Neck Pain
What Causes Neck Pain?
Neck pain can have many causes, ranging from minor issues like muscle strain to more serious medical conditions. Some common causes include:
1. Muscle Strain & Tension
Poor posture (e.g., hunching over a phone or computer)
Sleeping in an awkward position
Repetitive movements (e.g., prolonged driving or desk work)
Sudden movements (e.g., jerking the neck during exercise)
2. Injury & Trauma
Whiplash from car accidents
Falls or sports injuries
Blows to the head or neck
3. Joint & Bone Issues
Osteoarthritis (wear and tear of cartilage)
Herniated or bulging discs in the spine
Spinal stenosis (narrowing of the spinal canal)
4. Nerve Compression
Pinched nerves due to herniated discs or bone spurs
Cervical radiculopathy (nerve irritation in the neck causing pain, numbness, or weakness)
5. Medical Conditions
Infections (e.g., meningitis, which also causes fever and stiffness)
Fibromyalgia (widespread muscle pain and tenderness)
Rheumatoid arthritis (autoimmune joint inflammation)
6. Stress & Emotional Factors
Stress can cause muscle tension, leading to neck pain
Anxiety may contribute to stiffness or tightness
Why does my neck and arm hurt, I have tingling in my finger!
Cervical Radiculopathies
Cervical radiculopathy is a condition where a nerve in the neck (cervical spine) gets compressed or irritated, often due to a herniated disc, bone spur, or degenerative changes in the spine. This leads to pain, weakness, or numbness that can radiate from the neck into the shoulder, arm, and even the hand.
Symptoms of Cervical Radiculopathy
💥 Pain:
Sharp, burning, or aching pain in the neck, shoulder, arm, or upper back
Pain may worsen with certain movements (e.g., turning the head or looking down)
⚡ Numbness & Tingling:
A "pins and needles" sensation in the shoulder, arm, hand, or fingers
💪 Weakness:
Weakness in the arm, hand, or fingers
Difficulty gripping or lifting objects
🩺 Reduced Reflexes:
Diminished reflexes in the affected arm
🛌 Symptoms May Worsen with Certain Activities:
Sleeping in certain positions
Holding the head in one position for too long (e.g., using a phone or computer)
Physiotherapy Management of Neck Pain
1. Initial Assessment
A physiotherapist will evaluate:
🔹 Pain location and severity
🔹 Range of motion and posture
🔹 Muscle strength and flexibility
🔹 Nerve function (if symptoms radiate to arms/hands)
2. Physiotherapy Treatments
🛠️ Manual Therapy (Hands-on Techniques)
Joint Mobilisation – Gentle movements to restore joint flexibility.
Soft Tissue Massage – Helps relieve muscle tension and improve blood flow.
Myofascial Release – Targets tight connective tissues to improve mobility.
🏋️♂️ Therapeutic Exercises
Stretching Exercises – To relieve stiffness and improve flexibility.
Strengthening Exercises – Focus on neck, shoulders, and upper back muscles for better support.
Postural Exercises – To correct poor posture and prevent strain.
🔥 Pain Relief Modalities
Heat or Ice Therapy – Can improve symptoms of pain
Ultrasound Therapy – Uses sound waves to promote healing.
Electrotherapy (TENS) – Uses electrical stimulation to reduce pain signals.
🧍 Postural & Ergonomic Training
Proper sitting and standing posture.
Adjusting workstations (ergonomic chairs, monitor height).
Avoiding prolonged phone/computer use with a forward head posture.
3. Home Exercises & Self-Management
A physiotherapist will recommend a home exercise program to maintain progress, including:
✅ Neck stretches (chin tucks, side stretches)
✅ Strengthening exercises (resistance band exercises, scapular retractions)
✅ Postural corrections (wall angels, ergonomic adjustments)
4. When to Seek Further Medical Help
If symptoms persist despite physiotherapy or if there’s severe pain, numbness, or weakness, further evaluation (MRI, nerve tests) may be needed.
When might we refer a patient to see an Orthopaedic Surgeon?
When to See an Orthopaedic Surgeon for Neck Pain
While most neck pain can be managed with self-care, physiotherapy, or medications, you should consider seeing an orthopaedic surgeon if:
1. Persistent or Severe Pain
🔴 Pain Lasting More Than 6 Weeks – If pain doesn’t improve with treatment.
🔴 Severe, Unrelenting Pain – Especially if it worsens despite medication and physiotherapy.
🔴 Pain Worsens at Night – Could indicate a serious underlying issue.
2. Nerve-Related Symptoms (Possible Nerve Compression or Damage)
⚡ Pain Radiating Down Arm – Sharp, shooting pain in the shoulder, arm, or hand.
⚡ Numbness or Tingling – Persistent “pins and needles” in arms or fingers.
⚡ Muscle Weakness – Difficulty gripping objects, lifting your arm, or fine motor tasks.
⚡ Loss of Coordination – Trouble with balance, walking, or fine hand movements.
3. Signs of Spinal Cord Compression (Serious Condition)
🚨 Difficulty Walking or Weak Legs – May indicate cervical myelopathy.
🚨 Loss of Bladder or Bowel Control – Could signal severe spinal cord damage (emergency).
🚨 Severe Stiffness with Fever – Possible infection like meningitis or osteomyelitis.
4. Failed Non-Surgical Treatments
🩺 If pain doesn’t improve after:
✔️ 6-12+ weeks of physiotherapy
✔️ Medications (pain relievers, anti-inflammatories, muscle relaxants)
✔️ Steroid injections
5. Structural Issues That May Require Surgery
🔍 Diagnosed with:
Herniated Disc (pressing on nerves or spinal cord)
Spinal Stenosis (narrowing of spinal canal)
Cervical Spondylosis (Arthritis) causing severe degeneration
Fracture or Instability due to trauma or osteoporosis
Surgical Options an Orthopaedic Surgeon May Consider
🦴 Discectomy – Removing a herniated disc pressing on a nerve.
🦴 Cervical Fusion – Stabilising the spine if there’s severe instability.
🦴 Laminectomy – Removing bone to relieve pressure on the spinal cord.
🔹 Bottom Line:
If your neck pain is mild to moderate, try physiotherapy, medications, and home exercises first. But if you experience nerve symptoms, severe pain, or signs of spinal cord compression, see an orthopaedic surgeon as soon as possible.
Benefits of In-Home Physiotherapy for Neck Pain
In-home physiotherapy offers convenient, personalized care for managing neck pain. Here’s why it can be beneficial:
1. Convenience & Comfort
🏡 No Travel Needed – Avoid the stress of driving or sitting in waiting rooms.
🛏️ Familiar Environment – Recover in the comfort of your own home.
🕒 Flexible Scheduling – Sessions can be arranged at times that suit you best.
2. Personalised Treatment
🎯 One-on-One Attention – The physiotherapist tailors exercises and treatment to your needs.
🛠️ Home-Based Modifications – They assess your workspace, furniture, and daily activities to correct posture and ergonomics.
📈 Customized Progression – Exercises are adjusted based on your improvement.
3. Improved Compliance & Faster Recovery
✅ Easier to Stick to Exercises – You’re more likely to follow through when guided at home.
✅ Immediate Pain Relief Techniques – The therapist provides hands-on care (e.g., manual therapy, stretching).
✅ Fewer Interruptions – No distractions from busy clinic settings.
4. Focus on Posture & Ergonomics
💺 Workstation & Sleeping Adjustments – The therapist can recommend the best pillow, chair, and screen height for pain relief.
📱 Device Use Modifications – Helps prevent "tech neck" from prolonged phone or computer use.
5. Safe & Effective Recovery
🩹 Reduced Risk of Re-injury – Supervised exercises ensure correct form and prevent strain.
🔄 Gradual Progression – Therapy is adjusted based on pain levels and mobility improvement.
🛑 Avoids Unnecessary Medications & Surgery – Can be an effective alternative to invasive treatments.
Who Can Benefit from In-Home Physiotherapy?
✔️ People with severe neck pain or limited mobility
✔️ Busy individuals who can’t visit a clinic
✔️ Elderly patients or those with disabilities
✔️ Post-surgical patients needing guided rehabilitation
Would you like recommendations on at-home neck exercises? 😊
