Physical Therapy and its Role in Chronic Neck Pain

Physical Therapy and its Role in Chronic Neck Pain

Pain within the neck area can be one of the most frustrating conditions to deal with, especially if the pain has been identified as chronic. This means that the pain persists or recurs over a lengthy period of time. Thankfully, it’s been recently proven that physical therapy for neck pain can be highly beneficial in alleviating the amount of pain you experience. Here’s a closer look at the many benefits of physical therapy and its important role in chronic pain.

About Chronic Neck Pain

The neck area consists of a very complex system of joints, nerves, muscles and bones all working in tandem to ensure that the head is properly supported. Because there are so many components to this area of the body, there are many ways in which chronic pain can develop. For instance, getting into a car crash can lead to whiplash that eventually causes the development of these issues. The reason for this pain isn’t always clear. Simply sleeping in an uncomfortable position could eventually lead to this problem. What is clear is that chronic neck pain is very similar in nature to standard neck pain. The only difference is that it typically doesn’t go away. Even in the rare instances that it does, it will soon return in full force.

This pain can display itself through a stiff neck that doesn’t easily move when you attempt to turn it, with a sharp pain in one central location or with a basic soreness in and around the area. In some instance, chronic neck pain will spread to the arms and shoulders, sometimes even the fingers. This usually occurs when the spinal cord has been irritated. Over time, this pain can lead to other serious problems, including everything from not being able to grip objects as well as you should be able to and balancing issues that can facilitate themselves through dizziness and difficulties with walking straight.

While this type of neck pain sounds much worse than standard neck pain, it has absolutely nothing to do with severity. This type of pain can be anywhere from mild to severe in how acutely you feel it. This issue isn’t usually symptomatic of a larger problem at play either, though there are rare occasions where it could be a sign of cancer. People of any age can suffer from this issue. If pain within your neck has subsisted for longer than two weeks, this is a definite sign that you are suffering from a chronic version of this pain. While it can be very frustrating to go about your normal daily activities when experiencing chronic pain, physical therapy for neck pain has proven to be a highly beneficial remedy for the problem.

Benefits of Physical Therapy

While neck pain that eventually becomes chronic doesn’t have a large amount of treatments or remedies that can lessen the pain, physical therapy for neck pain is surprisingly effective at treating the core of the issue and relieving most, if not all, of the pain. In recent years, studies have been held to ascertain the effectiveness of physical therapy for neck pain. It’s important to note that these studies were done based on the patient receiving physical therapy services within four weeks after the pain started. Some patients that didn’t receive physical therapy until after this four week period were also included within the study to identify if there were any differences in the reduction of pain based on when the treatment was sought.

These parameters produced startling results that displayed that patients receiving treatment within the first four weeks after the pain began doubled their chances of greatly reducing the pain compared to people that waited for longer than four weeks to start treatment. Given that this type of non-surgical treatment is much more affordable than other alternatives for neck pain, it’s clear that physical therapy for neck pain is crucial towards your eventual recovery. A physical therapist offers a wide range of treatments that can be further divided into passive and active options.

The first round of treatments for the pain will usually involve the passive types of treatment. These are designed to get the neck and rest of your body in a more relaxed and comfortable position. Some of these treatments include a deep tissue massage, traction, TENS and hot/cold therapies. The massage focuses on the muscles in the neck to relieve any tension that may be present in the area, while the traction treatment stretches the spine in a manner that’s designed to reduce and remove some of the pain you’re going through. TENS is a type of nerve stimulation that uses electrical currents to lessen muscle spasms.

Lastly, hot and cold therapies increase blood flow to the area, which in turn causes more nutrients to pass through and assist with the healing of everything from inflammation to pain, all of which can work wonders in reducing your chronic pain. There are also times when an ultrasound may be provided to you. This helps to increase blood circulation in the neck. The results of better circulation include a reduction in swelling, cramping and stiffness, among other problems in the neck. Once these passive treatments have been applied, the active portion of the physical therapy will begin. The therapist in charge of your treatment helps you incorporate certain exercises into your routine that boost the strength, flexibility, stability and range of motion in the core area of the neck.

These programs take your health history into account to ensure that you receive the personalized care that you need when dealing with neck pain of a chronic nature. There are times when an overall poor posture could be the central cause of the pain. In these instances, your therapist will help you achieve the correct posture. While some of these exercises can be utilized in a home environment, a therapist is necessary at the beginning of treatment to make sure that you don’t re-injure the neck. You will even be provided with useful tips that you can use in the future to keep neck pain at bay.

Chronic pain in the neck, like most other types of pain in the body, can be very tricky to treat effectively, especially when you’re unsure of the exact cause for the pain in question. Whether you know the cause or have yet to identify it, physical therapy has proven to be essential in the ongoing treatment of this pain. While therapy isn’t always necessary to reduce this pain, it’s exceedingly beneficial if you want to eliminate it in a timely manner.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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