Neck pain is a serious problem in an individual’s life, which is difficult to ignore, as it limits your ability to perform daily activities and chores. Neck pain can be an unpleasant sensory and emotional experience that occurs due to biological (tissue damage) or psychological factors and can, in certain cases, spread to the shoulder area and down the arm to the fingers.
Neck and back pain is called a multifactorial disease, as it occurs due to various risk factors, such as degenerative changes in the spine, herniated disc, cervical spinal stenosis, lack of physical activity, excessive computer and phone use, the impact of stress, emotional distress, anxiety, old age, and low social support.
Timely detection of risk factors and triggers of neck pain leads to a more effective diagnosis, treatment, and pain management. Below we provide an explanation on how we help you achieve a pain-free life at Medicofit clinic.
Inadequate or late rehabilitation seriously jeopardises an individual’s long-term physical health and is the main culprit for unsuccessful results and permanent movement limitations.
The neck is the main support for the head and represents the connection to the rest of the body. Anatomically, it is located between the lower jaw and the clavicle. It contains the most complex and numerous vital structures that are essential for normal physiological functioning of the human body.
The anatomical structures in the neck enable uninterrupted functioning of breathing, speaking, swallowing, regulation of metabolism, connection of the brain to the spine, and circulatory and lymphatic inflow and outflow from the head.
The cervical spine consists of seven vertebrae, which are anatomically positioned one above the other. The vertebrae are linked to each other and form the spinal canal which holds the spinal cord and its nerves.
The main function of the spinal cord is the transmission of messages (sensory and motor impulses) between the brain and the rest of the body. Between individual vertebrae are intervertebral discs, which consist of a hard and flexible outer ring (called the annulus fibrosus) and a soft centre of the disc (called the nucleus pulposus). The intervertebral disc appropriately distributes the impact of mechanical forces that are generated on the spine during everyday life (gravity, physical activity, etc.).
What types of neck pain are there?
Neck pain is categorised according to the duration of the problem (acute phase lasts up to 6 weeks, subacute phase lasts 3 months or less, chronic phase lasts 3 months or more), severity of the pathology, type of aetiology (type of the cause of the problem), and type of pain (mechanical or neuropathic pain).
Neck pain can be of mechanical, neuropathic or secondary origin. Secondary or other causes include pain from the heart, vascular pathology, or referred pain from adjacent anatomical structures.
Mechanical pain originates from the spine or its supporting structures (ligaments, muscles) and manifests in the form of arthritis, discogenic pain, and myofascial pain. Mechanical pain typically worsens during movement.
Neuropathic pain occurs as a result of injury or disease of the nervous system and is divided into central or peripheral pain. The main symptom of neuropathic pain is a burning pain in the neck.
The cause of central neuropathic pain is in the spinal cord and manifests itself in the form of symptoms of myelopathy (disturbed motor and sensory impulses). Peripheral neuropathic pain occurs due to damage to the peripheral nerves and can be recognised in the form of radicular symptoms that occur as a result of a herniated disc, osteophytes (bone spurs), or spinal stenosis.
Neck pain rating scale
NECK PAIN LEVEL
DESCRIPTION
LEVEL I.
Neck pain that causes minimal or almost no limitation in everyday activities.
LEVEL II.
Neck pain that limits everyday activities.
LEVEL III.
Neck pain radiating to the arm (associated radiculopathy / “pinched nerve” – burning pain in the neck, weakness and numbness in the arm).
LEVEL IV.
Neck pain resulting from a serious pathology (tumour, fracture, infection, systemic disease).
Why does neck pain occur?
Did you know that neck pain affects women more often than men?
Risk factors that affect the occurrence of pain include genetics, psychopathology (depression, anxiety, catastrophising, etc.), sleep disorders, smoking, and a sedentary lifestyle.
Obesity has been shown to be a major factor in the occurrence of neck pain, as individuals with increased body weight are more susceptible to systemic inflammation, harmful structural changes, increased mechanical stress, reduced muscle strength, and are more prone to psychosocial issues.
Neck pain occurs as a result of trauma (brain injury, neck injury) or sports injury (wrestling, boxing, ice hockey, etc.).
According to some studies, office, computer, physical and healthcare workers are more susceptible to neck and back pain. A poor work environment and low job satisfaction significantly influence the development of neck pain.
Eight reasons for neck pain
Neck pain is the second most common cause of problems on the list of musculoskeletal disorders. The main causes of neck and back pain are cervical spine whiplash injuries, neck sprains or strains, cervical osteoarthritis, degenerative disc disease, cervical radiculopathy, torticollis or wry neck, and herniated disc. A more detailed description of the conditions is presented below.
Cervical spine whiplash injury
A whiplash injury usually occurs as a result of a car accident, sports injury, or fall, where there is a sudden movement of the head from hyperextension (head direction: extreme position facing back toward the ceiling) forward to flexion (head direction: position facing toward the ground). In some cases, spinal injury indirectly affects joint or disc damage, which irritates nerve roots and nerves.
Individuals with symptoms of whiplash injury report neck pain and stiffness, radiating pain to the shoulders or back, numbness and tingling of the entire upper extremity, headaches, dizziness, sleep disorders, or vision problems (blurred vision, sensitivity to light, etc.).
A whiplash injury is a set of clinical signs that lead to a medical diagnosis, such as a neck strain or sprain.
Neck strain or sprain
A neck strain is defined as a strain of a muscle in the neck or an injury to a muscle tendon (fibrous tissue that connects muscle to bone), while a sprain is a tear of a ligament (fibrous connective tissue that connects two bones) that connects the cervical vertebrae to each other.
Poor posture, inappropriate sleeping positions, and sudden neck movements (traffic accident, sports injury, fall) contribute to the occurrence of a neck strain or sprain.
Individuals experience pain and stiffness in the neck upon movement, radiating pain to the upper shoulder, reduced neck mobility, and the occurrence of muscle spasms (4).
Cervical osteoarthritis
Cervical osteoarthritis or cervical facet joint syndrome is a degenerative disease of the cervical spine, where the cartilage in the facet joints wears down. Often times, degeneration of the facet joints affects the degeneration of the intervertebral discs, which in turn leads to compression of the nerve root (leading to symptoms of radiculopathy).
Symptoms of cervical osteoarthritis include stiffness and pain in the neck, localised in one place (spot pain), less often the pain radiates to the shoulder or the back of the head.
Cervical osteoarthritis occurs as a degenerative process of ageing, as a result of neck injury or being overweight.
Ageing is a natural evolutionary process in which wear and tear changes occur in the intervertebral discs of the cervical spine. Individuals with degenerative disc disease experience neck pain and stiffness that worsens with movement.
Treatment of degenerative disc disease in the cervical spine depends on the severity of the symptoms and the presence of neurological symptoms.
Surgical treatment is necessary in long-term cases, in the presence of neurological symptoms.
Cervical radiculopathy
Degenerative changes lead to narrowing of the intervertebral space and the formation of bone spurs that compress the nerve root, which is called cervical radiculopathy.
Cervical radiculopathy is experienced as pain and tingling from the neck down the entire upper extremity and increased weakness of the neck muscles and muscles of the upper extremity.
Nerve root compression is caused by spondylosis (degenerative changes), osteophytes (bone spurs), instability of anatomical structures, traumatic injuries, or tumours.
A compressed nerve root causes problems with walking, balance, and bladder or bowel dysfunction.
Torticollis or wry neck
Torticollis usually occurs as a result of muscle tension or a disease of the joints in the cervical spine (osteoarthritis, facet joint injury). Torticollis occurs after lifting a heavy load or, more commonly, while sleeping in an inappropriate position.
The main symptom of torticollis is limited range of motion of the cervical spine or difficulty moving the head. The stiffness caused by torticollis occasionally leads to muscle pain or nerve compression, which is experienced as a burning pain in the neck and tingling throughout the upper extremity (2).
Torticollis symptoms can be treated at home by relieving pain and improving range of motion in the neck. For the first three days after the onset of torticollis, it is recommended to use ice (cryotherapy), as this reduces inflammation and pain. In the following days, focus on using heat (thermotherapy) to increase blood flow to the neck area and reduce stiffness.
Management of the main torticollis symptom, the limited range of motion, can be improved with appropriate stretching and range-of-motion exercises. It is recommended to avoid movements that further trigger pain.
Cervical herniated disc
A herniated disc can occur from the cervical to the first sacral spinal vertebra. A herniated disc occurs when the soft centre of the intervertebral disc (nucleus pulposus) bulges and compresses the nerve root – this is often the cause of neck pain.
Symptoms of a herniated disc manifest as radiculopathy (nerve root compression), which individuals describe as a burning pain in the neck or a feeling of electricity that spreads from the neck down the arm to the fingers. Symptoms of a hernia include a tingling sensation in the hand, palm, fingers, weakness of the neck muscles and the muscles of the entire upper extremity.
A herniated disc is diagnosed using an appropriate diagnostic test and physical examination. To further confirm the diagnosis of a herniated disc, an imaging diagnostic method called magnetic resonance imaging (MRI) is recommended.
With an appropriate diagnostic examination and special physiotherapy rehabilitation, we drastically reduce the likelihood of surgery (cervical discectomy) to remove a herniated disc.
Cervical spinal stenosis
Cervical spinal stenosis is a term that describes the narrowing of the spinal canal in the cervical spine.This narrowing can cause pressure on the spinal cord and nerves, causing various symptoms. This is most often the result of degenerative changes – osteoarthritis or herniated disc in the cervical spine.
Symptoms of cervical spinal stenosis include pain in the neck, shoulders, or arms, especially with movement.Tingling, weakness, and coordination problems may also occur.
Diagnosis usually requires imaging tests such as X-ray, MRI, or CT scan to assess the extent of the narrowing and any other structural changes.
Treatment for cervical spinal stenosis initially always includes conservative methods such as physiotherapy, pain therapy, and lifestyle adjustments.In some cases, when symptoms are severe or unresponsive to conservative treatment, surgery may be considered.
Poor posture
Poor posture is a common cause of neck pain. Incorrect posture can lead to excessive strain on the neck muscles, ligaments, and vertebrae, over time causing discomfort and pain. Some of the main causes of neck pain due to poor posture include:
Muscle overuse: Maintaining an incorrect posture for a long time, especially while sitting or standing, can lead to overuse of muscles in the neck.
Stress on intervertebral discs: Incorrect posture can increase pressure on the intervertebral discs in the cervical spine, which can accelerate their degeneration.
Ligament tension: Poor posture can also cause excessive tension in the neck ligaments, further contributing to pain.
Poor circulation: Poor posture restricts blood flow to neck tissues, which can lead to an inadequate supply of nutrients and oxygen.
Improving posture is key to preventing and managing neck pain. Regularly doing exercises to strengthen the neck muscles, proper ergonomics when sitting and standing, and taking regular breaks for stretching can help reduce neck strain and prevent pain.
There are many other causes of neck pain that are not of musculoskeletal origin. Neck pain can be caused by a number of infections, which often lead to enlarged cervical lymph nodes – the lymph nodes are tender and painful, and an elevated body temperature is often present.
There are also numerous cysts on the neck, which are the result of embryonic development and can cause many problems throughout life – the cysts can fill with fluid and become inflamed. They are usually found on the lateral side of the neck or in the medial position.
WHEN TO OPT FOR MEDICOFIT DIAGNOSTIC THERAPY?
If neck pain persists for over 14 days, it is necessary to undergo diagnostic therapy.
When you have a feeling that your neck is tense or mobility is significantly reduced, especially after an injury.
If you have previously had problems with your cervical spine and the symptoms are recurring, this means that the injury was not properly treated or that a new injury has occurred.
At Medicofit clinic, we provide patients with neck pain with scientifically supported specialist physiotherapy, which begins with booking a diagnostic therapy appointment.
Neck pain is dangerous when it occurs as a result of a traumatic injury or when symptoms of headache, fever, nausea, vomiting, or difficulty breathing are present.
Be especially careful when symptoms include:
Severe pain that does not improve: If neck pain does not improve with proper care or rest, it is recommended to seek medical attention for a thorough evaluation.
Numbness or weakness in the arms or legs: If you notice numbness, weakness, or problems with sensation in your hands, arms, or legs, this may indicate neurological involvement.
Walking or balance problems: If neck pain causes problems with walking, coordination, or balance, this is a worrisome symptom that requires medical attention.
Headaches, dizziness or nausea: If neck pain is accompanied by headaches, dizziness, or nausea, this may indicate blood supply issues or other more serious problems.
Severe pain after injury: If neck pain is caused by a recent injury, such as an accident, fall, or blow, it is recommended to seek medical attention to rule out any serious injury to the cervical spine.
Below we describe how you can reduce burning neck pain yourself and thus improve the quality of your life.
Avoid prolonged sitting positions or organise time for movement into your sitting routine during which you can stretch, move, and exercise (this will limit the consequences of poor posture).
Follow ergonomic advice when using your computer and phone (ideally set at eye level).
Organise your sleep routine appropriately to ensure your body gets enough sleep (use an appropriate pillow for optimal neck alignment while sleeping).
At Medicofit clinic, we recommend you self-massage tense neck muscles to relieve pain and properly execute appropriate exercises for neck pain, which are aimed at strengthening neck muscles.
Exercises for neck pain
Below, we also present some effective exercises that you can incorporate into your routine to reduce discomfort and regain flexibility and strength in your neck. Performing these exercises correctly will help you improve your quality of life and prevent further injuries.
Important notice
•The exercise can be performed in numerous modifications and different load regimens; proper execution will be prescribed by a Medicofit physiotherapy specialist for neck pain rehabilitation as part of your comprehensive treatment. • If you have neck problems, please book an diagnostic therapy appointment before performing the exercise. The exercise may also be contraindicated. • Always do the exercise strictly according to the prescribed regimen and as demonstrated by the physiotherapy specialist for rehabilitation and cervical spine disorders. • We recommend the exercise as part of guided, comprehensive specialist physiotherapy for neck rehabilitation. • If you perform the exercise independently without the supervision of a physiotherapy specialist, we are not responsible for potential symptomatic responses.
Exercise no. 1: Cervical spine retractions + elastic band
Exercise no. 2: Lateral flexion of the cervical spine sideways + lateral head movement
Exercise no. 3: Bilateral arm glide with back against wall
Diagnostic therapy of neck
A physiotherapist diagnostician will properly determine the source of primary neck pain through anamnesis, the history of your symptoms, and the aetiology of your problems.
They further determine the duration of the problem, as acute neck pain often becomes chronic. Through the diagnostic process, they eliminate any referred neck pain from pathologies that require specific treatment, such as thoracic outlet syndrome, upper extremity pain, vascular pathology, and pain from thoracic internal organs (heart, lungs).
Using physiotherapy diagnosis, it is important to distinguish neuropathic from mechanical pain, which influences decisions about further treatment.
Neuropathic pain, which can occur as a result of spinal stenosis or herniated disc, is described by individuals as a stabbing, electrical, and burning pain in the neck that radiates into one or both upper extremities. Mechanical pain, in contrast to neuropathic pain, is more throbbing and sharp.
The physiotherapy diagnostic process includes a physical examination, where the physiotherapist diagnostician checks your neck range of motion, muscle strength, identifies any muscle imbalances, sensory sensitivity, body posture, analysis of spinal movement patterns, and functional mobility.
An important diagnostic factor is the load-carrying capacity of the cervical spine, which is used to obtain an assessment of its ability to withstand loads.
Based on all the information collected about your health condition, a specialised individualised physiotherapy programme is prepared.
WHY CHOOSE SPECIALIST PHYSIOTHERAPY TREATMENT?
We ensure high treatment success and long-term results.
Up to 90% lower risk of cervical spine surgery!
We offer state-of-the-art non-invasive treatment methods that provide optimal conditions for the healing of cervical spine injuries.
Comprehensive treatment of neck pain at Medicofit clinic is recommended by numerous renowned orthopaedic surgery specialists.
The effectiveness of specialised physiotherapy differs from passive treatments such as rest, as it focuses on individualised kinesiotherapy, i.e. performing active exercises and establishing postural correction in the treatment of neck pain. Rest is recommended, but in a reasonable proportion to your activity.
In the initial phase of individualised physiotherapy, the physiotherapist diagnostician performs an examination to determine what type of pain you are experiencing (neuropathic/mechanical) and, based on the findings, appropriately adjusts the individualised kinesiology programme, which is aimed at reducing neck pain, potential irritation of the nerves, i.e. radiating pain and tingling into the upper extremity, and increasing the load-carrying capacity of the cervical spine.
Individual kinesiotherapy is based on your diagnostic results, which provide insight into the range of motion of your neck (which, in case of limitation, is increased with mobility exercises), any muscle imbalances and weaknesses of individual muscles or muscle groups (which are initially appropriately strengthened with isometric exercises, and with resistance exercises in the next phase), which is why the programme is created specifically for your individual needs.
Analysis of postural movement patterns allows for in-depth insight into the dynamics of your spine and any deviations from the norm. In order to correct posture and spinal movement patterns, we initially focus on performing activation exercises for the spinal neck muscles, which are key for postural control.
Next, we perform active exercises, aimed first at establishing the correct load-carrying capacity of the cervical spine (exercising full range and strengthening in all directions of movement in the neck – flexion, extension, lateroflexion and rotation) and, once results are achieved, we focus on increasing the load-carrying capacity of the cervical spine.
Active rehabilitation is crucial for a successful treatment outcome; however, to achieve optimal results, we are assisted by state-of-the-art physiotherapy support technology, such as HiToP electrotherapy, LASER therapy, ultrasound therapy and PERISO therapy.
DANGERS AND PITFALLS OF DELAYED REHABILITATION
Medicofit specialists
Long-term pain leads to weakness of neck and shoulder muscles, causing the problem to progress and weakening your posture.
Untreated neck pain accelerates degenerative changes in the spine, such as osteoarthritis, intervertebral disc degeneration, and spondylosis.
Due to pressure on the nerve roots, serious neurological damage can occur, such as tingling, numbness, and weakness in the hands.
Eliminate neck pain forever
Neck pain negatively affects the functionality of your everyday tasks and activities. The first step to successfully resolving problems is an expert diagnostic examination, which is a prerequisite for setting up an individualised specialised physiotherapy programme.
The main purpose of modern physiotherapy rehabilitation for long-term elimination of neck pain is a comprehensive approach that includes inter-professional collaboration between experts in the fields of medicine, physiotherapy, and kinesiology, with a common focus on improving physical function and, consequently, your quality of life. This is the modern reality that Medicofit clinic experts offer today!
Book an appointment for neck pain rehabilitation
References and literature
Kelc R., 2012. Funkcionalna anatomija hrbtenice. VIII. Mariborsko ortopedsko srečanje. Interdisciplinarno strokovno srečanje. Hrbtenica v ortopediji. Zbornik predavanj. Maribor, pp. 13-23
Cohen S. P. (2015). Epidemiology, diagnosis, and treatment of neck pain. Mayo Clinic proceedings, 90(2), 284–299. DOI
Roesch ZK, Tadi P. Anatomy, Head and Neck, Neck. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: NCBI
Bragg KJ, Varacallo M. Cervical Sprain. [Updated 2022 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: NCBI
6 ways to ease neck pain – Harvard Health. (2015, April 25). Harvard Health. Retrieved October 19, 2022.
Kazeminasab S, Nejadghaderi SA, Amiri P, Pourfathi H, Araj-Khodaei M, Sullman MJM, Kolahi AA, Safiri S. Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord. 2022 Jan 3;23(1):26. doi: 10.1186/s12891-021-04957-4. PMID: 34980079; PMCID: PMC8725362.
Sharrak S, Al Khalili Y. Cervical Disc Herniation. [Updated 2022 Aug 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: NCBI
