Neck Pain

The WellHub Team

The neck is a strong, flexible structure which allows movement in all directions. Neck pain is common and will affect 2 out of 3 people at some point in their lives.

 

The neck is made up of a column of seven bones called the cervical vertebrae. The vertebrae house and protect the spinal cord and support the head. Strong muscles that surround and support the neck allow you to move your head in any direction. Between each vertebra there is an intervertebral disc. At each disc a nerve passes out of the spinal cord and travels down your arm sending messages to and from your brain.

 

Neck pain is generally caused by being in one position for too long or a strain or sprain and is not serious. There are three main categories of neck pain.

 

1.     Mechanical Neck Pain

 

With mechanical neck pain there may be pain and stiffness but there is no structural damage to the neck.  It can occur due to prolonged poor posture, perhaps when using a laptop or ipad, or from sleeping awkwardly.  Other causes of mechanical neck pain include whiplash and stress, which can cause muscle tension and result in pain and stiffness. More information on whiplash can be found later in the article.

 

Sometimes with mechanical neck pain you may hear clicking or grating sounds in your neck when you move.   This is called crepitus and is due to ligaments moving over bones or bony surfaces rubbing over each other.  It can be alarming but is nothing to be concerned about.  It occurs in all joints but because your neck is near your ears it will sound louder.

 

2.     Nerve root pain

 

With nerve root pain there will be neck pain, but symptoms such as pain, pins and needles or numbness, can travel down the arm and into the hand.  This is due to irritation of a nerve in the neck.  It is advisable that if you experience any of those symptoms to consult your GP or physiotherapist.

 

3.     Serious Patholgy 

 

Serious Pathology is very rare and occurs in less than 1% of neck pain.  If you have any of the following it is advisable to seek immediate medical attention

 

  • Dizziness
  • Problems with your speech or swallow
  • A lack of co-ordination
  • Problems walking
  • Fainting episodes
  • Unusual nausea
  • Unusual headaches
  • Loss of bladder or bowel control
  • Numbness of the face

 

 

How to self-manage neck pain

 

  1. Avoid resting for more than 24 to 48 hours as inactivity can increase pain and stiffness.
  2. Posture – poor posture can contribute to neck pain. One of the main problems can be sitting for long periods at a computer/workstation. To help ease the strain on your neck, ensure that you get up and move regularly and try to rotate your tasks. Looking at the positioning of your computer and set up of your work station can help ease the strain on your neck.
  3. Look at your sleeping position – there is no right or wrong way to sleep as it is different for each person.  Here is some guidance which may be helpful:  
  • If you lie on your back to use one pillow
  • If you lie on your side you will need a slightly thicker pillow to fill in the space between your neck and shoulder
  • If you lie on your tummy only a very thin pillow or none at all.  If your neck is stiff and sore it may be beneficial to avoid lying on your stomach until your symptoms have settled.

 

As to the type of pillow to use, it comes down to individual choice.  Things to consider when choosing a pillow are, do you like a shallow or deep pillow and do you like it soft or firm.

 

4. Take regular pain relief to allow you to move.  Speak to your GP or pharmacist about appropriate pain relief.

 

5.     Reduce stress – stress can cause muscle tension which in turn can cause neck pain and headaches.

 

 

6.     Exercise – it is important not to stay inactive for too long as this can lead to weak muscles and cause stiffness.  Doing gentle neck exercises can help to ease pain and reduce stiffness, it is best to start slowly and gradually build it up. Try to get back to normal as soon as possible.

 

Prevention of Neck Pain

 

Prevention is often better than cure. Follow the few simple steps below to help prevent neck pain.

  1. The main advice is to ensure that you avoid sitting in one place for too long and get up and move regularly, even if you have a good supportive chair.
  2. Try to rotate your tasks to help prevent repetitive strain
  3. Look at your work station set up and carry out the DSE self –assessment
  4. Stay fit and active.

 

 

Whiplash

 

Whiplash is an injury to the neck which is due to the head being forced forward and then back very suddenly, resulting in the soft tissues (muscles and ligaments) in your neck being over stretched.  It can occur in a number of ways:

 

  • Following a car accident
  • If the head is suddenly jolted back during a slip or fall
  • Following a blow to the head

 

The symptoms of whiplash can develop straight away, a few hours later or the following day.  Symptoms can include:

 

  • Pain in the neck and head
  • Stiffness of neck movements
  • Headache
  • Muscle spasm
  • Pain in the shoulders and arms

 

 

How to treat whiplash

 

Whiplash is usually not serious and will settle within 6 to 12 weeks.  In some circumstances the pain can last longer - up to 6 months.

 

1.     Exercise - One of the most important things to treat whiplash is exercise.  Recent evidence-based guidelines produced by the Chartered Society of Physiotherapy advise gentle exercises in the early stages following injury to help prevent long term problems and help to get you back to normal as soon as possible.

Initially exercise may be painful and range of movement will be limited.  However, it is important to start moving your neck as soon as possible.  Begin by moving little and often (every few hours is ideal) and gradually increase how many exercises you do and also increase the range that you move.  

2.     Pain relief - simple pain relief can help ease the pain to allow you to start to move again.  Speak to your GP or pharmacist for advice.

 

3.     Heat and cold – in the first 48hrs following an incident ice is preferable.  Wrap a bag of frozen peas or ice pack in a damp towel and apply to the skin for approximately 15-20 minutes.  Some people prefer heat, you could use a hot water bottle or wheat bag.

 

4.     Good posture – think about your posture when sitting, standing or walking.  Posture is important to prevent putting extra strain on painful structures. Try to lift your chest and keep your head over your shoulders, and relax your shoulders. Try to move and change your position regularly, especially if you have a job where you are working in a sustained posture for a long period of time. 

 

5.     Reduce stress – stress can cause muscle tension which will result in an increase in pain and stiffness.

 

If your symptoms are becoming worse or not improving after a few weeks it may be beneficial to seek advice from your Physiotherapist or GP

 

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