The term whiplash is linked to a neck injury from a sudden movement that causes the head to be jolted forwards and backwards or side to side. Road traffic accidents are commonly linked to this injury, it can also be linked to sports that involve sudden changes in speed such as water skiing, football, martial arts and many others.
Symptoms can often commence a number of hours up to 1-2 days after the incident. At the time of accident, it is advised to seek medical advice to complete an assessment. Once cleared of any structural injury that relates to the majority of cases, whiplash can be treated with an individualised combination of medication, reassurance and advice on movements. Physiotherapy can support this through hands on therapy and specific exercises to help return you back to normal function and the sports you enjoy.
Mechanical Neck Pain
Mechanical neck pain is widely understood to be pain around the neck region that does not arise from a specific trauma or pathology. It can come on suddenly, eg waking in the morning having ‘slept funny’ or more slowly over time. The pain can manifest as both dull pain or sharp sudden pains on certain movements. Some people experience this pain on one side of the neck, whereas others describe it as affecting the whole neck and even spreading to the head or shoulder region.
Most people recover well from mechanical neck pain, particularly once they start to regain their normal movements. For some they improve quickly, within a few days, and may just take some simple pain relief or apply heat to the area. Others can require help and this type of complaint tends to respond very well to manual therapy from a clinician such as a physiotherapist (eg massage, manipulation) and specific exercises.
Around 10-15% of headaches can be linked to neck pain that are called cervicogenic headaches. The neck pain normally starts first then headaches begin from the base of the head and across the side of the head can be experienced. Symptoms that people report are neck stiffness and tightness, pain that increases while in the same position for long periods (sitting at desk or driving) and you may notice a reduced range of neck movement.
These symptoms can start at any age and are commonly seen in people who have a desk-based jobs, those who remain in a forward head posture such as hair stylist, drivers or carpenters and are also seen among weight-lifters.
Physiotherapists are able to assess these headaches and determine if there are treatable in clinic or refer you to a GP if there are not physio related. Evidence suggests a combination of hands on (manual therapy) and exercise based therapy can have good results.
Spondylosis is a term that relates to bony changes of the spine that happen over time, very much like arthritis of the knees and hips. As we age our body adapts along the way to the forces we apply. These forces over time can mean the joints can gradually change shape and our discs reduce in hydration therefore reducing in height. Rarely these changes ever cause pain however at times in the neck where these slowly formed changes occur it can lead to joint pain, stiffness and reduced range of movement. Common symptoms are pain localised to the neck, a gradual onset of symptoms, clicking. Additional symptoms are pins and needles and intermittent numbness in the arm or hand.
This condition has been shown to benefit from physiotherapy treatment through an individualised management plan and manual therapy when indicated.
Nerve related neck/arm pain (aka ‘trapped nerve’, ‘slipped disc’)
Nerve related neck and arm pain is commonly seen by physiotherapists and 90% of these symptoms resolve with non-surgical management.
Your neck consists of seven bones (vertebrae) with nerves exiting at each level through small tunnels that run down your arm to your hands via different routes. If the small tunnel where the nerve exits the spine is partially obscured or if the nerve is repeatedly aggravated it can lead to symptoms being experienced in your neck, down your arm and at times in your hand. These symptoms are normally experienced in one arm and have been described as pins and needles, numbness, shooting, burning or the sense of freezing cold water being pour down your arm along with many other descriptions. Highly repetitive movements or during sudden movements can irritate the nerve that can begin a cascade of events resulting in symptoms.
During the early stages these symptoms can be highly concerning and interruptive to people’s daily lives. Physiotherapist are able to assess these symptoms and provide a management plan that can involve providing clear information of serious signs and symptoms to be aware of that require urgent care, advice on managing pain, suggest positions of ease, select appropriate exercises and trial manual therapy in attempt to settle the symptoms. Normally with good management symptoms settle over 2-8 weeks (can be longer) and physiotherapists will develop your care at the speed that matches your recovery to full function. If indicated during the initial assessment or if symptoms are not improving within normal healing time frames Physiotherapist are able to refer on for further investigations and different treatment options.
Text Neck/’Bad Posture’
‘Text neck’ is a relatively new phrase that some have been using to refer to pain in the neck associated with prolonged positions with the head tilted forwards. Many of us use handheld electronic devices in our daily lives and it’s thought that sustained periods with the head looking down at the screen can cause a build up of ‘strain’ associated with pain. The long-held belief by many that ‘bad posture’ causes pain has been refuted by recent research, but rather the evidence suggests that overly sustained positions of any posture are in fact the thing that can result in stiffness and pain. This underlines the old adage that ‘movement is medicine’ when it concerns the body.
Nonetheless, if someone develops pain associated with sustained positions or high stress, many will respond very well to hands-on treatment such as massage, or specific stretches to alleviate muscles.