Are you a “pain in the neck”? – Trends in Mechanical Neck Pain

In general, neck pain is a result of trauma / injury, poor posture (sitting, standing, while we sleep, through activity), degeneration, and various diseases.

The primary types of neck pain tend to fit into four categories: mechanical (musculotendinous, ligamentous, and joint), referred (pain arising from a different source), radicular (nerve root irritation), and myelopathic (relating to the spinal cord).

In this post, I will outline an interesting trend that relates to mechanical neck pain. Again, mechanical neck pain arises from dysfunction of muscle, tendon, ligament, bone, or joint.

In a comparison study by Yoshida and colleagues (1), when compared to individuals without neck pain, those with neck pain had hypomobility (too little) in cervical vertebrae 3, 4, and thoracic vertebrae 1 and 2 and hypermobility (too much) in cervical vertebrae 5, 6, and 7.

This is a trend found in individuals who have less active lifestyles, are required to sit for prolonged periods for work or recreation, or had a previous injury associated with the head or vertebrae in the upper neck. This presents as pain local to the mid-lower neck, stiff with motion, and often headaches.

How do we address this?

A guided combination of strength for the neck and mobility for the upper and mid back, through help from a physical therapist and exercises for self-maintenance, can help reduce and resolve this form of neck pain. See 2 exercises outlined below to start!

Exercises

1. Mobility to the upper/mid back: Turtle rotations
   – On knees, round low back, stack elbows in front of one another
   
   – Keeping low back round, elbow bent, rotate as far as you can following your elbow with your eyes
   
2. Stability to the lower neck: Neck raise
   – Lay on stomach with forehead rested on the back of your hands
   
   -Keeping a chin tuck, gently raise your head keeping your neck long
   

Source:

Yoshida R, Yasuda T, Kuruma H. Analysis of cervical and upper thoracic spinal segmental rotation angles during end-range neck rotation: Comparison with and without neck pain. Journal of Manual & Manipulative Therapy. 2022;30(6):328-333. doi:10.1080/10669817.2022.2056309.

Curtis Cramblett, PT, CFMT, CSCS, May 8, 2023

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