Neck Pain

Neck pain is very common, with most people having an episode at some point in their lifetime. Most episodes will get better within a few weeks, often without treatment. However, for some pain will continue for longer than 3-months. This is called persistent or chronic pain and lasts well beyond the time that most body tissues have healed following injury. 

Risk factors for developing neck pain include a history of neck or back pain; repetitive or high demand job roles; low social or work support and job security; older age; smoking; obesity; inactive lifestyle; sleep problems; and mental stress. Women are also at greater risk than men. 

Symptoms 

• Pain and/or discomfort in the neck, which can spread to the shoulders and sometimes down one or both arms. 

• Neck stiffness and/or reduced movement. 

• Sometimes pins and needles or numbness can develop in the arms, hands or fingers. 

• Can have associated headache. 

• Muscle spasms or tension in the neck and/or shoulders. 

Causes 

• Most neck pain is muscular; a soft tissue strain and sprain. 

• Age-related bone, joint, disc or soft tissue changes. However, many people who don’t have pain, or who are under 30 have similar changes and the link between the level of these changes and pain severity is poor. Spondylosis is a condition associated with age-related changes of the spine. 

• Neck injury, such as Whiplash during a fall, a rugby tackle or traffic accident. 

• Repeated activities or postures 

• Stress and/or anxiety, low mood. 

• Neck pain with shooting arm pain, and/or sensation loss and weakness can be caused by compression of a nerve in the neck, which reduces the nerve signals sent from the brain to the arm / arms.  

Serious causes of neck pain

• Less commonly neck pain can result from serious causes, such as: 
• Tumours 
• Infections 
• Fractures 
• Inflammatory Disease – e.g. Rheumatoid Arthritis

YOU SHOULD SEE YOUR DOCTOR FOR URGENT REVIEW IF YOU SUSPECT A SERIOUS CAUSE OF YOUR NECK PAIN. 

What can I do about my neck pain? 

No one treatment or medication has been found to be 100% reliable in curing persistent neck pain.  

Exercise 

Keeping the neck joints mobile and lubricated, the muscles flexible and strong and the nerves receiving oxygen and nutrients is important in maintaining good neck and wider health. Doing regular specific neck stretching mobility and strengthening exercises can help with pain but any exercise is good, whatever the type. Find something you enjoy and can fit regularly into your lifestyle, such as walking, swimming or cycling. 

Neck mobility exercises – https://www.csp.org.uk/conditions/neck-pain/video-exercises-neck-pain 

Strength exercises – https://www.csp.org.uk/campaigns-influencing/campaigns/stronger-my-way/i-want-feel-stronger/strengthening-exercises/upper#curltoOHP 

For more information on physiotherapy services who can help you to manage neck pain, visit the MSK Together website for Mid Notts patients, Connect Health website for Notts County patients and Circle MSK website for Rushcliffe patients.

Medication 

Pain relief medications can help relieve symptoms a little in some people, but the effect is variable. They are not ‘pain-killers’. People may experience side-effects or sensitivities which mean they can’t tolerate certain pain medications, or over time they may build a tolerance or dependence to medication. Morphine-based medication is not recommended for the treatment of long-lasting, non-cancer pain. Before recommending a new pain medication or increasing the dose of your existing pain relief, for your safety it is important to consider how these might react with any medications you already take for pain or other medical conditions. Pain relief medication should be used to help you stay active within reasonable levels, to help with sleep and rest and to improve your quality of life. Ineffective pain medications should be reduced and stopped. 

Lifestyle 

Research has found that people with lower mood and higher anxiety and emotional stress often feel higher levels of persistent pain. Likewise, people with persistent pain whose sleep is poor often experience worse pain. This is probably to do with the effects on the body’s immune, hormone and nervous systems. Working to improve your mood and manage stress and anxiety can help to rebalance these systems and change how you experience pain. Recent research has suggested links between a lack of healthy gut bacteria and increased nervous system inflammation, Excess body weight increases levels of inflammation in body tissues and the nervous system, which can contribute to persistent pain. Eating a diet that increases healthy gut bacteria, trying to lose weight if overweight, managing stress, anxiety and low mood, improving sleep and increasing physical activity and exercise can all help improve persistent pain in the long-term. 

Pain management 

Persistent neck pain is common and the impact of this pain on the persons physical and mental health, work, social activities and relationships can all affect how much that person suffers with their pain.

There is good research evidence that a wide-ranging treatment approach that considers the whole person, their beliefs and expectations, lifestyle and wider health, sleep, stress levels, mood, work and relationships help people to manage and improve their pain in the long-term. We can help you with this and run pain management courses link to pain rehab page 

Injection

Occasionally the neck pain may be suitable for an injection. This is if the pain is coming directly from the facet joint. Suitability for this can be assessed for by the Advanced Physiotherapy Practitioner.