Neck pain is a common complaint in physical therapy, being the number three cause of chronic pain in the United States. The unfortunate byproduct is that most people believe that neck pain is a normal condition, with 41% believing it’s a part of the aging process and a whopping 60% not bothering to talk to a medical practitioner about their chronic pain.
The truth is physical therapy can make a huge impact in improvement in a patient’s neck pain. A new study (Study: Early Physical Therapist Management for Neck Pain Makes Sense) found that if a patient receives physical therapy within 4 weeks of first experiencing neck pain, it is the most beneficial not only for the patient, but for getting the most improvement per insurance money spent on treatment. The study found that physical therapy can actually significantly decrease a patient’s need for disability compared to patients who delayed their treatment for four weeks or longer. These findings echoed the results of research studying early intervention for low back pain (Early Guideline Based Physical Therapy Results in Healthcare Savings) which also found that early treatment provides the most value, both for patients and insurance companies.
The question then becomes how do we educate patients to seek early treatment when they experience pain? It becomes important for medical practitioners to educate patients on their options for chronic pain and stress that early intervention is their best chance for returning to pain-free function.
Common Causes of Neck Pain
- Accidents or falls can cause severe neck injuries, such as vertebral fractures
- Blood vessel injury
- Cervical arthritis
- Cervical spondylosis
The Common Causes of Neck Pain
Any discomfort felt in the structures of the neck is classified as neck pain. These structures include the muscles, nerves, bones (vertebrae), and the disks between the bones of the neck area.
Additional Symptoms in Addition to Neck Pain
Neck pain doesn’t only include pain itself. When patient’s experience neck pain they may experience additional symptoms, such as:
- Limited range of motion (could be moving to one side or both)
- Numbness due to nerve compression
- Weakness in arm or hand
While medical conditions such as arthritis or fibromyalgia can create neck pain, several common daily activities can cause neck pain including: bending over a desk for hours, poor posture during tv or reading time, too high or too low computer monitor placement, improper sleeping position or jarring movement during exercise.
Physical therapy can help many of the problems and symptoms associated with neck pain.
- Therapeutic exercise: Therapeutic exercises like stretching and strengthening the appropriate neck and shoulder muscles can help bring the head and neck into neutral alignment. Maintaining a neutral alignment is important in lowering neck pain and releasing any impinged nerves.
- Ultrasound Therapy: Ultrasound therapy machines have been found to not only decrease neck pain but increase muscular function. Ultrasound sound waves convert into heat which penetrates deep within the deep tissues. This conversion also opens the blood vessels and allows more oxygen to be delivered to the tissues which enhances circulation to the muscles.
- Electrical Stimulation: Electrical stimulation provides pain relief by helping tight or spasming neck muscles relax. Electrical stimulation provides stimulation to the body allowing it to react differently from the typical response to pain, for example by making the muscle contract it breaks up the spasm cycle.
- Ultrasound/TENS combo: Sometimes neck pain can be a result of trigger points. A study in The Journal of Exercise Science and Physiotherapy found that Ultrasound/TENS combination units immediately reduced pain and increased range of motion when applied to trigger points found in the neck and shoulders. TENS units work by applying two pads placed on an area of discomfort. The small unit emits an electric signal activating the natural opioid pain-relieving system in the body.
- Low Level Laser Therapy (LLLT): Headaches can be another symptom of neck pain. Poor posture of the neck, head and shoulders is one of the main causes of headaches associated with neck pain. A study published in the International Journal of Sports Physical Therapy showed that LLLT machines effectively reduces headache pain immediately after treatment.
- Traction: Spinal traction is a form of decompression therapy which helps relieve pressure on the spine. Traction can either be performed manually or mechanically on a traction table. In rehabilitation, spinal traction is used to treat herniated discs, degenerative disc disease, and pinched nerves. Spinal traction stretches the spine to take pressure off compressed discs which can alleviate neck pain.
- Ice & Cold Compression Therapy: Icing the neck soon after the injury will help to reduce pain and swelling. Cold compression therapy is a powerful modality that combines ice and compression which can help improve circulation, reduce inflammation, while decreasing both muscle spasms and pain. Most likely treatment will alternate between cold and heat therapy for maximum benefit.
- Moist heat: When using heat in physical therapy, more blood will flow to the neck, and the increased blood flow brings more oxygen and nutrients to that area. This is important because blood is needed to remove waste byproducts created by muscle spasms. This will help decrease any neck pain and will facilitate healing.
- Deep Tissue Massage: Deep tissue massage targets muscle tension that can develop as a result of poor posture, injury or chronic conditions. Direct pressure is applied to the neck and shoulders, using friction to try to release the tension in the soft tissues (ligaments, tendons, muscles).
- Transcutaneous electrical nerve stimulation (TENS): TENS units work by applying two pads placed near the neck and shoulders. In treatment, the device emits an electric signal activating the natural opioid pain-relieving system in the body, making it an immediate pain reliever.
As we’ve shown, there are many modalities and options to treat neck pain in physical therapy, whether it is caused by an injury or a chronic condition. The truth is statistically people aren’t as likely to seek treatment when they experience neck pain, but as research has shown, the sooner they receive treatment, the better their chances of alleviating their pain and returning to their daily activities.
Where chronic conditions and certain injuries are concerned, it may not be possible to completely eradicate neck pain. However, the importance of this research is it shows that early intervention can make a significant impact in decreasing pain and increasing function. Further, early intervention is necessary to avoid any surgical intervention that would require more resources and downtime. Not only is this significant for the patient, but this is significant for insurance companies and employers as they incur some of the cost of treatment. In order to alleviate the cost of potentially avoidable surgery and downtime, making sure patients understand their options and the importance of early treatment is imperative.
Which leads to probably the most important aspect of this type of research, is it continues to shine a light on the importance of patient education. It’s time that insurance companies, employers and practitioners come on board to educate potential patients together so patients understand the rehabilitative services available to them that can successfully treat the symptoms they experience from their injury or conditions that result in neck pain. This education is the pivotal tool in decreasing not only the statistic of those who don’t seek treatment, but also decreasing those who are disabled by their neck pain.