in the upper back may be beneficial, whether it is through exercises or manual therapy by your physical therapist. Treatment in this area can affect movement and pain in your neck or arm. Sometimes people are really sensitive in the injured areas and cannot tolerate much movement through those body parts. Addressing the thoracic spine first can produce analgesic effects and increase movement in the affected areas, which in turn can be more tolerable when the PTs work on the painful body part. Coming into physical therapy will help address your main complaints, but other parts of your body would benefit as well.

Ask the experts at Wendy Wenn Schoenewald Physical Therapy and Vestibular Rehabilitation about treatment.

It’s A Pain in the Neck!

October 17, 2017 By Cassie Zanolini, PT, DPT Leave a Comment

We all have experienced neck stiffness and neck pain once in a while. Neck pain can also accompany by a headache, TMJ pain, shoulder pain or pain radiating in arms. A headache which is coming from your neck is known as a cervicogenic headache. The roots of the upper 3 cervical spinal nerves (located at C1, C2, and C3) share a pain nucleus (which routes pain signals to the brain) with the trigeminal nerve. Because of the shared nerve tracts, pain is misunderstood and thus “felt” by the brain as being located in the head. This headache sometimes can be misdiagnosed as a migraine or cluster headaches.

By far the most common cause of neck pain is poor posture, which can lead to soft tissue or muscle strain in the neck area. The most common muscle that gets involved with this strain is levator scapulae muscle which is located in your back and side of the neck. This muscle connects your shoulder (scapula) and your cervical spine (first four vertebrae).

Levator scapulae can be strained due to, sleeping with the neck in an awkward position or holding the neck in abnormal position for long periods. Sports or motor vehicle injury where getting the sudden impact that pushes the head to the side or repeated activity which involves turning head side to side can also cause levator scapulae strain. Many times, experiencing excessive stress or anxiety can lead to tension in the neck.

Neck pain and related headaches can be prevented by having good postural awareness. Supporting your lower back with a rolled pillow while sitting corrects lumber and cervical (neck) curvature. Always keeping your screen or your book at your eye level helps to prevent any extra strain while bending your neck. Moving neck in all different directions and stretching every couple of hours prevents it from getting stiff. Squeezing shoulder blades together and keeping ears in line with your shoulders prevents it from getting forward head posture.

Ask the Experts at Wendy Webb Schoenewald Physical Therapy and Vestibular Rehabilitation, #WWSPT about good postural awareness.

A Pain in the Neck?

When’s the right time to see a PT?

My shoulder and neck hurt, why are you looking at my back?

It’s A Pain in the Neck!

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