According to a Korean proverb, a turtle travels only when it sticks its neck out. Clever saying, and it makes sense: the neck bears one-seventh of the body’s weight; it’s our most freely moving body part; and when we have neck pain, we’re extremely limited—a genuine “pain in the neck!”
Unfortunately, a common response to neck pain is to pop pain killers, but that’s merely treating the symptoms, not the cause. To truly alleviate neck pain, you’ve got to pinpoint and genuinely address the underlying problem. Fortunately, physical therapy is highly effective in treating most neck conditions and injuries. Before we tackle how physical therapists (PTs) can help, let’s examine the signs and symptoms of, and common conditions associated with, neck pain.
Signs and Symptoms
According to the Mayo Clinic, neck pain can affect “about ten percent of the adult population at any single point in time,” which is understandable—there’s a lot going on in a very narrow space. Just to give you an idea, human necks contain the same number of vertebrae as the incredibly long neck of a giraffe. Neck pain can range from a dull ache to a sensation similar to sharp, electric shock. This pain can occur anywhere in your neck; however, it can also spread to your arms, shoulders, upper back, chest, and head (in the form of headaches). In addition to creating pain, neck problems can limit movement due to muscle stiffness, tenderness, and tension.
Strained neck muscles cause most instances of neck pain. Think about it: slouching and poor posture, staring downward at your cell phone or tablet, carrying a shoulder bag, cradling your phone, installing a ceiling fan (staring upward), sleeping oddly—these are all ways you can put undue stress on your neck, thus causing strains, sprains, or spasms.
Trauma also can cause neck pain. A common example would be falling or whiplash—where your neck suddenly moves backward and then forward (in a whip-like motion) as a result of being in a car accident or other impact- or force-related trauma. Emotional trauma also can cause neck pain.
Chronic Neck Pain
Pain is considered chronic when it lasts for three or more months. Unaddressed muscle knots, tension, or stiffness may lead to chronic neck pain. This pain may eventually spread to the shoulders, chest, upper back, and/or arms. It also can cause headaches or migraines and limit mobility. However, you also may feel weakness, tingling, and/or numbness. Additional symptoms of chronic pain include fatigue, depression, and anxiety.
Neck Pain Conditions
The following conditions are associated with neck pain:
- Ankylosing spondylitis: This inflammatory disease can cause some spine vertebrae to fuse together, making the spine less flexible and possibly causing hunched-forward posture.
- Cervical dystonia: With this rare disorder, neck muscles contract involuntarily, causing the head to uncontrollably turn to the side or tilt forward or backward.
- Cervical spondylosis: This is an age-related condition that causes spinal discs to dehydrate and shrink over time, leading to osteoarthritis.
- Fibromyalgia: This incurable disease is characterized by widespread musculoskeletal pain as well as tiredness and sleep, memory, and mood issues.
- Herniated disc: With this condition, the softer interior substance of a spinal disc—which is a rubbery cushion between vertebrae—seeps out of a crack in the harder exterior.
- Meningitis: This is a condition in which the membranes surrounding the neck and spinal cord become inflamed.
- Osteoarthritis: The most common form of arthritis, this condition occurs when the protective cartilage on bones wears down over time.
- Rheumatoid arthritis: This inflammatory condition affects the joints of the hands and feet.
- Spinal stenosis: This condition occurs when the open spaces within the spine narrow, putting pressure on the spine and nerves.
- TMJ disorders: These conditions are associated with the temporomandibular joint of the jaw and are commonly characterized by pain in the joint and surrounding muscles.
Physical Therapy for Neck Pain
If you suffer from an injury, trauma, strain, or sprain that results in mild to moderate neck pain, don’t panic. First and foremost, avoid excessive movement of the neck, rest as much as you can, and ice the affected area. The pain should subside in a few days. However, if the pain you experience is severe, or if it fails to subside—or becomes worse—over the next few weeks, or if you’re suffering from chronic neck pain, seek medical attention.
Physical therapy is incredibly effective in treating neck pain, and every state, along with the District of Columbia, has some form of direct access to physical therapy, which essentially means you don’t need a physician’s referral to see a PT. That being said, you should contact your insurance company to verify what your policy requires and allows regarding physical therapy. In selecting a PT, you’ll want to choose one who specializes in orthopedics, spinal care, and/or neck pain.
Your PT will focus on strengthening and improving the muscles, tendons, and ligaments that support the vertebrae, thus treating the source of the pain and not simply the symptoms. At your first appointment, your PT will conduct an initial examination, which may include:
- Determining the range and quality of motion of the neck.
- Examining the strength of the neck, back, shoulder, chest, and arm muscles.
- Determining tenderness to touch.
- Analyzing posture.
- Assessing functional mobility based on your ability to complete a series of tasks.
This initial evaluation allows the PT to develop a plan of care specific to the scope of the problem and the state of your health. The plan of care also will detail the frequency and duration of sessions necessary to achieve your treatment goals.
Physical therapy treatment for neck pain may include:
- Joint mobilization and manipulation
- Cervical traction (light stretching of the neck)
- Strength and stretching exercises
- Postural corrections as well as ergonomics consultation
- Applied ice, heat, or electrical stimulation
- Prescribed at-home exercises and stretches
By attending all PT sessions, completing the plan of care, and performing prescribed home exercises, you will set yourself up to regain normal mobility and function and eliminate your neck pain as quickly as possible. After you complete treatment, your PT may recommend performing stretching and strengthening exercises at home in order to maintain the health and flexibility of your neck. This may reduce your chances of reinjury or developing chronic pain.