Neck pain is one of the most common musculoskeletal disorders. Whether it’s a stiff neck after sleeping in an awkward position or a more severe injury, we’ve all dealt with neck pain in some form or another. But why does this pain occur?
One of the most common causes of neck pain is cervical osteoarthritis. Osteoarthritis is the degeneration of cartilage in the cervical spine joints. This often occurs as a result of wear and tear over time but can also be accelerated following an injury. Cartilage loss causes bone-on-bone contact and friction, which subsequently results in pain.
Pain is often localized to the cervical region and can result in stiffness, pain, and even headache. Initially, symptoms begin as stiffness in the morning, which typically eases throughout the day. In more chronic cases, degeneration in the cervical spine can cause compression of the nerve roots which give rise to the nerves that travel down our arms. Compression of the nerves can result in symptoms of pain, numbness, or weakness reaching down the arm.
Cervicogenic headaches can occur in conjunction with cervical pain as well. These headaches are a manifestation of musculoskeletal issues occurring in the cervical spine. With cervicogenic headaches, we commonly see dysfunction in the upper portion of the cervical spine, difficulty rotating, and muscle abnormalities and imbalances—all of which occur as a result of poor posture. Awareness of posture can relieve pressure in the upper cervical spine. Manual therapy and massage techniques can be helpful in reducing cervical pain and subsequent headaches. A well-tailored exercise program can help to provide relief from symptoms.
Cervicogenic dizziness can be another manifestation of neck pain. Cervical spine position and posture play a large role in our balance. Dysfunction in the upper portion of the cervical spine can lead to a sense of general disorientation and dizziness. These symptoms often worsen with neck movement or prolonged positioning. Typically, if the neck pain is able to be reduced, then the dizziness decreases as well. Manual therapy, exercise, and postural re-education are helpful to reduce symptoms.
Now that we have a better understanding of the signs and symptoms of neck pain, how can a physical therapist help you learn to manage it? Physical therapists can provide a variety of different exercise programs ranging from manual therapy to stretching, to strength, to nerve mobility—all of which help you better manage your symptoms and improve your activity tolerance.
Posture
Physical therapists are experts in posture, especially when performing functional activities. Poor posture when seated, driving, or sleeping can place increased strain on the spine, which can contribute to pain. The muscles in our neck work all day to stabilize our heads. Changes in position and posture alter our muscle position, causing muscles to be stretched too far or shortened too tight. A physical therapist can give you exercises to help correct these imbalances. Oftentimes, simple scapular retraction or shoulder-blade squeezes can help you correct upper-back posture.
Forward head posture is the most common contributor to neck pain. In this posture, our head is leaning forward out in front of our shoulders, which is exacerbated when seated while working on the computer or looking at our phones. Prolonged time in this position creates muscle imbalances that contribute to pain and even radicular symptoms reaching down the arm. Over time, these postural changes can result in loss of range of motion and degenerative changes.
Chin tucks can be an effective method for correcting this posture. With this exercise, sit upright, facing straight ahead, then pull your chin and head straight backward until a stretch is felt at the base of the skull. Chin tucks can be repeated frequently throughout the day in sets of 5 reps.
The good news is poor posture can be corrected. When working at the computer, being mindful of posture is important. Your screen should be placed approximately at eye level to ensure a neutral cervical spine position. Try setting an alarm on your phone to give you a cue to correct your posture every half hour or hour. When seated, you should be conscious of pulling your shoulder blades together and sitting up tall. Standing desks can be beneficial in helping to allow for more changes in position over the course of the day. When seated in the car, we often fall into slouched, poor posture. I recommend setting your mirrors when you’re in a position of ideal posture. This will remind you to self-correct when you slouch because you will be unable to see out of your mirrors.
Sleeping
The use of a towel roll can be beneficial in helping those with cervical pain find a more comfortable way to sleep. Tucking a cervical pillow, or rolled-up towel, into your pillow can help to support the cervical spine and maintain your normal spinal curvature while you sleep. If you sleep on your back, place the cervical pillow underneath your neck. If you sleep on your side, then place the cervical pillow in the open space between your neck and the pillow to allow for better support.
Physical Therapy
If cervical pain is interfering with your life and preventing you from doing what you love, then, schedule an appointment to see one of our experts at WWS Physical Therapy for an evaluation (215-489-3234). Physical therapists in our office will evaluate you, provide you with a program to address your needs, and help guide you in the healing process.
Dr. Cassie Zanolini, PT, DPT,
WWS Physical Therapy and Vestibular Rehabilitation
Doylestown, PA.
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