Treatments of Neck Pain
As with any medical issue, choosing the best treatment for neck pain should be based on what has been found to be the cause. Sometimes the cause of the pain lies somewhere away from the neck itself. For example, stiffness in the shoulder blade muscles can cause increased pull on the muscles that connect from the neck to the shoulder blade. Because of this close relationship, problems with shoulder blade movement can cause neck pain. Therefore, suggesting that treatments like stretching, heat, traction or any other treatment is the “best” treatment would be inaccurate without knowing the exact cause. However, we will discuss some treatment options for some of the more common causes of neck pain.
Joint/Disc Degeneration
When the small joints (facet joints) located on either side of the spine on the back are degenerated or irritated, the goal should be to open those joints, or provide separation of the joints. This can be accomplished by manual stretching, from a physical therapist or chiropractor, some selected range of motion exercises or cervical traction. Mobilizing joints can be very effective in the treatment of neck pain. In fact, mobilization to adjacent spinal segments like those in the thoracic spine has been shown to help neck pain. If the thoracic spine joints do not move properly more demand is placed on the cervical spine which can result in pain.
Nerve Irritation
This is usually caused by narrowing of the space where nerves exit the sides of the vertebrae. Similar treatments that open the joints or provide decompression are often effective for nerve compression and irritation. In addition, methods for reducing nerve irritation can also be effective. This can include electrical stimulation or even selective injections performed by a skilled physician. Avoiding poor neck and shoulder posture as well as limiting heavy lifting with the arms and shoulder may be helpful temporarily.
Neck Sprains
Neck sprains are often described as “whiplash.” Generally, in less serious cases immobilization is not needed. However, in more severe cases temporary and intermittent immobilization may be helpful as the ligaments heal. Treatment can consist of all the treatments mentioned above as well as promoting good alignment during normal activities. Avoidance of overhead activities and lifting may be beneficial temporarily since muscles that attach to the shoulder blades that are used in reaching or lifting overhead also have attachments on the neck. Remember sprains occur to ligaments, while strains occur to muscles and tendons.
Neck Strains
Neck strains can be a little more complicated to treat because there are so many different muscles that attach to the neck. As described in a previous article on neck pain, muscles of the neck not only vary in size, attachment and the jobs they perform, but also how they get injured. Chronic positioning of the head, upper back and shoulders can be an important consideration in treating and avoiding neck muscle strain. Since muscles heal best by keeping tension off of them, knowing which muscles are affected is the key to the treatment. Very commonly injured are the bigger muscles of the neck and shoulder called the upper trapezius and the levator scapulae. Putting increased stress on these by stretching them may not be the answer. On the other hand, what may be needed is to maintain support of the arms and shoulders to take weight and tension off those muscles. A health care provider experienced in determining what muscles need to be addressed and in what way should guide your treatment of these injuries.
As with many physical injuries, it is often easier and less limiting to prevent the injuries than it is to treat them. Making sure your sitting and work postures are good can go a long way to keeping your neck healthy. Additionally, keeping your upper body and core strong will help lessen the strain on your neck when pulling, pushing or using the arms and muscles that attach to the neck.
