Treatment of Neck Pain

Neck pain is a common issue, affecting millions of people every year. In fact, it’s estimated that up to 75% percent of people will, at some point, experience acute or chronic neck pain in their lifetime.

This is particularly true in large urban centres like Toronto, where for many people, countless hours are spent staring down at their computer or smart phone, resulting in increased postural stress and strain onto their neck and back, often leading to both neck pain and back pain over time. 

This is a common reason why people consult with a neck pain chiropractor to treat their neck pain before it worsens, or to take proactive steps to prevent it from occurring in the first place.

 Neck pain is commonly felt anywhere from the base of your skull to the top of your shoulders, often spreading into the upper back and shoulder area. This can often result in both joint pain and in protective muscle spasms in your neck that may feel like painful or burning muscle knots, and can make turning your neck or even moving your head extremely difficult and painful.

 Neck irritation can contribute to headaches (termed cervicogenic headache), and in more severe cases of pinched nerves or cervical disc bulges, can result in pain radiating into the arms and hands, causing numbness, tingling, weakness, and carpal tunnel syndrome like symptoms.

 In the majority of cases, neck pain episodes will subside after a few days, but extended episodes lasting for weeks or even months may indicate a more significant underlying medical issue that requires further diagnostic investigation. Proper assessment and treatment is required for optimal neck injury recovery.

What are the common causes of neck pain:

  • Chronic postural strain from prolonged hours at a computer or staring down at a smart phone.
  • Poor posture resulting in muscle spasms and associated trigger points.
  • Poor sleeping posture, particularly sleeping on the stomach with the head turned all night.
  • Whiplash injury from a car accident or other forms of neck trauma.
  • Repeatedly carrying a heavy purse or back pack for extended periods.
  • Sports injuries resulting in rapid whiplash type neck movements or concussions.
  • Occupational stress from extreme neck postures: cradling a phone between your head and shoulder, painting ceilings all day, roofing or doing flooring staring down all day.

Muscle Strain/Soft tissue sprain injuries:

Specific muscles and tendons/ligaments may be injured, most often from chronic poor posture, repetitive stress overuse injuries, or sports injuries. This can also result in a myofascial pain syndrome, with associated trigger points in the muscles. A proper assessment can help determine the best stretches and exercises to help the injured connective tissue recover, and any chronic postural problems can be corrected to prevent future issues.

Cervical Osteoarthritis:

Commonly referred to as “wear-tear” arthritis, this occurs from chronic postural stress over many years, leading to the joints/cartilage (cervical facet joint) wearing down over time. This is also referred to as cervical spondylosis. Restoring proper movement patterns through manual therapy, stretching tight muscles, and improving posture can greatly aid with osteoarthritis at any age.

Whiplash injuries:

Whiplash is a rapid forceful acceleration deceleration injury of the head and neck most commonly associated with motor vehicle accidents, falls or trauma. This may injure the muscles, joints and ligaments of the neck, and in severe cases may also result in concussions. Recovery of severe whiplash injuries may require months of passive and active treatment.

Cervical Degenerative Disc Disease (DDD):

This results from wear and tear of one of the intervertebral discs in the neck/cervical spine over many years. As the cervical disc continues to degenerate, this may lead to localized inflammation and increased pressure on the cervical nerves, contributing to more pain. With proper treatment, focusing on improved posture and rehabilitative exercises, many cases of cervical degenerative disc disease can be successfully managed.

Cervical Disc Herniation/Cervical Disc Bulge:

A herniated disc in the neck commonly occurs from chronic postural loading, resulting in a gradual leakage or migration of the inner disc material (nucleus pulposus) backwards through the outer layers (annular fibres), commonly called a slipped disc. This can compress a cervical nerve root or spinal cord, resulting in severe pain.

Cervical Spinal Stenosis:

Spinal stenosis in the neck most often results from advanced spinal degeneration over many years, with a herniated disc or bone spur/osteophyte gradually encroaching into the spinal canal, narrowing it over time. Proper diagnosis requires advanced imaging, often including an X-ray and MRI. This narrowing of the canal may compress the spinal cord or nerve roots as it worsens, resulting in pain and other neurological symptoms.

Cervical Foraminal Stenosis/Cervical Radiculopathy:

Foraminal stenosis occurs when the foramen (holes) on the side of the spine narrow, most commonly from advanced osteoarthritis (bone spurs) in the spine, or a herniated cervical disc. This stenosis or narrowing of the nerve opening can compress the nerve, resulting in severe neck pain, often with referred pain travelling down into the arm and hand. This often feels as a burning or shooting pain, and may be accompanied by numbness or tingling. With appropriate conservative care, often combined with short-term pain medications, symptoms can often be significantly reduced. Recovery may be slow, often requiring weeks to several months. Advanced imaging (MRI, X-rays) can aid in a proper diagnosis, and in some severe cases, surgical intervention may be necessary.

What is the best way to properly diagnose neck pain?

Without a proper diagnosis and a full understanding of why you have neck pain, your treatment and long-term recovery will be less successful.

Any proper diagnosis must always start with a thorough patient history and consultation, to understand what occupational stresses, lifestyle factors, or trauma may be contributing to your neck pain.

A thorough assessment must then be performed, looking at your posture, your neck and upper back movement and mobility, range of motion testing, palpation to determine full joint movement in your neck, and orthopedic and muscle testing.

Depending on the history of your pain and examination findings, advanced diagnostic imaging, such as an X-ray or MRI, may be recommended to visualize the underlying spinal structures.

Chiropractic treatment for neck pain:

Chiropractic care has been shown to be highly effective for patients looking for neck pain relief.

Chiropractors are a qualified health care practitioner and spinal specialist (with a minimum of seven years post-secondary education) who provide effective care for a variety of spinal conditions, including neck pain and back pain treatment.

Proper treatment and patient results begin with finding the root cause of your neck pain, through a proper consultation, history and physical examination.

Multiple approaches are used to effectively treat your neck pain: specific chiropractic adjustments, soft tissue therapy, and neck stretching and mobilization protocols. Postural strengthening and stabilization exercises may also be required.

 Our neck pain clinic in Toronto uses several techniques for chiropractic adjustments or cervical manipulations, depending on the needs and preferences of the patient. These range from activator use, to specific drop-table adjustments, to the more traditional manual chiropractic adjustment.

These approaches serve to increase proper motion and alignment in the cervical spine, often providing immediate neck pain relief, decreased stiffness and decreased muscle spasm. 

With a combination of chiropractic care, exercises, stretches, postural re-education and other treatment options, many patients experience immediate improvement of their symptoms, even for those with complicated cases of osteoarthritis, herniated discs, and radiculopathy. 

Our goal is to help you get relief from your pain and discomfort as quickly as possible, so you can get back to your life again.

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How long does it take to recover from neck pain?

Neck pain recovery time will vary based on the underlying cause, the chronicity of the condition, the severity, your age, and how soon you are able to begin effective treatment. Recovery may take as little as a week, or in the case of more severe neck issues, several months. It is important to be consistent with your treatment, and to do the prescribed stretches and exercises on a regular basis.

What are the best exercises to help relieve neck pain?

Strengthening weak neck and upper back postural muscles is an important part of any neck pain recovery program, and particularly important to prevent a reoccurrence of the symptoms in the future. These exercises should be combined with range of motion stretches, and should be individualized to the needs to the patient.

Caution should be used whenever beginning any exercise program, particularly for any tight and painful neck muscles. Begin gradually, and do not force any of the movements.

The muscle groups that are most commonly involved in neck pain sufferers are the deep neck flexor muscles in the front of the neck, and the trapezius, rhomboid and upper back postural extensor muscles.

Two of the best exercises for neck pain are the Chin Tuck exercise and the YTW exercise. A detailed explanation and demonstration video of each can be found on the link below. 

  1. Neck retraction exercise/chin tuck exercise 
  2. YTW postural exercise

What are the best stretches for neck pain?

Stretching tight neck muscles and postural muscles is a critical part of any effective neck pain therapy. By far the most common postural distortion related to neck pain is the slouched, forward head displacement posture, or anterior head carriage. 

Caution should be used when stretching tight muscles. Start gradually, and never force the stretches.

Some of the best neck pain stretches and postural correction stretches are included below. For a detailed explanation and video demonstration of each, follow the link below.

  1. Sternocleidomastoid Muscle (SCM) Stretch
  2. Scalene Muscle Stretch
  3. Pectoral Stretch
  4. Wall angel exercise
  5. Neck Curve Correction Exercise

How can you treat neck pain at home?

  1. If you can identify what may have caused your pain or aggravated it, try to avoid or minimize that activity, movement, or posture. In many cases, sitting or slouched postures place increased strain on your neck, and may aggravate your pain. Try to minimize how much sitting you are generally doing. Being upright and moving around (walking) is preferable to sitting, and if necessary, lying down in a comfortable position for short periods of time can help.
  2. Maintaining some movement with your neck will help with it to heal and recover faster. The most current research shows that for the vast majority of spinal and joint issues, total inactivity will often slow down your recovery, and your pain will generally last for longer. 
  3. Unless you are absolutely unable to move because of the pain (in which case we recommend consulting immediately with a health care professional), gentle neck motion (turning side to side slowly, bringing your ear to your shoulder, gently bringing your chin forwards) will help in the healing process. Even slow walking will help to bring some movement into your neck. 
  4. Unless you are consulting and being treated by a specialist, like a neck pain chiropractor, avoid any aggressive neck pain stretches or exercise, and do not force any neck movement into your neck joints on your own. 
  5. If your acute pain has just begun (less than 24 hours), you may respond well to ice to bring down some of the immediate inflammation and swelling. In the case of more chronic or lingering pain of several days to weeks, heat may be a better option. You can use a hot water bottle for heat, or or simply stand under a hot shower. 
  6. If your pain persists beyond several days in spite of the above efforts, talk with your pharmacist about possible pain or anti-inflammatory medications. Consider consulting with a qualified spinal expert to determine the underlying cause of your symptoms.

When should you worry about neck pain?

If your neck pain is accompanied by pain travelling down your arm into your hand, or tingling or numbness into your arm or hand, or weakness, please consult with a qualified health care professional. This may indicate a cervical disc bulge or cervical herniated disc, and may require advanced diagnostic imaging before beginning any therapy. 

If you’ve suffered a head or neck trauma, are unable to lift your head off your pillow on your own, or are experiencing dizziness or blurred vision, please consult with your medical doctor or hospital.

Toronto Neck Pain Clinic - Neck Pain Chiropractor

If you’re looking for a neck pain chiropractor in Toronto, we have been helping people overcome their neck pain for over 20 years, and in that time, have helped thousands of people find neck pain relief. 

While the advice and recommendations we’ve given throughout this article are all well researched, everyones clinical presentation of neck pain is different.

It is beyond the scope of this article to give specific treatment recommendations, as this will vary based on your clinical presentation, and on your examination findings.

If you continue to have neck pain and stiffness, are frustrated or not sure of your next step, a thorough assessment is highly encouraged. 

If we can be of assistance, or if you have specific questions, please feel free to contact our office today. 

Dr. Byron Mackay

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