The problem

Neck or cervical spine pain is a common problem affecting all age groups, cultures and socio-demographic levels. It can range from being mild and and a bit of a nuisance, to severely disabling and incapacitating. Recurrences of acute bouts of neck pain are common for many people and neck pain may become persistent or chronic. 

Pain associated with disorders of the neck can be felt locally in the neck or referred to other areas such as the head (cervical headache), arms or upper back.

What are the causes of neck pain?

The onset of neck pain may be associated with a traumatic event, such as whiplash injuries or sports trauma, or it may have a gradual onset not associated with any specific triggering events.

Although rare, neck pain may be caused by serious pathology such as tumours, infections or damage to the arteries in the cervical region. 

More commonly, neck pain is associated with disorders of the cervical musculoskeletal system including the intervertebral discs (the principal joints between two vertebrae in the spinal column), ligaments, muscles and joints. Pins and needles and numbness are symptoms often associated with irritation or compression of the cervical nerves and are often felt in the arm, hands and fingers. This is known as ‘radiculopathy’ or ‘radicular pain’. 

In some cases, the cause of the neck pain can be identified during a clinical examination and confirmed by appropriate investigations or imaging. However, in many cases, the exact cause of the pain is less clear and these cases are known as ‘non-specific pain’. This doesn’t mean that there isn’t a physical problem, but that a simple source can’t be reliably identified. Physiotherapy is still appropriate and effective for helping treat non-specific neck pain.

What other factors can contribute to neck pain?

Emotional state, social factors and past experiences all play a significant role in the experience of neck pain. Sleep disturbances, anxiety, stress levels and immune system dysfunction can influence neck pain and in turn, be adversely affected by the pain experience, setting up a vicious cycle that can lead to chronic or persistent pain.

How can physiotherapy help?

At Brisbane Physio Specialists we will perform a comprehensive interview to identify your symptoms and to understand how your neck pain affects your activity levels and quality of life. With a thorough examination we’ll identify any musculoskeletal problems that might be a cause of or a contributing factor to your neck pain. We will screen you for non-musculoskeletal causes of your pain and refer you for a medical assessment if needed. We also take into account your personal situation, your goals and what understanding you have of your neck condition. Together we can create an understanding of your pain, and develop a plan to provide relief in the short-term, and reduce the chance of reoccurrence in the long-term.

Treatment

At Brisbane Physio Specialists we will work with you to explore possible interventions and work out what treatment type is best for you and your specific condition. This can include hands-on treatment and/or an exercise program to reduce pain, improve flexibility and strength and regain normal neck function. 

Work and lifestyle advice can be an important part of your treatment. We will answer your questions and clear up any confusing advice you may have received about your neck condition. Our treatment is always ‘patient-centred’, making sure you are informed and respected in the decision-making process.

Interesting stats

  • Neck pain ranks fourth behind low back pain, depression and arthralgias as a cause of significant disability. 
  • The 12 month prevalence of neck pain ranges from 30-50% with up to 12% of cases classified as activity limiting.  (Can you explain what the 12 month prevalence refers to? Is that the number of people who have neck pain within a 12 monthe period?)
  • Neck pain is more common in women, most commonly occurring in middle age.

References

Cohen S Epidemiology, Diagnosis, and Treatment of Neck Pain Mayo Clin Proc. 2015;90(2):284-299 n http://dx.doi.org/10.1016/j.mayocp.2014.09.008

Jull G, Treleaven J, O’Leary S, Lewis J. Management of Neck Pain Disorders : A Research Informed Approach, Elsevier, 2018. ProQuest Ebook Central, https://ebookcentral-proquest-com.ez.library.latrobe.edu.au/lib/latrobe/detail.action?docID=5485005.

Hogg-Johnson S, van der Velde G, Carroll LJ, et al; Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. The burden and determinants of neck pain in the general population: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine 2008;33(4, suppl):S39-S51