How to relieve neck pain, by Shane Brennan, chartered physiotherapist at Mid West Physiotherapy, Limerick. Why neck pain happens, and how to fix it. References are numbered in [brackets] and the sources are listed at the end of this article. 

 

Why does my neck hurt?

Neck pain is common, with up to 70% of people experiencing neck pain at some stage in their life [5]. Unfortunately, the evidence also shows that if you have neck pain once, you are likely to have it recur in your lifetime [6]. But what causes neck pain?

The answer, as usual – is that several factors can contribute to neck pain. These include weakness in the muscles in the neck and upper back, disc irritation in the neck, or, very commonly, neck pain can come on after a car accident [7]. One of the most common reasons for neck pain over the past few years has been the amount of time people are spending at laptops, iPads, and smartphones – often staying in awkward postures for long periods [8].

In most people that we see here in clinic with neck pain, it is a combination of factors that lead to the person developing neck pain.

 

How long will I be injured for?

Neck pain varies from person to person. What we generally find is that the quicker a person starts rehab, and the sooner they return to their normal day to day activities, the quicker their recovery.

 

What does a typical recovery trajectory look like?

Generally, neck pain will present with stiffness and pain in 1 or more directions, there may be associated headaches as well. Sometimes neck pain can refer down the arm (see this post about nerve pain) Once we can start to reduce that stiffness, pain will improve. People generally start to feel much better once they start physiotherapy, but there is usually a rapid decrease in pain by during the first 6 weeks [9].

 

What can I do about my neck pain?

The good news is that there are loads of options for improving neck pain. Several studies have shown that manual therapy such as massage can reduce pain and improve function [7]. Other studies have shown that exercise can have a similar, or in some cases a bigger impact [6]. There is also evidence that correcting your desk set up can result in an immediate reduction in neck pain.

My approach to treating neck pain is to try a combination of exercise & massage and joint mobilisations, as well as examining and altering ergonomics if that is needed. In short – we find out what is causing the pain and figure out how to change it.

 

When / how often will I need to see the physio?

Again, this varies from person to person. Usually, we start with weekly sessions to reduce pain & irritability, before pushing the sessions out to fortnightly/every three weeks while we work on progressing muscle strength. Muscle strengthening takes at least 6 weeks – so generally people need 4-6 sessions in that period to see an improvement.

 

What type of rehab exercises will I get?

My approach with neck pain is to find out what is stiff & what movements are restricted, and through a combination of stretching & strengthening, reduce that muscular tightness. In general, I try to keep each exercise program to at most 3 different exercises. The evidence shows that there is no one type of exercise that is better than another for neck pain, so it’s useful to try a few different types of exercise and see what works. [4].

 

How often do I need to do my rehab exercises?

Depending on the type of exercises given, I will usually advise people to do their initial exercises 2-3 times/day. Each exercise session should take less than 10 minutes, so overall that’s less than a 30-minute commitment daily. I try to encourage people to find a way to incorporate the exercises into their daily routine – while waiting for the kettle to boil or while watching television – so that it’s not taking too much time out of our already busy lives!

 

Do I need to change my sleep position?

A big question I get asked when people have neck pain is whether they need to change their pillow or mattress. Usually, the answer is no. A recent systematic review showed that spring or rubber pillows can reduce symptoms in people with neck pain, but that they don’t have an impact on the alignment of the neck [1]. The key thing when choosing a pillow is to find one that feels comfortable to you!

 

Will my neck pain get better?

Yes! All the science tells us that neck pain does improve. The amount of improvement, and how long that improvement lasts can be impacted by several factors.

Increasing overall activity levels, having a positive outlook, reducing time spent in awkward postures, and engaging with a physiotherapy rehab program have all been shown to improve neck pain [7].

 

Can I book an appointment with you?

Yes! If you would like us to assess your neck pain and give you a tailored recovery plan, you can book an appointment with us online, or your can contact our Reception by ringing 061-201444 or emailing info@midwestphysio.ie.

 

Where can I get more information about neck pain?

The Chartered Society of Physiotherapists in the UK has an excellent section on their website about neck pain; click here to read.

 

References

1. Chun-Yiu JP, Man-Ha ST, Chak-Lun AF. The effects of pillow designs on neck pain, waking symptoms, neck disability, sleep quality and spinal alignment in adults: A systematic review and meta-analysis. Clin Biomech (Bristol, Avon). 2021 May;85:105353. doi: 10.1016/j.clinbiomech.2021.105353. Epub 2021 Apr 19. PMID: 33895703.
2. Jun D, Zoe M, Johnston V, O’Leary S. Physical risk factors for developing non-specific neck pain in office workers: a systematic review and meta-analysis. Int Arch Occup Environ Health.
3. 2017 Jul;90(5):373-410. doi: 10.1007/s00420-017-1205-3. Epub 2017 Feb 21. PMID: 28224291.
4. de Zoete RM, Armfield NR, McAuley JH, Chen K, Sterling M. Comparative effectiveness of physical exercise interventions for chronic non-specific neck pain: a systematic review with network meta-analysis of 40 randomised controlled trials. Br J Sports Med. 2020 Nov 2:bjsports-2020-102664. doi: 10.1136/bjsports-2020-102664. Epub ahead of print. PMID: 33139256.
5. Hoy D, March L, Woolf A, Blyth F, Brooks P, Smith E, Vos T, Barendregt J, Blore J, Murray C, Burstein R, Buchbinder R. The global burden of neck pain: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014 Jul;73(7):1309-15. doi: 10.1136/annrheumdis-2013-204431. Epub 2014 Jan 30. PMID: 24482302.
6. Hidalgo B, Hall T, Bossert J, Dugeny A, Cagnie B, Pitance L. The efficacy of manual therapy and exercise for treating non-specific neck pain: A systematic review. J Back Musculoskelet Rehabil. 2017 Nov 6;30(6):1149-1169. doi: 10.3233/BMR-169615. PMID: 28826164; PMCID: PMC5814665.
7. Neck Pain CPG J Orthop Sports Phys Ther. 2017;47(7):A1-A83. doi:10.2519/jospt.2017.0302
8. Keown GA, Tuchin PA. Workplace Factors Associated With Neck Pain Experienced by Computer Users: A Systematic Review. J Manipulative Physiol Ther. 2018 Jul-Aug;41(6):508-529. doi: 10.1016/j.jmpt.2018.01.005. Epub 2018 Jul 17. PMID: 30025880.
9. Hush JM, Lin CC, Michaleff ZA, Verhagen A, Refshauge KM. Prognosis of acute idiopathic neck pain is poor: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2011 May;92(5):824-9. doi: 10.1016/j.apmr.2010.12.025. Epub 2011 Apr 1. PMID: 21458776.