Neck Pain and Headaches
Neck pain is the second most common musculoskeletal complaint seen by practitioners. Similarly to low back pain, there is poor correlation between neck pain and findings on MRI x-ray etc. Pain is usually caused by local structures within or around the head or neck, but may be referred from or caused by other sources (such as the upper back, jaw or shoulders).
Headaches are defined as pain in the head, in or around the eyes or ears and behind the back of the head. There are a number of different types and causes of headaches with the most common being a cervicogenic (or tension) headache. Cervicogenic means “originating from the cervical spine” and is basically referred pain from the C0-C3 joints (the first few joints in the neck). Cervicogenic headaches can also cause nausea and sensitivity to light and sound and as such will often be misdiagnosed as “migraine”.
Treatment involves joint mobilisations, soft tissue releases, dry needling, stretches and postural advice all designed to desensitise and offload the upper cervical segments.
Postural Neck Pain
Poor posture is one of the most common causes of neck pain. Sleeping position, poor work station set-up and sitting posture may all be contributing factors. A classic cause is the “poked neck” posture which loads the upper cervical joints and shortens and stiffens the muscles at the back of the neck.
Mobilisations and massage may be effective in the short term, however effective treatments involves addressing the cause of poor posture such as the factors listed above.
Acute Wry Neck
Acute wry neck is a painful, but short-lived presentation in which the neck “locks”. It will often be as a result of sleeping or sitting in an awkward position for an extended period. The physical damage suffered from this is normally very minimal, however the muscle spasm, stiffness and pain can be quite severe.
With appropriate, early physiotherapy intervention, this condition will normally resolve within a week at most.
An acceleration / deceleration injury of the neck typically occurring as a result of a motor vehicle accident whereby the head is forcefully thrown forwards, then backwards. Whiplash can also occur in other incidents where a similar mechanism of injury is present, such as a fall or being tackled in a football game. This can lead to increased neck pain and stiffness.
There are varying degrees of severity of whiplash and your physiotherapist can assist in diagnosing the severity (grade 1 – grade 4). Immobilisation with a neck brace is not indicated unless there has been a fracture of cervical vertebrae.
Treatment for most whiplash conditions will involve joint mobilisations to address stiffness, strengthening of the deep stabilising muscles to restore stability and range of motion exercises to restore normal movement.
For more on neck pain and headaches, or if you are seeking help and want relief from neck pain