Article by Graceville Physiotherapist Molly Cartledge
Neck pain is a common presentation to physiotherapy clinics. Muscles, joints and nerves are different sources of neck pain. This may include muscle tightness or strains, joint sprains and dysfunction, joint degeneration, discal pain and nerve compression . Neck pain can arise suddenly from injury or can build over time from tightness, weakness and suboptimal postures . Pain may be referred into the head, upper back, shoulder, arm and hand. Other common symptoms accompanying neck pain are headaches, migraines, nausea, dizziness and jaw pain.
There are many different types of headaches and migraines. Headaches arising from neck pain are known as cervigogenic headaches. Pain is usually one-sided and is exacerbated by neck movements or postures . Presentation usually includes tightness in the surrounding muscles, especially the upper trapezius, levator scapulae, scalenes and suboccipital muscles [1,4]. Weakness is often present in the deep stabilising muscles of the neck, while the superficial muscles can become overactive [5,6,7]. Treatment begins with calming down the corresponding joints and muscles with manual therapy. Long-term management is guided toward strengthening the deep neck muscles and back muscles and improving postural habits.
Another presentation we see in our clinic is called an acute wry neck. Patients usually complain of waking up with moderate to severe pain. Their neck movement will often be severely restricted, usually worse to one side.
The neck can appear to be locked out of range but this is usually caused by muscle spasm rather than true joint locking. Wry necks can cause a lot of pain and stress to individuals but they can be well managed, especially if treatment is sought early. A strengthening program is often required to address any underline weakness or contributing factors.
If would like to discuss the management of patients experiencing neck pain, cervigogenic headaches or wry neck, please contact us today and we would be happy to help.
1.Goodman, C, Fuller, K. Pathology: Implications for the Physical Therapist. 3rd ed. St. Louis: Saunders Elsevier, 2009.
2. Grant Cooper, M., 2019. Types of Neck Pain. [online] Spine-health. Available at: <https://www.spine-health.com/conditions/neck-pain/types-neck-pain> [Accessed 21 May 2021].
3. Jull G, Stanton W. Predictors of responsiveness to physiotherapy management of cervicogenic headache. Cephalalgia. 2005;25:101-108.
4. Page P. Cervicogenic headaches: an evidence-led approach to clinical management. International journal of sports physical therapy. 2011 Sep;6(3):254.
5. Jull G, Trott P, Potter H et al., A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache: The cervical therapeutic exercise programme, Spine 2002
6. Page P, Cervicogenic headaches: An evidence-led approach to clinical management, The International Journal of Sports Physical Therapy, Volume 6, Nr 3, September 2011
7. McDonnell MK et al., A Specific Exercise Program and Modification of Postural Alignment for Treatment of Cervicogenic Headache: A Case Report, J Orthop Sports Phys Ther, Volume 35, Nr 1, January 2005