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All About Neck Pain

4 Cavendish Square, London

Neck Pain Affects Up to 75.1% Of Us!

Research has shown that neck pain occurs in up to 75.1% of the population in any given year*. This figure was taken from an analysis of vast quantities of published research on neck pain. This isn’t terribly surprising, a lot of patients we see quite often live with neck pain for months or even years before actually getting around to seeking treatment.

We have seen a lot of patients (with spinal imaging) of their neck & spine over the years. After seeing so many people struggling with acute and chronic pain alike, it has become clear there are a few common themes. Hopefully, you can learn from some of our patients’ challenges and in doing so, avoid suffering from chronic neck pain, as well as permanent degenerative change.

Neck pain is often ignored

One of the big problems with neck pain is that it normally first shows up as stiffness and discomfort across the neck and shoulder area. Sometimes this can progress to pain down the arm and tingling or numbness into the fingers. The numbness and tingling are referred to as neurological symptoms. This means they are caused by irritation of the nerves in some way.

A lot of people that we have seen will notice that their neck pain, stiffness or discomfort first started in their early 20’s. This is normally around the time you are either studying hard for exams or really getting into working (desk based) life. The excessive hours at a desk start to add up. Because you are spending longer and longer each day behind the desk or slaving over paperwork, neck stiffness begins to set in.

The neck pain, as with any pain, is an indication that something needs attention. For those few forward thinking people in their mid 20’s action at this point pays dividends in the future.  Having seen and taken care of patients in the clinic in their mid 20’s with neck problems on thing is clear. It is incredibly satisfying to help some of these patients by making the right changes, rehab recommendations, and treatment plans, to help them avoid a more permanent issue in the future.

Remember, muscles become stiff becuase the joints that they move are irritated through trauma, repettitive stress, or they’ve been overworked in a workout.

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If You’re doing this you’re probably missing something!

Problems that cause neck pain often give you stiffness and tightness across the bands of muscle on the back of your neck and shoulder area (trapezius).

The most common error we see in the long term treatment of this stiffness is stretching and massaging the muscle by stretching the head further forwards or off to the side. Although this can sometimes be helpful, it is a short term strategy. If you find that you’re experiencing the need to do this stretch daily or multiple times a week, there is probably something happening that requires further examination.

If you’re doing this, you really need to read on and figure out exactly what is causing this stiffness so you no stop making your neck pain worse.

What are some common causes of neck pain?

Neck pain can be caused by lots of different things, serious causes that would require an emergency trip to Accident & Emergency however, are rare. Having said this, the biggest problem with neck pain is the negative impact it can have on your quality of life. One thing worth noting before you proceed, Almost all of these conditions will start off with some sort of “neck or shoulder stiffness”. 

Arthritis in you’re neck joints

There are lots of different forms of arthritis that can affect different parts of the neck, here are some types of arthritis that can cause neck pain. Arthritis is a degenerative condition that will take often years to become present. So if there are traces of arthritis and specific joints in your spine, it is clear that there have been problems building up for quite some time. This isn’t always reflected in the levels of neck pain.

Spondylosis or Degenerative Disc Disease Causing Neck Pain

This refers to the disc portion of the spinal segment. The intervertebral discs are supposed to be like little cushions between the vertebra. However, research shows that certain neck positions can cause more pressure to build up in this part of the segment of the spine. Over time, the discs begin to lose the fluid that gives them their shock absorbing qualities. These discs are often referred to as dehydrated, and in most cases, there will also be a certain degree of bulging.

Quite often the degree of neck pain here is more achy and deep. The pain itself will often not be that severe but will be consistent. Patients sometimes say the persistent nature of this makes the pain less bearable.

Spondyloarthrosis or Facet Joint Arthritis

If Spondylosis and DDD (degenerative disc disease) affect the front part of the vertebra, this affects the back part. The facet joints are arranged in pairs at every segment of the spine. Patients that have arthritis here are often more likely to also experience a sharp “catching pain”.

The reality, however, is that if there is arthritis in one part of the segment, you are likely to have arthritis in the other part. This arthritis can be on a scale from very mild bony change all the way through to near-fusion of the two segments of the spine. This process needs time to occur, so chances are you will likely be able to avoid it getting really bad if you’re proactive and seek a proper assessment when symptoms first start.

Stenosis as a cause of neck pain

Stenosis is one of those conditions we find patients are diagnosed with but don’t really get an explanation of what it actually means. Stenosis or Spinal Stenosis commonly occurs in the lower back or in the neck. It means a narrowing of a canal or hole. There are two places this can occur.

  • In the spinal canal. This is the “hole” that the spinal cord runs through. If you get spinal stenosis in this part of the spine, stenosis can affect everything below the level of the stenosis. This is why if stenosis occurs in the neck it can cause problems that leave you quite confused.
  • The lateral recess. This is the hole that the smaller spinal nerves come off, stenosis here will normally only affect the areas that the nerves supply, this is why this type of stenosis in the neck will often cause symptoms down certain parts of your arm.

In our opinion, spinal stenosis is really a consequence of another problem, normally this is a disc bulge or arthritic change. There can be other more sinister causes of stenosis, but these will normally be ruled out or in very quickly and you will be referred for appropriate treatment swiftly.

Slipped Discs as a cause of spinal stenosis

When a disc in between two of the vertebrae in your neck slips, bulges or herniates, what is happening is quite simple. The disc is moving from its normal location, to occupy space in either the spinal canal or the lateral recess. If this happens it will reduce the size of the canal or recess and therefore stenosis occurs. For more information on slipped discs, check out the full page here, but the pain in the neck (and often down the arm) caused by this kind of injury can be resolved quite nicely with the right treatment.

Bad posture is one of the great causes of avoidable neck pain

Are you sat at a desk all day? Could Your Posture be better? Do you have rounded shoulders?

Poor posture can be a considerable contributor to neck pain, the sort that affects your neck and shoulder muscles. Because of the mechanics, it can also give you headaches.

This sort of bad posture will result in your head moving forwards significantly. As you probably know by now, this has an effect of accelerating the pressure and wear through the joints in the neck which naturally leads to the muscles around your neck and shoulders becoming stiff and tense.

Postural problems are typical amongst anyone spending a significant proportion of their day at a desk. You will probably recognise a few colleagues at your workplace with the typical rounded shoulders posture. As the head moves forwards you magnify its weight and pressure exerted on the cervical spine and surrounding muscles.

No Wonder Your Neck Muscles Are Tight And Tired!

Bad posture is normally part of the picture in early degenerative changes to the neck. The weight of the head is magnified being held so far forwards it increases the compressive loading through the cervical discs. Added up over time this bad posture causes neck pain and by correcting this early on you can really help reduce & avoid chronic neck pain!

What Is Not A Cause Of Neck Pain?

Probably the biggest neck pain complaint or “misdiagnosis” is a muscle spasm or muscle tension. You might have even been given this as a diagnosis before but this really is one of our “pet-peeves” and it is because muscles do not spasm or become tense for no reason.

Muscles are reactive, and therefore will go into spasm or become tense because of something.

You wouldn’t put a fire out by throwing water on the smoke. Muscle tension or spasm is the smoke. So if your neck pain, stiffness or discomfort does persist and you are finding there is muscle spasm around your neck and shoulders, contact us and see how we can help.

Acute Neck Pain Vs. Chronic Neck Pain

Acute Neck Pain is a short term neck pain, often people will call this a trapped nerve, normally because the pain will be sharp. It can also shoot into the shoulder as well. It commonly is due to catching the smaller “facet joints” on the back of the spine. This sort of neck pain can come on really quickly for example after a trauma like a whiplash, or if you’ve slept in an awkward position.

Most of the time with some gentle stretching and icing this sort of acute pain can resolve quite quickly. If you do find that symptoms are recurrent or not resolving then it would be best to get in touch and see how a thorough examination and treatment could help resolve the issue more permanently.

Chronic Neck Pain

In practice one of the big contributors to neck pain becoming chronic is prolonged neck flexion. Chronic here is categorized as neck pain that lasts longer than 3 months. You probably won’t be surprised to learn that with the explosion in smart phone use, a phenomenon such as “text-neck” are becoming more and more commonplace.

Some people, unfortunately, will have a loss of their normal cervical lordosis which is flexion by definition. This, therefore, means the person’s neck is in a constant position of flexion which is not good for your neck. Research proves time and time again that these facts are important in understanding your neck problems.

Therefore we would recommend that all acute and chronic neck pain gets the appropriate examinations with necessary spinal imaging where clinically relevant to ensure that “no stones are left unturned”. Knowing that chronic neck pain has co-morbidities such as anxiety, depression and even low back pain, it is important that your neck pain is dealt with effectively & competently.

Why does sleeping cause neck pain?

Sleeping is a great opportunity to recover but it can also be a real trouble for some people. Sleeping on your front forces your neck to twist and is not good for anyone at all. Spending 6-8 hours with your head twisted one way or other is definitely not a good move if you suffer from neck pain.

If you have any degeneration, or arthritic change or even get the occasional stiff neck, sleeping on your tummy is a bad idea and should be avoided as much as possible.

If sleeping on your side or back, make sure you avoid flexion of your neck (i.e. looking towards your feet). Having your neck & head “propped up is far from helpful.

 

How to sleep to avoid neck pain

Knowing that sleeping is when your body recovers, whether or not you have neck pain, sleeping on your side or back is preferable, however here are some tips for sleeping in a way that is good for your neck.

Firstly, sleep with your head in a neutral position if, on your side, this means using just enough pillows to support your head so it isn’t tilting to one side.

Second, make sure your chin is in the neutral position and your face looking straight forwards.

Finally, if you are on your back, make sure your neck is supported nicely, a good orthopaedic pillow should do this well, supporting the natural arch in your neck.

What movements should you avoid?

Avoid rapid movement of the head or neck. These rapid movements are likely to cause further pain and inflammation.

If there is more severe damage quick movements can cause the injury to worsen. Whether it is the ligament, muscle or disc tissue, an injury means damage and quickly moving something thats damaged is always unwise.

Quite often people have less control over their neck movements particularly in acute neck pain when the damage is fresh. Often if knocked, the neck will be less able to react instinctively if moved quickly.

 

Some gentle movement can help

Small amounts of controlled and slow movement within a normal range in a quiet room, free from distractions can help with reduction in the inflammatory build up. Quite often no movement at all will actually make things worse in terms of pain levels.

This slow movement prevents the neck from seizing up and the movement helps with keeping the non-injured parts of the neck from becoming stiff and irritable.

If you have had a car accident or severe trauma seek emergency care and avoid this until you have been assessed professionally.

Help for your neck pain

Ultimately a lot of people are understandably concerned about their neck because its a delicate area and carries a lot of important information through your spinal cord! Because neck pain can often be complex, if your pain is persistent and lasting longer than 7 to 10 days, book an appointment with a professional, like the team at our clinic who are trained to effectively and accurately examine for the true cause of your neck pain.

We always ensure you get the most appropriate treatment, and the methods we employ in the clinic are considered to be extremely safe and low risk, whilst also being very effective at reduction of pain, inflammation & swelling. On top of this our treatment approach is designed to reduce pressure on the neck injury whilst speeding up the healing process.

Knowing the delicate nature of your cervical spine, situated deep in the neck, we take specific care right from the consultation process, to learn more about our unique approach watch the short video or visit the new patients page for the step by step process of what to expect.

 

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