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Neck Pain Treatment
Neck pain is an extremely common complaint in doctor's offices around the developed world. In Canada, for instance, over 50% of the general adult population reported that they experienced neck pain in some form over the previous six months. Carpal tunnel syndrome is not the only workplace injury that occurs as a consequence of spending large amounts of time seated at a desk in front of a computer. Athletes can develop neck pain certainly, but when neck pain arises from a specific jarring activity, it is often in people who attempt an activity they are not conditioned or prepared (i.e. "weekend warriors"). In each case, neck pain treatment is targeted to the cause, but includes exercises that restore and strengthen the painful neck.
The main causes of neck pain
The vast majority of neck pain cases are either classified as whiplash or "nonspecific" neck pain. Other causes of neck pain like autoimmune disorders, neurological alterations, or intrinsic muscle diseases occur much less frequently, have their own special neck pain treatment, and are not discussed here. While it is important to rule out one of these serious neck pain causes before starting treatment, chances are good that even after professional diagnosis and triage, the cause will either be whiplash or "nonspecific" neck pain. Whiplash is caused by the sudden acceleration or deceleration of the neck, as would occur in a car accident or while playing contact sports. "Nonspecific" injury is the type that occurs in the office or daily life and is the accumulation of innumerable little traumas, stresses, and strains. Regardless of the cause, the treatment for whiplash and nonspecific neck pain is basically the same.
Rest is for the weak (weak neck, that is)
Physicians and physical therapists will tell you that once the scary causes of neck pain have been ruled out, the first step in neck pain treatment is to get back to work. Inactivity leads to muscle atrophy and muscle atrophy leads to a neck that is even more prone to injury. In other words, it is best to use the neck muscles even if there is a bit of pain. The alternative, and what many of us do, is to coddle the sore neck and give it rest until the pain is gone. While no one advocates immediately returning to an activity that is going to put the neck in danger, it is an important part of neck pain treatment to get back some sort of activity and level of function right away. Realize, though, the while a little pain during activity is usually unavoidable, severe pain is an indication that you actually should rest the neck and seek medical advice.
Patient education as neck pain treatment
Clinical research suggests that when patients are taught about their condition as part of their neck pain treatment, they do better than those that simply receive a generic neck pain treatment. The education is not simply about the anatomy of the neck or the physiology of the muscles, but rather it is a brief course of cognitive behavioral therapy. The patient is taught how to take care of themselves and their neck, empowered to perform neck pain exercises, and encouraged to manage their own behavior and illness. Why would this work? Because patients with neck pain often avoid treatment and submit to an ever-increasing sense of helplessness and avoidance of activity. This is potentially disastrous for neck pain treatment.
Physical therapy and manual therapy
The two mainstays of neck pain treatment are physical therapy and manual therapy. In physical therapy, the patient is prescribed a set of rehabilitation exercises that the patient must actively perform in order to return to or exceed a previous level of musculoskeletal health. Manual therapy, on the other hand, is a passive neck pain treatment in which a practitioner manipulates the bones and muscles while the patient remains still. Research shows that physical therapy is an integral part of neck pain treatment. However, no one exercise program seems to work in every case of neck pain. Thus it is usually best to seek a professionally directed course of physical therapy. Likewise, manual therapy can be helpful as neck pain treatment. However studies show that manual therapy should not be used without some other form of treatment.
neck pain treatment references
Moffett J, McLean S. The role of physiotherapy in the management of non-specific back pain and neck pain. Rheumatology (Oxford) 2006;45:371-378.
Cote P, Cassidy JD, Carroll L. The factors associated with neck pain and its related disability in the Saskatchewan population. Spine (Phila Pa 1976 ) 2000;25:1109-1117.
Griffiths KL, Mackey MG, Adamson BJ. The impact of a computerized work environment on professional occupational groups and behavioural and physiological risk factors for musculoskeletal symptoms: a literature review. J Occup Rehabil 2007;17:743-765.
Klaber Moffett JA, Jackson DA, Richmond S et al. Randomised trial of a brief physiotherapy intervention compared with usual physiotherapy for neck pain patients: outcomes and patients' preference. BMJ 2005;330:75.
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