Acute and Chronic neck pain – What’s next?

In December 2014 I suffered a grade two whiplash injury from a skiing accident whilst in Whistler, Canada. My symptoms were initially limited to restrictions in range of motion through the cervical spine and ongoing headaches. After the initial weeks of stretches, mobilisation and range of motion movements I noticed the pain moving through my upper scapular and mid thoracic region. As a result of this I incorporated a range of specific upper body stretches and exercises to my programme to reduce this discomfort. I am still completing these exercises and stretches to this day to assist and notice an increase in symptoms when I don’t.

After never having more than an ankle sprain when growing up this injury provided me with several realisations about chronic neck pain.  The main three being the impact it has on all aspects of your day, including sleeping, sitting and driving, how much of an emotional toll it can take and how being compliant and diligent with the rehabilitation process can fast track recovery. It is also important to understand the underlying mechanic of any injury.

Neck pain is one of the most common musculoskeletal conditions with up to 50% of adults experiencing it in any given year. For most people, an acute episode of neck pain will resolve in approximately 6-8 weeks with correct management, but chronic neck pain can persist in up to 34% of cases. Neck pain prevalence and disability has dramatically increased over the past 25 years and will likely increase further with an aging population.

Mechanical neck pain is the most common type of neck pain. It occurs when movement or sustained postures strain the neck causing pain in the discs, tendons, muscles and joints of the spine. There is a higher reported incident rate in occupations that involve working with arms raised to or above shoulder level or continued repetitive movements. Age, low physical capacity and poor work posture can also increase the risk of occurrence.

Referred neck pain can also occur resulting in headaches, pain in the arm, shoulders and mid back. When nerve compression and inflammation is present symptoms can include arm discomfort, numbness, tingling and weakness.

If neck pain is present, a full examination of the neck, shoulder and upper back should be performed. The exam should look at identifying the features that may alter neck mechanics as well as the causative factors.

Treatment for this condition should be comprehensive and specific to each case. The initial stage of rehabilitation should be aimed at incorporating active exercise involving a range of motion and stretching as well as strengthening of the neck and scapular. Reassurance and education on the treatment plan also provides the best possible outcomes as restriction of activity may lead to secondary complications and delay recovery. There is evidence to suggest that heat, ice and massage can reduce symptoms, but further treatment is necessary to avoid reoccurrence.

If you would like more information on managing your neck pain contact Absolute Balance by mail or view our website

Michael Buswell (B.Sc. – Exercise Physiology)

Accredited Exercise Physiologist (AEP) (ESSAM)


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