One of the most common, generalized questions that I am posed with is, “Is this [enter area of the body] pain normal?” My answer is consistently, “No, however it is common so let’s figure out how to fix it.” Most of the people who I treat want to know if they have something seriously wrong with them, where the pain is coming from, and if their pain can be resolved.
Neck pain is not normal and should not be looked at as something that you just have to live with. Here are some stats:
Incidence and Prevalence
- 1 year incidence of neck pain ranges from 10.4% to 23.1%
- More common in women than in men
- Higher incidence in computer / office workers
- Most prevalent within the age range of 35 – 49 years old.
These statistics are consistent with the patient population that I see in the clinic. The statistics tell us that it is relatively common. What I would like you all to understand is that it does not have to be “normal” and pain does not have to go on forever, despite how long it has been going on already. If you have been experiencing pain for days, months or even years, that means that something needs to change!
Did you know that there is likely something you are doing on a daily basis that is contributing to your symptoms? There are plenty of minor adjustments to your daily life that can have a strong impact on your current symptoms. These will be discussed in detail in The Neck Pain Epidemic Part II: What to do about your neck pain, stay tuned!
Types of Neck Pain
In general, neck pain can be classified into 4 categories. These categories help clinicians determine the best treatment strategies to address the symptoms. The categories are as follows:
- Neck pain with headaches – this type of neck pain can present with a headache. This headache can present in a few different forms. One presentation is called a tension-type headache. This is the one that comes up from the back of the neck, it is painful on both sides and radiates into the back of the head. Another can stem directly from the spine itself. These present more as one sided and are in the temple, ear and sometimes back of the head.
- Neck pain with range of motion limitations – this type of neck pain is when you “slept wrong”, wake up, and can not turn your head. These are more acute cases and usually resolve fairly quickly with some generalized soreness lasting no more than a few days.
- Neck pain with referred pain – this type of pain comes from the cervical spine and refers down into the shoulder, arm, or upper back. This can be caused by a nerve, joint, or a muscle within your neck.
- Neck pain with coordination impairments – this type of neck pain relates to the majority of the population. These are the people who have chronic neck tension and sometimes upper back pain.
It is important for your neck pain to be addressed as a whole by your doctor or therapist to ensure you are being treated in the most effective manner. All of the above presentations can be treated with physical therapy!
Let’s get something straight. Most who come into my clinic want a diagnosis. They want one or two words to explain their pain. Neck pain, well, pain in general for that matter, should not be named by one or two words. There are always multiple factors that contribute to someone’s symptoms.
Here are a few common misconceptions:
“I have always had bad posture and I know that is why I am in pain.”
This is not the case. First off, no posture is “bad”. However, any position sustained over a long period of time is not recommended. I preach the rule that your NEXT posture is your BEST posture. Constant movement, frequent re-positioning, and awareness of neck and head position in space are the most valuable ways to improve neck pain.
“I have been told that my neck is weak and unstable and it just needs to get stronger”
Strength is a definitely a contributing factor to most neck issues, however, to think that your neck is “weak” is not favorable to a positive outcome. Additionally, neck pain treatment can not be solely about strengthening, there are many other factors involved
“I have a pinched nerve, maybe a slipped disc or something..”
When a nerve is involved, there are very clear cut signs and symptoms. In the majority of cases, this is not the cause. Structural issues such as a these are not common causes of neck pain.
Causes of neck pain
This means that it could be coming from a muscle or a joint. Repeated or sustained postures over time can create overload which exceeds the tissues tolerance. Basically, muscles become overloaded and reach a point in which they can no longer tolerate the position and pain can be experienced
This is a combination of personal, internal factors as well as external factors. The brain is extremely powerful and can greatly impact the level of pain the patient is experiencing. Three major things to discuss are the topics of fear avoidance, thought viruses, and stress.
What is fear avoidance?
It is avoiding certain movements or activities that are associated with the pain because of fear that it will hurt. The fear that certain movements might hurt or make the pain worse can actually contribute to continued pain. The brain is very smart, it doesn’t allow you to do something that will harm it. It has a very sharp memory as well, and it recalls how it felt to do that movement when pain was experienced in the acute stage. Past that acute stage, there are likely no inflammatory processes going on and the pain that is likely being experienced is based upon the brain’s memory of that painful experience. Because of this, it changes the way we move during that activity and does not allow proper movement to occur. This vicious cycle can contribute to continued symptoms if not addressed appropriately.
What are thought viruses?
These are things that patients are told that instill a sense of uneasiness. These can actually perpetuate a person’s symptoms. They can be certain diagnoses or conditions, as well as activity restriction recommendations.
Prime examples are some of the following:
- “You have bone-on-bone arthritis”
- “Don’t ever think about doing [ENTER FAVORITE SPORT OR ACTIVITY HERE] again.”
- “You have a bulging disc and will need surgery”
- “You are probably going to have pain for the rest of your life, you will just have to deal with it.”
- “You just have a weak and unstable neck”
In the majority of cases, these are not factual and if you are told these things, please take them lightly!
How does stress play a role? “I carry all my tension up here…” [40 year old, female, office worker patient points to her neck and shoulders] – remember the statistics from before? Completely secondary to the actual neck pain itself, stress plays a major role in neck pain! I am also not referring to just holding your shoulders high creating tension in your neck. I am referring to stress at work, stress at home, stress during traffic, you get it, STRESS. It mentally taxes the brain and can cause actual pain felt in the neck simply related to the stress itself. Muscle tension and pain can decrease through lowering stress levels without ANY form of treatment (ie. massage, dry needling, or exercise).
If you love what you read and want to learn more, please stay tuned for Neck Pain Part II: What to do about your neck Pain
If you are having neck pain and would be interested in a complimentary phone consult, please visit the booking link at https://ipptw.intakeq.com/booking and book your consult today!