How to manage neck pain?

Senior Musculoskeletal Physiotherapist Paul Atkinson’s clinical area of interest is managing neck pain. Neck pain is one of the most common presentations to Promotion Health. Physiotherapy management is a very effective as a first line management for both acute and chronic neck pain (1).

Neck pain can have high levels of disability and burden. It is most common in the ages of 45-54, however, can affect people of any age. It is one of the 10 most frequent musculoskeletal conditions globally with up to 70% of people experiencing neck pain in their lifetime, with the majority of these having recurrent events in the future (2). We believe that our holistic and thorough management approach at Promotion Health can help reduce these recurrences.

Although occurrences of neck pain are high, severe pathology requiring imaging or surgery are quite low. Most episodes of neck pain resolve well with conservative management. Some of our strategies are outlined below.

Common Types of Neck Pain we see at PROmotion Health

1)    Idiopathic Neck Pain – neck pain that comes on without significant trauma. Typical presentations are wry neck or a stiff neck presentation.

2)    Neck and Arm Pain – these are described as radicular or radiculopathy injuries due to causes centrally at the neck affecting the nerve to the arm. Although it can be very painful and distressing having this injury, many resolve without invasive management such as surgery. We work closely with our referring GP’s, Sports Medicine Physicians, and Neurosurgeons to ensure your injury is managed appropriately.

3)    Neck and Shoulder Pain – this can be neck pain that is contributed by the shoulder girdle. Commonly symptoms can be muscular pain in the shoulder and neck region. A chronic feeling of ‘tightness’ in the upper trapezius muscle is commonly described. These progress exceptionally well with specific retraining and strength exercises. Many people progress to our small group strength and rehab classes for these injuries.

4)    Upper Cervical Pain – this is pain in the upper neck area. It can present in conjunction with headaches and jaw pain due to the common nerve supply of the trigeminal nucleus in this area.

5)    Whiplash associated disorders – these are post traumatic injuries following a whiplash mechanism. For these injuries, an early and through assessment is advised. We assess any structural injury that may require further imaging or medical review before starting our management plan. In some very traumatic cases, we can liaise with a Clinical Psychologist to assist with management.

We pride ourselves on an individualised approach to your case. Paul’s main goals of management are to identify your specific impairments, clearly diagnose your issue, and to align treatment with your values as well as best available scientific evidence.

Identifying other contributing factors to your pain is central to Paul’s approach. These can include family and life commitments, lifestyle behaviours such as a sedentary work role, and your physical and mental health. These factors can play a pivotal role to your individual pain experience.

Paul finds a multimodal approach works best for managing neck pain. Utilising manual therapy to modulate pain or to improve movement, specific movement and muscle retraining, and a progressive strength training programme are all key interventions. These management strategies all have extensive research and have been shown to be effective for neck pain (1).

Starting your journey

The best place to start is to book an assessment. Our team at Promotion health will guide you in diagnosing your issue, and collaboratively setting out your management goals. You will be on the path to recovery in no time.

1)    Sterling, M., de Zoete, R. M. J., Coppieters, I., & Farrell, S. F. (2019). Best Evidence Rehabilitation for Chronic Pain Part 4: Neck Pain. Journal of Clinical Medicine, 8(8). https://doi.org/10.3390/jcm8081219

2)    Gwendolen Jull, E. (2021). Curbing the burden of idiopathic neck pain:Can a stitch in time save nine? Musculoskeletal Science and Practice, 51, 102323. https://doi.org/10.1016/j.msksp.2021.102323