Neck pain can be so mild that it is merely annoying and distracting. Or it can be so severe that it is unbearable and incapacitating. Most instances of neck pain are minor and commonly caused by something you did. That is, if you keep your head in an awkward position for too long the joints in your neck can "lock" and the neck muscles can become painfully fatigued. Poor postures while working, watching TV, using a computer, reading a book, or talking on the phone with the receiver held against your shoulder and under your chin can be responsible for neck pain.
Neck pain that persists for many days or keeps coming back may be a sign that something is wrong. Disease, an injury (such as whiplash in an auto accident), a congenital malformation, or age-related changes may be responsible for more significant pain. A trained medical professional must determine the underlying causes of such neck pain. Examination and diagnosis by a medical doctor and treatment by a physical therapist may quickly relieve your pain or help you deal with it on a long-term basis.
Almost everyone experiences some sort of neck pain or stiffness at one time or another during their life. The neck requires good alignment, proper movement, strength and stability to work correctly. Because you walk upright and your head is "balanced" on top of your spine like a golf ball on a tee. The head weighs between 10-12 pounds. If the muscles that support your head and neck are not kept flexible and strong, poor and prolonged postures can put too much stress on the head and neck muscles and joints, which may cause a change in alignment, weakness and instability to start to occur. This irritates the structures of the neck and can even impinge on the nerves exiting the neck, or the central canal protecting the spinal cord.
As we age, our joints wear out (this is called osteoarthritis) and the discs in the spine dry up and flatten (this loosely describes Degenerative Disc Disease). You may experience pain that radiates into the top of the shoulders or in between your shoulder blades. Occasionally, a pinched nerve (called radiculopathy) occurs and you may feel tingling, pain, and/or numbness radiating into the arm, forearm, hand, and fingers. As always, with persistent pain you should be evaluated by a medical doctor and seek treatment from a trained physical therapist.
Our physical therapists perform a thorough evaluation of your neck to determine your range of motion, strength, posture and alignment. Sometimes, where the pain is occurring, is not the source of the problem. Often a limitation in movement above or below the painful area is causing excessive pressure or poor function of the painful area. With gentle hands on therapy, special exercises and modalities such as ultrasound or electrical stimulation, we can relieve your pain, restore motion and get you back to activities quickly without neck pain.
If you are experiencing radiating pain to the shoulder, arm and even hands, the source of your trouble could be your neck or “cervical spine”. The nerves that supply sensation and movement travel from your neck down your arms. These nerves exit from your spine on both sides supplying the left and right sides respectively. Often with poor posture, poor alignment, muscle weakness or injury, the structure of the spine can change. This can lead to a narrowing of the holes where the different nerves exit from your spinal cord, out of the neck to the shoulders and upper extremities. These holes (foramen) depend on the proper alignment and movement of each level of joints in your neck.
Symptoms often start off as a mild, occasional tingling to certain areas of the shoulder, arm or hand. It can then worsen to pain and even numbness. This does require medical attention, so call us for an evaluation immediately and we will coordinate with your physician. Most symptoms can be reduced quickly. However, the time it takes to reduce symptoms depends on how long and to the extent the symptoms have been occurring.
By improving neck joint mobility, posture, alignment and muscle strength, support and stability can be returned to your neck. This reduces pressure on the affected nerve and allows it to heal, resolving symptoms.
Forward head syndrome is extremely common in today's society and describes a condition where, due to changes in posture, the head juts forward actually shortening the neck. This can be mild or severe and is affected by different factors such as type of work, age, arthritis and genetic factors.
Due to prolonged sitting, poor posture with work, working at a computer, sitting at home in poor posture watching TV and a host of other common poor postures, changes in your spine can occur over time. Think about how much time you spend looking into a screen and hunched over a desk. The 10–12lbs of your head are pulling forward on your spine.
Over time, the normal curve in your neck reduces, the length of the spine decreases and muscles in the neck become weaker. This can lead to a variety of symptoms from neck pain, to headaches and even impinged nerves radiating pain into the upper extremities.
Physical therapy works in a variety of ways to improve your posture and actually change your neck posture over time. With hands on therapy, stretching, special exercises and postural re–training, our physical therapists work with you to improve your posture, alignment and neck strength. In addition, we train you on proper postural positioning and techniques to adapt your work and home areas to reduce the strain on your neck.
As we age, we use our neck joints and muscles thousands of times a day. This wear and tear over time can lead to bony changes in the joints and bones (vertebrae) of the neck. These bony changes, along with poor posture, cause spurs of bone that can rub and irritate the surrounding tissue.
When the spurs protrude in the holes on the side of the neck where the nerves exit out (foramen), or the central spinal cord canal, this is called spinal stenosis. Spinal stenosis can be central stenosis or foramenal stenosis. It can cause a variety of symptoms, from chronic pain, to numbness and tingling into the arms. In severe cases of central canal stenosis, which affects the spinal cord, poor balance, pain in the legs and difficulty with walking can occur.
People with osteoarthritis in the neck can experience chronic pain, stiffness and limited range of motion with turning their head and looking up. Pain may be worse in the morning or after prolonged sitting.
Our physical therapists work with you and your physician to restore natural movement, eliminate pain and get you back to enjoying your normal activities.This may involve: gentle hands on therapy to restore joint range of motion, massage to improve muscle mobility, strengthening, range of motion exercises and postural re–training.
As a normal part of the aging process, the fluid filled discs between our neck bones (vertebrae) dry out and shrink. However, in some individuals, this can be excessive, leading to a severe loss of height in one or more sections of the neck. This loss of height can increase rubbing of bone on bone, produce bone spurring, increase pressure on joints and nerves exiting the neck. Symptoms can range from chronic aching pain in the neck, to radiating pain in the arms, numbness / tingling and headaches.
Physical therapy is a very important part in the maintenance of degenerative disc disease (DDD) and degenerative joint disease (DJD). While the disease process itself can't be changed, maintaining good posture, joint mobility, alignment, strength and range of motion, can reduce or eliminate symptoms and maintain a healthier spine.
A disc is a jelly like, fluid filled sac that acts as a cushion between the bones of your neck (vertebrae). Your discs change as you age, drying out and becoming more brittle. In addition, as the discs dry out with age, the change in height between the vertebrae decreases, causing changes in posture and function. In younger adults, the center of the disc (nucleus) is held in place by many rings of the disc (picture a cross section of a tree trunk). With minor or major injuries, poor posture and strain, these rings can rupture allowing a pressing outward of the disc nucleus. Finally, as the nucleus reaches the outer edges, the disc can begin to bulge, which in turn can rub and irritate nerve roots exiting your spine. Changes in posture, strength and range of motion can all affect the positioning of the disc and how much bulging or herniation is occurring.
In more severe cases, the disc can become herniated, which further presses into the spaces where nerves are exiting. Symptoms can range from localized pain, to numbness / tingling to a specific part of the shoulder, arm or hands. In more severe cases complete lack of sensation, muscle weakness and paralysis of an area of the upper extremity can occur.
The good news is that the majority of bulging and herniated discs can be treated conservatively with physical therapy. A thorough plan is then created to relieve pressure on the disc by improving joint function, muscle strength and posture. Modalities, such as ultrasound or electrical stimulation may be used to reduce pain, muscle spasm or inflammation. In addition, we then train you on the correct exercises to maintain good posture and reduce the risk of future episodes.
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