by Alan Jordan
A lot of patients visit our practice with neck pain and these neck problems can be divided into different categories depending on how severe the condition is and how long it is likely to last.
First, it is important to identify the factors surrounding the onset of symptoms and how the situation has progressed or regressed. The objective examination will then begin and will depend on the facts the physiotherapist is presented with.
During the assessment, neurological, structural, postural, ergonomics and muscular factors are considered and the physiotherapist may focus more on specific areas depending on the information provided during the initial interview. If you would like more information about the role of the physiotherapist in the management of neck disorders, please click here.
Your physiotherapist will be looking out for conditions such as the following:
A slipped disc is a herniation of gel-like structure from the disc resulting from a rupture of the outer border. When this material impinges on the nerves exiting the spine, it can cause pain, numbness, pins and needles and muscle weakness.
A disc bulge can cause similar symptoms and this occurs when there is weakening of the outer border of the disc the original shape of the disc is distorted. This can be a precursor to herniation, but if a bulging disc is diagnosed, physiotherapy can be used to stop this progression happening.
Spinal Cord Compression
The spinal cord can be compromised by trauma and vertebral fracture, tumour, abscess and disc herniation. It is important to make this diagnosis early and look out for red flags, which are clinical signs and symptoms that must be immediately acknowledged so treatment can begin right away. Radiological imaging is very important in determining the best approach to treat this condition.
Thoracic Outlet Syndrome
The thoracic outlet is the area that sits between the rib cage, neck and collarbone. Pain, weakness and numbness may be felt in this area when compression from an extra cervical rib or muscular tightness affects the circulation and/or nerves.
When the head is vigorously jarred forwards and backwards, soft tissue structures, such as muscles, tendons, ligaments and nerves, can be injured. Whiplash injuries are commonly caused by car crashes and sporting activities and they are graded depending on severity. For more information, view the Quebec Task Force Clinical Classification of Whiplash Associated Disorders.
Acute Torticollis (Wry neck)
This is a very common condition where the neck is locked with muscle spasm and pain. Patients commonly find they have trouble making rotating or side flexing movements and, while this is normally a benign condition, it is important to rule out other possible causes such as certain medications or ear and laryngeal infections. This condition can usually be treated very successfully with physiotherapy and manipulative therapy.
To read more about identifying and treating neck pain and cervical disorders with physiotherapy, click here.