What causes Neck pain and why do I have it ?
Neck pain with or without arm pain or other arm symptoms is extremely common affecting around 60% of us at some point. Certainly it is second only to low back pain in terms of the number of patients that present with it to our clinic in Eskbank just outside Edinburgh . Therefore as with low back pain we have considerable experience in the successful assessment treatment and overall management of neck pain with/or without referred pain or other symptoms such as numbness or weakness. During the course of this post I will often refer to the post on low back pain as there are obviously significant similarities between neck and low back pain.
As with low back pain the vast majority of people with neck pain will be diagnosed as having mechanical or non specific neck pain. i.e. it is not possible to isolate the source of the pain being present. Therefore as discussed in the low back pain page, there is no advantage to having the neck X-rayed or having any other investigation unless your GP or physiotherapist or other medical professional feels it is necessary to rule out more serious pathology or if surgery is potentially a treatment option. However as with low back pain surgery is very rarely appropriate and is in fact even less common.
Similarly to the case with low back pain it is common for pathological changes on X ray or other investigation such as MRI or CT scan to be found when patients are investigated. As with low back pain assuming serious pathology is ruled out and surgery is not appropriate, it is important that you bear in mind that multiple studies have shown that changes such as disc degenerative change, disc bulges or herniation, stenosis, spondylosis and spondylolisthesis are commonly found in individuals who have not got and have never had pain or other symptoms.
If you want to read one of these studies I would suggest this one which looked at the frequency of neck disc bulges in individuals with no history of pain.
As I explained in more detail with regard to low back pain, what I conclude from this research is that these changes occur normally in pain free individuals, and they therefore don’t necessarily lead to neck pain or other symptoms. Also if you have these changes present it does not mean that you can’t significantly improve your symptoms and your ability to participate in the activities that you want to do.
As mentioned in the review of low back pain the onset of neck pain can be sudden or gradual and often for no apparent reason. Therefore as with low back pain it is important to bear in mind that although these conditions can be extremely painful and debilitating, it is rare that they are due to serious conditions and they will often resolve within 6-8 weeks.
Please also remember that just as in the case of low back pain and indeed in the case of all the conditions that we treat, an important part of our assessment is to screen for more serious pathology. Therefore you can rest assured that if your physio has any concerns that this is the case, they would discuss this with you and expedite your referral onwards via your GP or other medical professional for appropriate investigation.
In addition to neck and arm symptoms it is not uncommon for patients to complain of headaches due to neck problems, this is referred to as being a cervicogenic headache. Research estimates that cervicogenic headaches make up between 4% and 22% of all headaches. Cervicogenic headache may present with or without neck and other related symptoms.
What to expect during your Physio assessment
When you attend the clinic with neck pain, arm pain or suspected neck related headache, your physio would carry out a thorough in depth subjective assessment which would include questions about your pain and any other symptoms, your medical history, your medication, your lifestyle and other relevant factors such as sporting or work activities.
An objective assessment would then be carried out looking at your posture, the range and quality of movement available at your neck, your shoulder, your shoulder girdle, your thoracic spine and the neural structures around this area. Muscle power, sensation and reflexes would be assessed to identify if there is an element of nerve root compression or radiculopathy present.
Your physio would then palpate your neck and the surrounding structures to assess the amount and quality of movement available and the presence or absence of muscle spasm etc.
As with the lumbar spine increasingly we are aware that your ability to control or stabilise the neck is important both to reduce pain at the present but also to cut the risk of reoccurance. Therefore assuming pain allows your physiotherapist would assess your ability to control your neck.
Following this subjective and objective assessment you and your physiotherapist would then discuss a plan to address any problems identified using the methods and approaches outline below.
So then what can I do about neck pain and how Physio can help ?
As with low back pain there is no one fix or cure for neck pain, however there is widespread concensus that an approach that is made up of various types of manual therapy(if indicated), a specific graded exercise programme that is tailored you and to your specific needs and advice regarding lifestyle such as avoiding sitting for too long, ergonomic issues including carrying out DSE assessments if required and any other relevant issues; can be effective.
All of our clinicians have been qualified for over 15 years and have a wealth of experience in the assessment and management of neck pain. We will assess and treat you as an individual in a holistic manner that is tailored to your specific needs and concerns.
Making an Appointment
Our clinc is in Eskbank near Edinbugh, we have no waiting list, we have appointments from 8 am to 8 pm and we don’t require you to be referred by your GP if you are paying yourself. If you are using health insurance we would suggest you contact your insurer to ensure that you follow their procedure, as they may specify that you see your GP first.
To book an appointment or if you have any questions please contact us.