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Nowadays there is significant increase in the amount of patients with neck pain. Clinical experience and scientific data shows that this recent increase is due to excessive usage of hand held devices, computers, excessive sitting and increased amounts of stress.
Many patients complain of the pain in the shoulder area where in fact what they are experiencing is lower neck pain. Muscles and joints of the lower neck are also known to refer pain into mid back or between the shoulder blades. Myofascial involvement occasionally may refer pain into the arm, elbow or even as far as the hand. The herniated disc in the cervical spine which compresses the nerve root will produce pain, numbness and tingling down the arm and into the hand. Although disc bulges, protrusions and herniations in the cervical spine are not uncommon, majority of people suffer from myofascial pain when it comes to the neck pain. The most consisted characteristic of the myofascial pain in the neck is that of the pain changing location.
Bringing together the reported data from different studies, we can claim that pain in the neck has increased by 10.4% and 21.3% in the past five years. Prevalence in general population is higher in women compered to man, however a high peak of this type of pain is observed in sitting-workers of both genders.
The cervical spine consists of seven vertebras interconnected by the discs, spinal joins and the ligaments. The top of the cervical spine is connected to the cranium (head) through intricate anatomically designed cranio-cervical junction. The muscle of the neck connect many anatomical areas together. In order to fulfill many different neuromuscular functions for mobility, stability and connection of the central nervous system to the neck the muscular and fascial system are anatomically very complex in this area of the body. The neck muscles serve as connectors for integration of very precise mobility necessary not only for movement but for integration of: vision, hearing, balance and breathing.
Reasons for neck pain may vary from many disorders of different tissues within shoulder girdle and cervical spine. Here are some of the causes:
The protruded, bulged or herniated disc in the cervical spine are not uncommon however most of them go away with proper conservative care in a relatively short time. Surgery is rarely necessary. However when its warranted the healing is much faster and reoperations are very rare.
Neck arthritis is not uncommon. It causes limitation in the movement of the neck and pain. However in the hands of experienced physical therapist or a chiropractor the pain can be eliminated and enough of the lost movement can be restored in order for the symptoms to subside.
The cervico-cranial syndrome is characterized by the neck pain at the junction with the skull, headaches, occasional dizziness and blurry vision. Sometimes patient may have concomitant pain in the jaw. Depending on the symptom presentation this syndrome may be called as orofacial pain or TMJ (temporo-mandibular joint) pain syndrome. Irregardless of the name the etiology of this syndrome is within the musculoskeletal system and not the problem in the mouth or the nervous system.
Pain in the cervical spine may be a symptom of more serious problems like degenerative disc disease, herniated disc, or a pinched nerve. Cervical facet joints are rare source of pain. Most of the pain experienced in the cervical spine outside disc disease is of myofascial character. In the absence of perpetuating factors myofascial pain responds well to variety of different manual therapies in combination with rehabilitative exercises , acupuncture and extracorporeal shockwave therapy.
Preventive treatment for reducing the risks of this type of pain should include ergonomic work space arrangement, gentle stretching, postural exercises, Pilates specific neck and breathing exercises.
Neck pain treatment should address all functionally interrelated body segments such as: whole upper extremity, shoulder girdle, rib cage, cervical spine, and even skull and TMJ. Movement dysfunction in any above described areas could affect biomechanics of the cervical spine through kinetic interlinking of muscular chains. Sitting postures, lifting, prehension, breathing as well as ergonomic conditions must be examined and addressed. The use of hand held devises must be minimized for the time of symptom duration because hand held devices perpetuate abnormal movement stereotypes affecting the upper quarter. Patient is recommended to take short breaks with performance of brief remedial postural exercises for reduction of strain to the neck imposed by desk and computer work.
At Dr. Kalika’s clinic neck pain treatment is conducted by a combination of DNS (dynamic neuromuscular stabilization) therapy, clinical Pilates, variety of manual myofascial and neuromuscular methods, acupuncture, extracorporeal shockwave therapy which concurrently address all interrelated tissues as well as motor control of the upper quarter of the human body. Home exercise program based on movement impairment examination is also very effective component of successful and long lasting relief.
