NECK PAIN

Neck Pain

Along with low back pain, neck pain is one of the most common musculoskeletal diagnoses in the United States, with about 70% of the population experiencing at least one episode of neck pain and 15% experiencing chronic pain. Whether it be from poor posture at work, intense physical activity, or the infamous “texting neck,” it can make it difficult to complete daily tasks. Neck pain can generally be grouped into one of three categories: mechanical neck pain, radiculopathy, and whiplash.

TREATMENTS:

Whiplash often presents with moderate to high irritability, meaning it is important to slowly progress patients. Initial treatment will focus on minimizing pain and discomfort while using specific low level exercise to limit muscle atrophy. As pain and irritability improve, patients will gradually be introduced to higher intensity activity.

Radiculopathy can progress from sensory deficits to motor deficits if nerve progression persists for an extended period of time. Initial treatment will focus on centralizing symptoms through manipulation and mobilization of the cervical and thoracic spine. Posture re-education and scapular strengthening will be a primary focus.

Mechanical neck pain is the most common condition and is treated through mobilization and manipulation to restore normal cervical joint mechanics. Specific strengthening will improve control of neck and shoulder to prevent future pain.

Manual therapy

Manual therapy is used to decrease pain and improve the mobility of patients experiencing pain. This approach uses a combination of manipulation/mobilization techniques of joint and soft tissue designed to help patients reduce pain restore their functional movement. Neck pain can be highly irritable making it important to address early with appropriate manual therapy.

Therapeutic exercise programs

Therapeutic exercise programs are developed and tailored to the patient’s specific diagnosis. Posture re-education and restoring normal movements patterns are necessary for early resumption of activity. Specific strengthening exercises are used to improve neck and shoulder control, and to prevent future pain.

EVIDENCE:

Cervical mobilization can be used to assist with restoring proper cervical joint mechanics and centralizing radicular symptoms. (Langevin, JOSPT) Thrust manipulation has been shown to be superior to non-thrust mobilization for improving pain and function. (Dunning, JOSPT)

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Whiplash
Mechanical
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