Neck pain
Neck pain is unfortunately such a common problem, with 1 in 5 Australian adults suffering from neck pain right now, and 50% of adults will suffer from some form of neck pain at some point in their lifetime. It tends to peak in middle age and has a higher incidence in females than males. The majority of acute neck pain episodes will resolve in 6-8 weeks with conservative care, however, 10-34% will persist and become chronic neck pain sufferers (1).
Neck pain is particularly common among desk bound workers. This is due poor ergonomics, insufficient movement breaks and prolonged muscle contractions (activation). For each of these problems there are several solutions. Ergonomics is a big problem, and many people do not give it the attention it deserves. It is much easier to prevent neck pain due to poor ergonomics then it is to treat it. There are a few simple things that can be done to improve your workstation such as getting a height adjustable desk, get a good chair that provides adjustable back support and adjustable height, position your keyboard and mouse appropriately (go online to see optimal set ups), get proper lighting so you don’t have to strain your eyes (natural lighting is best, LED lights and fluorescent lights are not ideal), get up every 30 mins and move around (set a computer or phone alarm to prompt you). If you want to go one step further, you can get your home or business workstation assessed by a professional ergonomist, it will save you unnecessary pain and suffering and even improve your productivity.
Neck muscle pain is one of the most common causes of neck pain. Muscles function like your heart (in fact your heart is a muscle) - when a muscle like your biceps contract they push blood out which is an effective way of pumping de-oxygenated blood back to the heart so it can get more oxygen. Another benefit of this pumping action is that it gets waste products (which build up in muscles due to use and metabolism) out of the muscles to organs (liver, kidneys) that will excrete them from the body. When the muscle relaxes after a contraction, new oxygenated blood gets into a muscle which provides it with oxygen and nutrients. If both of these processes do not occur regularly in a muscle, the waste products build up and the muscle becomes hypoxic (lack of oxygen) which in return leads to the formation of adhesions and trigger points, both of which are undesirable. Adhesions form when the muscles produce a glue-like substance that causes muscles and fascia (cling wrap like tissue that surrounds all muscles of the body) to stick together. Adhesions can form from one of three processes: overuse, disuse, and trauma (injury).
Throughout the body muscles are arranged next to one another, either side by side or one on top of the other (layers). When adhesions form between these layers, the muscles stick together and fail to slide past each other like they were designed to do. This is a big problem because if a muscle is sticking to another muscle, they cannot perform their function properly and they will interfere with each other. For example, think of your fingers like individual muscles, I can ask you to bend your index finger without bending all your other fingers, right? Well, now imagine if I put some super glue between all your fingers, now when I ask you to bend your index finger you cannot do so without bending all your fingers. So now the action of one muscle (your index finger) has affected the function of other muscles (all the other fingers of your hand). The good news is that these adhesions can get broken down. If they are relatively new adhesions (days or weeks old) they can often be broken down with specific movements or stretches. If however, the adhesions are quite old (months or years) you will need to see a manual therapist who knows some form of myofascial (soft tissue) release technique in order to break it down, just as a heads up this is rarely a pain free process.
Trigger points are another source of pain, dysfunction, and sub-optimal muscle function. We all have trigger points, some people more than others. They can be found in almost any muscle of the body, if you would like to find one just dig around in your upper traps (muscle between your neck and shoulder) until you find a hard exquisitely tender nodule (feels like a little marble under the skin), and you have found one. Trigger points form in a similar manner to adhesions: muscle overuse, disuse, or trauma. The neck is particularly susceptible to triggers points because many of the muscles in the neck are postural muscles, which need to stay on for long periods of time. They develop even faster and more proliferative when we maintain poor postures such as the chin poke (see picture below) when working at a desk for longer periods.
Trigger points in the neck, specifically the suboccipital muscles of the neck (located just beneath the back of the skull) can lead to another common neck related problem – tension headaches. Tension headaches are one of the most prevalent types of headaches. The good news is they are very treatable and even preventable.
Even better, you can resolve trigger points yourself or by consulting a manual therapist. Unfortunately, like with adhesions it is not a painless procedure. If you want to release a trigger point yourself you can do so with your hand, or elbow, some people use trigger balls or spiky balls, and you can even buy trigger point stick to get those hard to reach spots. Therapists can use their hands, elbows, trigger point release tools (knobbly like plastic or wooden hand held tools), acupuncture or dry needles, and shock wave therapy (you can find out about shock wave here). All are effective techniques; however, I have a shock wave therapy machine and have found it to be the most effective and long lasting of the techniques mentioned above. Other methods of resolving or minimizing the effects of trigger points that you can do by yourself include proper hydration (water preferably filtered with a bit of salt and lemon juice), having adequate electrolytes (from food or supplements), heat (warm baths, heat packs, infrared sauna), heat rubs (denco rub, tiger balm), and mineral/oil rubs (magnesium, eucalyptus oil). In my experience a lot of my patients respond very well to the Bioceuticals magnesium cream that we stock in our clinic.
There are a multitude of causes of neck pain, I have highlighted two of the most common and treatable causes of neck pain. If however, you are suffering from high levels of persistent pain, neurological symptoms (numbness, pins and needles, weakness), loss of consciousness, dizziness, double vision, slurred or troubled speech, please do not delay in consulting a medical doctor as these signs may indicate a medical emergency.
Should you have any questions, comments or concerns regarding any of the information provided in this article please get in touch with us and we will get back to you as soon as possible.
Take care!
Adam
1. Australian pain management association (2020, May 18). Neck pain. https://www.painmanagement.org.au/2014-09-11-13-34-03/2014-09-11-13-35-16/273-what-is-causing-my-neck-pain.html Retrieved on 18/05/20.