Much like low back pain, neck pain is a major cause of impairment, with 70% of people suffering from neck pain through their lives. It is second only to low back pain as the most frequent cause of long term absenteeism. Akin to low back pain, imaging (MRI) and pain are not predictive factors of dysfunction. From this we can ascertain that there is something else driving the pain.
Factors such as a sedentary lifestyle, occupation, trauma, fear avoidance, stress, anxiety, and depression have been outlined in the literature to play a major role in neck pain.
Current best evidence takes a multimodal approach to managing neck pain, with exercise, manual therapy and patient education being key components. Strengthening postural muscles combined with neuromuscular re-education and endurance training, are important elements of an exercise programme.
Mobilisation, traction and manipulation have been found to reduce pain when combined with an exercise programme. The purpose of these hands on therapies is to help the client move properly which will act as an inhibitor to pain. As the cervical postural muscles begin to take over, (due to exercise programme) pain inhibition is further utilised and the client no longer needs hands on therapy.
There is strong evidence in the literature to suggest patient education has a positive relationship to a good prognosis. Emphasising and reinforcing current evidence that pain doesn’t mean damage and motion is good for your neck are important messages. Early return to non-provocative activities is central to recovery.
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