Have you woken up in the morning wondering why your neck is stiff, sore or painful?
Sometimes you can catch yourself wondering how this happened even though you may not have had a specific moment of injury that would account for the pain.
This can become frustrating as you know you are feeling pain, but there is no obvious reason. It’s pretty normal when you are experiencing neck pain to also lose some movement and feeling the neck muscles contract, which often worsens the condition.
What causes neck pain?
- Immobility (reduction of movement/no movement) – think of that time when you or somebody you know had to be in a cast or brace for an extended period of time. Say you had an arm cast on for 6 weeks that included stopping movement of your wrist. After getting the cast removed you would have noticed firstly that your arm will have shrunk in muscle size but also your wrist will have limited movement. This is because your body got used to not moving and the ligaments, tendons and muscles over the joint will have shortened and become stiff. The other thing that you would have noticed is that the wrist will be more sensitive to movement and if pushed to its new limit cause pain faster than usual.
The same process happens in your neck joints when you stop moving it as much as normally. There is no injury of tissue, but the ligaments, tendons and muscles in the area have potentially reduced in length, but more accurately increased in sensitivity to movement.
- Deconditioning (decreased muscular ability) – Now think of a leg in a cast for 12 weeks. Not only does the leg in the cast have a reduced weight bearing, but the non-injured leg has an increase weight bearing. After removal of the cast the injured leg has decreased muscle mass and the other increased muscle mass. Along with this the injured leg is significantly weaker and will fatigue faster and become sore and potentially painful if trying to return to normal function too fast. In healthy adults immobilisation causes detectable muscle wasting/deconditioning in 10 days and up to a 40% reduction of strength in 1 week!
These are the extreme cases of deconditioning, but can be transferrable to normal cases of neck muscle deconditioning and pain. If you have had a reduction of your normal exercise / weight lifting routine over consecutive weeks you will find your muscles will have deconditioned and doing some normal activities like sitting at a desk looking at a computer for a few hours now increases irritability of the neck muscles and results in pain.
- Overuse (doing activities your body is not conditioned for regularly) – lets now think of the neck above that has deconditioned and is now having to extend its normal desk work at a computer and constant muscle activity from 3 hours a day to 6 hours. This load increase on a deconditioned neck will leave the muscles and tendons of the neck vulnerable to overuse which will result in pain. It may also leave the neck and shoulder region vulnerable to tendon type pathologies like tendinosis or strains.
How to get rid of and treat neck pain effectively?
It’s quite normal to find yourself having a combination of the above key reasons for neck pain so having a specific program made for you by your trusted practitioner will make sure you are addressing everything in a balanced and specific way that is individualised to your case.
Below I will outline the most common modes of therapy that are useful in treatment of neck pain.
Addressing the Pain – there are a lot of therapies available for reducing pain, most are aimed at short term relief, but are beneficial in combination with long term treatment methods. Manual therapy including joint manipulations (back cracking/popping) and mobilisation (therapist moving joints) and massage (deep or soft tissue) can be very relieving short term for muscular and joint stiffness and soreness. This is great for relieving the pain temporarily and often greatly appreciated by people who are suffering with neck pain.
Addressing the Cause of the Problem – the most effective way in treating neck pain is with exercise therapy, not only to reduce the pain short term, but also to give long term reduction of pain to increase in neck function by increasing the muscular capacity. Normally exercise therapy will begin with range of motion exercises for increasing joint mobility and reducing sensitivity of movement. Therapy will then be focused on progressing the neck muscles through a progressive exercise program to reach a point of capacity that surpasses your original level of strength.
In our clinic, we focus on educating each client so they understand why it’s so important to not just get out of pain, but to get strong! We know that people that are empowered with knowledge of evidence based practice are in the best position to condition their bodies to become strong and are at the lowest risk of recurrence of pain in the future.
Written By:
Ryan Michell,
Physiotherapist,
Proactive Health & Movement
