Ever have a “crick” in your neck that doesn’t seem to get any better? No matter how you stretch, bend, or move it, it never seems to get better. If so, you’re not alone. In fact, a lot of research has been published over the last several years about neck pain and the various treatment options. Unfortunately, all of that research and evidence tends to cause overwhelm and confusion when trying to navigate those waters. So, hopefully, this article will help shed some light on research-backed treatment options.
The Effect of Neck Pain
Let’s start with the basics: Neck and back pain are the leading cause of years of lived with disability across the world. In fact, In 2015, more than a third of a billion people had neck pain of more than 3 months duration [2]. That’s a whole lot of people! Obviously, with this many people being affected, a lot of treatment options exist out there.
Research seems to suggest that acute traumas (or injuries) to the neck often do not heal correctly and continue to cause societal and healthcare burdens for those involved [1]. Neck pain has also been found to be associated with long term psychological issues like anxiety, depression, fear of movement, and cognitive distress [2]. Simply put, persistent neck pain affects not only the body, but also the emotional and mental side of health. And, as we like to say here at ProActive, since every person is a unique individual, those effects look different for every person.
Every year neck pain causes pain and disability in the working population as well. It acts as a continuing source of activity limitation in those who work [4]. Neck pain keeps people from being able to complete job-related tasks and can lead to missed days, using up sick leave, and even job loss.
Many people struggle through their days with chronic neck pain and little hope for relief outside of medication. Occupational and Physical therapy, however provide a non- pharmaceutical option for these patients. And the research shows that PT/OT treatment can decrease pain and improve function for those experiencing chronic neck pain.
What the Research Says
So, much like any pain or injury, neck issues affect each person differently. This quote from a recent article sums it up nicely, especially for people who’s pain is affecting their work:
“Neck disorders are a significant source of pain and activity limitations. Most neck pain results from complex relationships between individual and workplace risk factors.” [3]
As with any injury, there’s no one-size-fits-all treatment that will deal with the pain once and for all. That being said, the research shows that there are certain treatment techniques that are more effective than others. Let’s take a look at some of those treatment techniques below.
What does therapy for neck pain look like?
Typical treatment for neck pain includes patient education, active stretching, exercise, manual therapy, modality application, body mechanic education, and cognitive training. As I’ve written about here, pain acts like our brain’s alarm signal of danger. Depending on how the brain interprets information it receives, we may experience pain with certain movements even if there is no damage happening to our tissues.
In this case, calming the nervous system down and retraining those alarm signals becomes the first priority. PT & OT can do this using techniques like graded exposure, motor imagery, and Pain Reprocessing Therapy.. Then, once you can move with little or no pain, “traditional” techniques of exercising/strengthening muscles and tissues can reinforce those neural pathways of safety and then to both build resilience and strength to prevent future injury.
How can Physical Therapy and Occupational Therapy help?
Results of a systematic review found that the strongest effects in treating neck pain were associated with exercise [3]. Research shows that movement is the best pain medication that we have at our disposal. Additionally, another randomized control trial found that pain education used in in addition to exercise was more effective than just pain education alone in treating mixed chronic neck pain [3]. Since pain is an alarm system of our brain, sometimes we need to provide education around that system in order to calm down the alarm signals.
Studies also found that when patients were actively involved in decision making and goal setting there was a greater effect on overall outcomes [3]. Realizing long-term healing and recovery requires that you take an active role in developing your plan of care. That means, if you’re experiencing any kind of pain, you need to find a clinic that empowers you to become the driver of your own healthcare, rather than a passive recipient.
ProActive Rehabilitation & Wellness is dedicated to encouraging patients to be active members of their healing process. Physical and Occupational therapy can decrease the amount of pain that patients have to live with, improving their overall wellness and quality of life.
References
[1] Hurwitz, E. L., Randhawa, K., Yu, H., Côté, P., & Haldeman, S. (2018). The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 27(Suppl 6), 796–801. https://doi.org/10.1007/s00586-017-5432-9
[2] Campbell L., Smith A., McGregor L., Sterling M. psychological factors and the development of chronic whiplash associated disorder(s): A systematic review. Clin. J. Pain. 2018;34:755–768. doi: 10.1097/AJP.0000000000000597.
[3] Sterling, M., de Zoete, R., Coppieters, I., & Farrell, S. F. (2019). Best Evidence Rehabilitation for Chronic Pain Part 4: Neck Pain. Journal of clinical medicine, 8(8), 1219. https://doi.org/10.3390/jcm8081219
[4] Côté P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, Carragee EJ, Haldeman S, Nordin M, Hurwitz EL, Guzman J, Peloso PM; Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. The burden and determinants of neck pain in workers: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. Spine (Phila Pa 1976). 2008 Feb 15;33(4 Suppl):S60-74. doi: 10.1097/BRS.0b013e3181643ee4. PMID: 18204402.
