Treatment of Neck Pain

What is Neck Pain?

Neck pain is medically referred to as Cervical spine dysfunction. Neck Pain is a common aliment especially prevalent in downtown Toronto’s, Financial district. Here countless hours are spent sitting in front of a computer screen or looking down at smart phones. As a result of this lifestyle our neck takes increased loads for prolonged periods and neck pain is common.

Seeking treatment with a trusted Physiotherapist, Chiropractor, Massage therapist, or with a Sports Medicine Doctor and/or having an Ergonomic assessment is a smart way to treat the pain or prevent it before it happens.

What are the Causes of Neck pain?

Muscle Strain or Soft Tissue Sprain

In this case the muscles, ligaments of joint capsules have been overloaded and as a result have been injured and damaged. This is best treated with gentle stretches and movements that are specific to your injury presentation. It may also be important to learn what postures/positions caused the strain/sprain so that you prevent this condition from recurring in the future.

“Wry Neck” is an Acutely Stiff or Stuck Joint

This often occurs when you wake up with a painful neck and are unable to turn your head in a certain direction. It is most likely caused by a small piece of tissue that naturally surrounds the joint getting stuck in the joint space. It is best treated with manual and manipulative therapy from a Physiotherapist or Chiropractor as well as in conjunction with Massage therapy.

Degenerative Disc Disease of the Cervical Spine

This term is used to describe arthritis or a disc lesion in the neck. This is the wear and tear that develops over time and is a natural part of aging. Think of it like wrinkles on the inside of our bodies. Sometimes this type of pain can be more stubborn but will resolve with treatment and consistent rehabilitation exercises with a particular focus on good posture.

Neck and Shoulder Pain Caused by a Cervical Radiculopathy

This occurs when there is compression on a nerve exiting at your neck which may refer pain down into the arm and hand. The pain down the arm can be described as shooting, burning, tingling and or numb. You can also experience pain and/or stiffness at the neck. Once the pressure on the nerve root is released the symptoms will be reduced. In most cases Physiotherapy and or Chiropractor in conjunct with Massage therapy will resolve the pain. If your therapist recognizes the pain is severe or not decreasing in a normal timeline they will refer to a Sports Medicine Doctor. Here they may provide you with safe and effective medication management and diagnostic imaging. In more rare cases, surgical management may be needed. Be patient with your treatment and do not rush to surgical intervention if it is not necessary. Remember the timeline for this recovery spans from a few weeks to months.

Cervicogenic Headaches

This type of headache is common in office workers. It is caused by the tightness in the upper area of your neck joints and/or muscles of the head and neck. When tight, these joints and muscles refer pain around the head and can feel like headaches. This condition can be treated effectively with Physiotherapy and Chiropractic. It is important that you change your posture, reduce stress and seek proper treatment

How can Physiotherapy, Chiropractic, Massage Therapy and a Sports Medicine Doctor Help your Neck Pain?

A team of healthcare professionals can personalize your treatments to address your specific injury and help you return to your personal lifestyle goals. Each member of the team has its role. Treatments can include controlling pain with therapeutic modalities, acupuncture or Gunn IMS. Improving range of motion with hands on manual therapy or manipulation and soft tissue release. Maintaining motion by working on regular range of motion exercises for the neck. Increasing strength with a stabilization and strengthening program. Education in regards to lifestyle modifications, posture re-education and ergonomic set up are also important. If your neck pain has not resolved in 1-2 weeks from it’s initial onset it is best to be assessed by a health care professional.

How Long Does it Take to Recover from Neck Pain?

Depending on the cause, severity, duration of the pain and your ability to get the proper treatment, recovery can take a few weeks up to months. It is important to understand what is happening and to seek guidance and treatment from a qualified health practitioner as soon as possible. Remember to be patient and consistent with your exercise program. Your trusted health provider will inform you if your symptoms are not progressing as expected and if you should seek out further investigations or surgical management.

Remember that your trusted physiotherapist and/or chiropractor sees these types of conditions regularly and will be the best person to advise you on the best route of management.

What are the Best Exercises to Help with Neck Pain?

A well-rounded program should consist of core, neck and shoulder stabilization strengthening. It should also include daily range of motion and a stretching regime. These exercises should be individualized to your particular needs and goals.

How to Treat Neck Pain at Home?

  • If you have acute pain in your neck, you may first want to try ice especially immediately after an injury event. If the pain has more of a gradual onset or has been lingering for some time then heat might be the better choice. You may also choose to apply both intermittently depending on how they make your symptoms feels.
  • You should also try to improve the positions and postures that can be aggravating your symptoms. Pay close attention to the positions that make you feel worse such as sitting at your computer, sleeping on your stomach, texting on your phone or using your tablet. Try to adjust these problem causing postures.
  • Try gentle range of motion (ROM) exercises. Turn your head to the left and right. Bring your ear down to your shoulder. Bring your chin to your chest and look up towards the ceiling. Keep these movements within your pain free limits. A qualified physiotherapist will be able to guide you on more individualized and specific exercises that will benefit you.
  • If the pain continues and does not respond to the aforementioned strategies, then over the counter pain or anti-inflammatory medication might be indicated, talk to your pharmacist to help direct you.

If your neck continues to have pain or feel stiff an assessment and treatment for Physiotherapy, Chiropractic and/or Massage Therapy is highly encouraged. Contact us today!

Treatment of Cervicogenic Headaches

What are Cervicogenic Headaches?

Cervicogenic HeadachesCervicogenic headaches are headaches that stem from the neck. The pain is perceived in the head but the dysfunction is originating in the neck. Typically, these headaches originate in the upper three vertebrae of the neck (vertebrae are the bones of the spine). Certain movements or sustained postures can cause strain or compression to the joints, muscles, ligaments, discs and/or nerves of the neck. This in turn, can refer pain to the head in the form of a headache.

The reason that upper neck dysfunction refers to the head and face causing headache is because there is a merger of the upper neck spinal nerves (C1, C2, C3) with the trigeminal nerve (which controls the sensation of head, forehead, jaw line, back of eyes and ears). This cross-communication between these nerves is what leads to cervicogenic headache.

What Causes Cervicogenic Headaches?

Cervicogenic headache is caused by any activity or event that puts excessive stress/load on the upper neck. This can occur with one specific event (such as whiplash or blunt trauma) or may build up gradually with sustained poor postures (at the computer or while doing housework for example) .

What are the Signs and Symptoms of Cervicogenic Headache?

The headache itself can feel like a constant dull ache, typically on one side of the head and face but if there is significant injury affecting both sides of the neck, then the headache can occur on both sides. Also, the headache can be accompanied by neck pain or neck stiffness. It usually comes on during the provocative activity or after the activity and even sometimes the next morning following the provocative event.

What Are Some Exercises That Can Help Cervicogenic Headache?

Since posture of the entire spine and specifically the upper neck is a leading contributing factor for developing cervicogenic headache, the goals of exercise will be to improve posture. Keep in mind that an individualized approach to exercise will be more effective in treating cervicogenic headache when compared to a general program. A qualified physiotherapist will be able to assess you and will develop the best exercises for your specific posture and your lifestyle goals.

Here is a list of generalized exercises that may be helpful for this condition. Exercises should not exacerbate symptoms and should be conducted in pain free ranges of motion.

Posture Based Exercises

  • Gentle Chin Tucks while elongating the back of the neck
  • Shoulder Blade Pinching while lengthening and lifting through the spine

Neck Stabilization Exercises

  • Deep Neck Flexor Activation while keeping the spine in neutral
  • Gradually stacking the neck bone by bone into upright alignment (from a flexed position)

Muscle Release/Stretching

  • Myofascial release with two balls at juncture between the head and top of the neck
  • Upper Trapezius stretching
  • Flexion of the neck to stretch all the long muscles on the back of the neck
  • Sternocleidomastoid stretching
  • Scalenes stretching
  • Levator scapulae stretching
  • Pectoralis stretching

Upper Back Stabilization Exercises

  • Lifting spine to neutral from a flexed position over an exercise ball

Functional Exercises

  • Whole body exercises that improve core and postural musculature (such as squats, shoulder press, push up, pull up, deadlift etc)

Physiotherapy for Cervicogenic Headache

It is advisable to visit a trusted physiotherapist at the onset of your symptoms. Your physiotherapist will conduct a thorough assessment and develop an individualized treatment plan. A multi-modal approach to care is the most effective. Your treatment plan may consist of the following strategies and techniques:

How to Treat Neck Pain at Home?

  • Hands on Manual Therapies: to mobilize the joints of the neck, upper back, shoulders or other areas of the body that may be contributing to your symptoms
  • Acupuncture: to stimulate the nervous system, release tight bands of muscle and stimulate a physiological response that will activate the bodies’ natural healing process.
  • Gunn IMS: to release tight bands of muscle and re-set the nerve impulse to the associated muscles
  • Prescriptive Exercise: individualized exercises that will address muscle imbalances and postural dysfunctions.
  • Soft Tissue Release: stretching and manipulation of soft tissues and muscles that may be contributing to your symptoms
  • Posture Re-Education and Activity Modifications: to prevent further aggravation and make you more mindful about your posture.

Can Cervicogenic Headache Be Cured?

Yes, of course! The most efficient route would be to see a physiotherapist who can help develop a personalized program that will target your specific issues. Most simple cases will resolve within 1-2 weeks but more complex cases will take weeks to months for full resolution of symptoms. This will all depend on the cause, severity, duration of the pain, your ability to get the proper treatment and your ability to modify any aggravating activities/demands. The key is to stay consistent with your prescriptive exercises and make any necessary lifestyle changes to prevent this condition from recurring (such as adjusting your work station and limiting phone/tablet browsing for instance).

Best Position to Sleep in if you suffer from Cervicogenic Headache?

If you suffer from cervicogenic headaches, it’s important that you try to maintain a neutral neck posture when you are sleeping. This means that the posture that you achieve with your head and neck when you are sitting up straight is the same posture that you want your neck to be in as you lie on your pillow.

If you are a side sleeper, then you must ensure that your pillow is supportive enough to maintain your head and neck alignment. Your pillow must fill and support the space that is created between the top of your shoulder, neck and head. Otherwise, your head will end up in a side-bent position.

If you are a back sleeper, then you must ensure that your pillow does not prop your head up too high and force you into a flexed position. If you prefer to sleep on your back, you may want to ensure that your pillow can compress down to allow your head to rest in a position that is aligned with the rest of your spine. If you have forward head posture and your bones have adapted to this posture, then you may need some additional pillow support to account for the fact that your head rests a bit forward.

We recommend that you always try a pillow in store before you purchase it. Remember, the fancier and more expensive pillows (with all the bells and whistles) are not always the best. What works for you, will not work for the next person.

If you are suffering from cervicogenic headaches and would like to see one of our experienced physiotherapists, contact us today!