WHAT’S THAT PAIN IN MY NECK?
Trish Muse, MPT, CSCS
Physical Therapist
Pilates practitioner
Wellness Coach
PowerBar Team Elite Fitness Expert
Doce Vida Fitness East Coast Fitness Ambassador
The Neck
• Most mobile part of the spine
• Consists of 7 vertebrae• Supports the head• Held by 32 muscles• Supplied by 8 nerves
for the head to the arms & chest
The Neck
• Supplied by 4 major arteries & veins
• Spinal cord runs through the vertebrae
• Spinal nerves exit through foramen
• Ligaments connect the vertebrae in the back & front
The Neck
• Discs are attached to & lie between the vertebrae
• Discs are made of cartilage
• Discs act as cushions & shock absorbers
Causes of Neck Pain
• Minor injuries
• Aging
• Over exertion
• Poor biomechanics
• Poor posture
• Increased tension
• Wear & tear
• Disease
• Emotional stress
Neck Injuries
• Sports related – ie blocking with the head down in football
• Shallow dives• Whiplash –
hyperextension when neck moves back & body moves forward then head recoils
Neck Injuries
• Collision –hyperflexion injury when head keeps moving forward when the body suddenly stops then head snaps back on rebound
• Sprains – forced movement beyond the ROM tearing a muscle and/or ligament
• Sprain – decreased motion when muscles are tense
Posture
• Balance in relation to the line of gravity
The Wall Test
• Stand• Place your back
against the wall• Heels several inches
away from the wall• Butt & shoulders
touch the wall• Back of your head
close to the wall
• Keep your chin level• Walk away from the
wall• Then return to the wall• Check to see if you
kept this posture• Keep this posture
everyday
Poor Posture
• Poor posture, obesity, weak abs, prolonged sitting pull the low back curve forward & upper back curve farther backward
• Forces the neck curve forward to compensate
Poor Posture
• Jobs/tasks that involve increased time leaning over cause a hunched shoulder and arch the cervical spine forward
• When the weight of the head is off center it causes tight and fatigued cervical muscles
• When cervical muscles contract without rest it leads to cervical pain
Referred Pain
• Pain that starts in the neck but is felt from the head to the fingers is called referred pain.
Sleep
• Wry neck – when you sleep with the cervical spine is out of alignment
• Relieved in a few days
Stress
• Causes cervical muscle tightness
• Cervical muscle tightness causes injuries
• Takes longer to recover when you’re nervous & tense
• Decrease stress by relaxing
• Lessen stress by focusing on problem solving
Degenerative Disc Disease
• Wear & tear disease• Occurs with age• Areas with the most
movement C4-C6 change
• Occurs between 40-60 years of age
Degenerative Disc Disease
• Disc wears down
• Disc space narrows
• Disc becomes less elastic & loses water
• Vertebrae get closer together & may touch causing irritation
• Bone spurs develop possibly pinching nerves
• If this develops slowly there may not be symptoms
• Facets wear down which is a form of arthritis
• Swelling occurs in surrounding tissue
• Cervical spine nerves get compressed
Herniated Discs
• Worn disc ruptures• Presses nerve roots• Can cause referred
pain
What Happens Next?
• With treatment improvement can occur
• If due to aging or disease it may take 6-8 weeks
• Reoccurrences are common
• You can lessen reoccurrences with good neck care and exercise
Pain Relievers
• Relieve pressure and spasm
• Lie down to lessen the load on the cervical spine by the head
• Cervical Collar – increases head support, decreases neck motion, worn during an acute phase, should fit snuggly & should be long enough to support the chin
Pain Relievers
• Home Traction Unit – decreases the weight off the cervical spine muscles & discs
• Stretches cramped muscles
• Increases the foraminal space
• Helps to decrease pain
Sleep
• Fit your pillow to body and bed
• Support your natural curves
• Thicker & firmer at the neck
• Thinner & softer under the head
• Look for a straight spine
• Very firm mattress =use a thicker pillow
• Very soft mattress = use a thinner pillow
Keyboard Posture
• Keep your wrists and hands straight
• Sit up straight
• Feet flat on the floor under you
Daily Neck Care
• Pain is a warning sign • Avoid discomfort• Decrease bending
backwards when shaving
• Wash hair in the shower vs sink
• Use a straw when drinking from a can or bottle
• Take posture breaks at work
• Keep work at eye level• Use a step ladder vs
reaching up
Daily Neck Care
• Use an upright stand to type or read
• Use proper lifting mechanics
• Avoid prolonged driving
• Take frequent rest breaks
• Adjust seat and headrests to maximize support
Exercises
• Chin retraction• Active range of
motion• Doorway/corner
stretch• Upper trapezius
stretch• Shoulder shrugs
• Isometrics• Stress management• Levator stretch• Towel stretch