As a physical therapist, one of the most common complaints I see is neck pain. As the head is a complex region of our body, there can be many types and causes of neck pain. Whether you have a headache, pain down the arms, or even difficulty moving, you must seek an appropriate diagnosis. The earlier you manage it, the hastier the recovery. Below we will discuss some of the most frequent types of neck pain, their causes, and how they can be managed.
What are the most common types of neck pain?
Although there are many types of neck pain, the four most common classifications are mechanical, whiplash, wry neck, and cervical radiculopathy. However, the vast majority of ALL cases are mechanical, which means that there is no inherent structural problem in the neck. Consequently, investigations such as X-rays will generally not be able to pick up these types of injuries. Under most circumstances, you should seek the advice of a qualified physical therapist for an appropriate diagnosis and management plan.
To help you understand the differences between these neck conditions, we will concisely detail and distinguish each type.
Mechanical neck pain
As mentioned before, Mechanical neck pain is the most common type of neck injury. You may also hear it being described as a “cervical strain” or a pulled muscle. Usually, there will be no damage to the neck. Although there are many causes of mechanical neck pain, most cases will be because of sitting bad postures which can create stress through the neck. Symptoms will vary depending on the individual, although most sufferers will recover quickly.
Cervical radiculopathy is a complex term. So let’s break it down.
- Cervical = neck
- Radiculo = Nerve roots (where the nerve starts from the spine)
- Pathy = Disorder or disease
To put it simply, this means that there is a compromise to the nerve roots in the neck. As the nerves help with your arms movement and sensation, people with cervical radiculopathy suffer from a wide range of symptoms such as:
- Burning sensations down the arm
- Pins and needles
- Generalized pain down the arm
- Altered sensation in the hand
- Loss of grip strength
- Poor fine motor control
Based on my experience as a physical therapist, there are many causes of cervical radiculopathy. For those suffering from milder symptoms, this could be caused by age-related changes or even poor posture. However, for those with more severe symptoms, this could be related to structural changes (e.g. disc, vertebrae, etc.) or medical conditions.
Whiplash is frequently seen in those in car accidents or trauma to the head (e.g. collision with an object or person). These are what we call “acceleration-deceleration” injuries because they involve a sudden change in speed, where the neck moves very quickly in one direction and then again in the opposite. Symptoms often occur shortly after the injury and include reduced neck range of movement, pain along the back of your neck, and headaches. It is vital that if you have been in an accident, you see your GP and rule out any serious injuries such as fractures. Whiplash injuries can be unpredictable and last longer than a year if not managed appropriately.
Wry necks usually have no specific cause. However, patients will often report that they’ve woken up with a “crick in the neck” or stiffened up after a quick awkward movement. A hallmark sign of this condition is that the neck suddenly feels stuck and extremely stiff. For those with a wry neck, it would be advised to see a physical therapist as soon as possible. Treatment such as gentle exercises and hands-on therapy (e.g. massage, trigger points, etc.) will be used to help recovery. Fortunately, most wry necks will slowly alleviate within 2-4 weeks.
What are some exercises that can be done to ‘fix’ my neck?
If you do experience any of the previously mentioned issues with your neck, it is crucial to seek advice from your physical therapist promptly. Although there are many ways to help ‘fix’ neck pain, one of the most fool-proof ways is exercise and rehabilitation. Below will be one exercise for each condition to help relieve symptoms.
Mechanical neck pain – upper trapezius stretch
As a physical therapist, a common trait of those presenting with mechanical neck pain is tightness through the muscles of the neck. One of those muscles is the upper trapezius which lies between the neck and shoulders. To help relieve this initial tightness, we would suggest an upper trap stretch. Performing this stretch confers many benefits such as improving neck range of motion and reducing pain. The video will demonstrate how this exercise will be performed.
Cervical radiculopathy – Median nerve stretch
A medical opinion from a physical therapist or a trained physician should be sought to rule out any sinister causes of cervical radiculopathy. Although the median nerves stretch can be beneficial, it can also be quite provocative to your symptoms. Seeking appropriate guidance is recommended if this exercise becomes aggravating.
Like other tissues in the body, nerves can be stretched and moved around in the body. One hypothesis regarding cervical radiculopathy is that the median nerve becomes stuck within the structures it travels through such as the muscle. Theoretically, by performing the ‘median nerve stretch,’ you can help stretch and free the nerve to help ease discomfort down the arms and neck. Although there are multiple ways to achieve this stretch, the video below shows you just one way of performing it.
Whiplash – isometric strengthening exercises
For a whiplash injury, gentle injuries are initially recommended as the neck can be very sensitive. Physical therapists can often recommend isometric strengthening exercises as they help stimulate movement and relief pain through the neck. An isometric exercise refers to the active contraction of the muscle without movement. In this case, the exercise is performed by lightly pushing into your hand in several directions of movements. Please refer to the video and audio instructions in the video below.
Wry neck – gentle mobility exercises
Like the whiplash injury, a wry neck can be extremely sensitive during the first few days. Although you may find it exceedingly painful to move your neck, you must introduce gentle mobility exercises as soon as possible. The earlier you can restore your neck movement, the faster you can recover from your wry neck. Although the video below demonstrates the exercise in sitting, you might find it more comfortable performing these lying down first. By lying down, you are removing the tension and compression down the neck. Try attempting these exercises slowly and gently push into a small amount of discomfort. If the pain becomes unbearable, then you should seek the expert opinion of a physical therapist.
Other ways to help get rid of neck pain
Besides exercises, there are different ways you can help reduce your neck pain. However, it’s best to consult with a health professional about how suitable these treatments might be. For a detailed explanation about some of these options, please have a read of 5 Simple Tips to Reduce Neck Pain.
- Heat pack: Help reduce spasms through the shoulder and posterior neck muscles
- Reduce and modify sitting posture: By breaking up bad sitting habits, you can begin to eliminate stress through the neck.
- Stress management: Stress is one of the most significant direct factors associated with neck pain. Try to reduce this by removing stressors and performing activities that will relieve stress (e.g. jogging, yoga etc.)
- Ergonomic equipment: Some workplaces are set-up in a way that will create tension in the neck. Ergonomic equipment minimizes these risks and helps decrease the likelihood of developing neck pain.
How do you know if neck pain is serious?
In some cases, neck pain can be a sign of more severe injuries or diseases such as cancer. These include neck conditions such as fractures, neck instability, and vertebrobasilar insufficiency – a condition where the blood flow to the brain is reduced or completely obstructed. There are certain accompanying signs and symptoms which are indicative of these serious conditions. If you have any of the following symptoms, it is essential you visit your physician prompt for an appropriate assessment and examination.
- Severe pain after trauma or an accident
- Ongoing night pain
- Unexplained weight loss
- Night sweats
- Double vision
- Difficulty speaking
- Difficulty swallowing
- Sudden, spontaneous falling or ‘drop attacks.’
- Flickering of your eyeballs or ‘nystagmus.’
- Any balance issues when walking normally
Disclaimer: The content written on this page created for educational purposes. Information on this page should not be used as medical advice or a substitution for seeking the services of a health professional. Anyone suffering from neck pain should book in a consultation with their primary healthcare practitioner (e.g. physical therapist, family doctor, etc.)