“What a pain in the neck!” Admit it. You’ve uttered that phrase when you were stuck in traffic or on eternal hold with customer service. But sometimes, a pain in the neck really is a problem with your neck, and suddenly even simple tasks become, well, a pain in the neck.
Fortunately, your neck pain doesn’t have to limit your everyday activities. With help from doctors and physical therapists, you can manage your condition and regain your neck health. Just follow these five steps.
1. Get evaluated
So, you’ve been resting and taking over-the-counter painkillers. That’s fine. A simple strain should resolve itself in a few days, says Scott Ramsey, DPT, co-owner of Hershey Orthopedic & Spine Rehabilitation (www.hersheyrehab.com). Pain from an injury could clear up in about three months, says Dr. Norman Haueisen, of Susquehanna Valley Pain Management (www.susquehannapaincenter.com) in Harrisburg.
It’s when your neck pain won’t go away and is possibly accompanied by other symptoms such as arm pain, loss of balance, and headaches that you “definitely want to call a professional for evaluation,” says Ramsey. “The longer you wait to seek treatment, the longer it’s going to take to resolve.”
Don’t wait to see a doctor if the neck pain comes with fevers and chills. That could indicate meningitis, so get help right away, says Dr. Jeffrey Conly, Orthopedic Associates of Lancaster (www.fixbones.com).
2. Pinpoint the problem
The neck is a complex structure of muscles, ligaments, tendons, bones, and discs. With all that complicated machinery, a lot can go wrong:
Muscle and ligament sprain or strain: Overuse or prolonged poor posture are often the culprits here. So are those yoga, Pilates, or high-intensity workout routines, if done improperly.
Whiplash: The classic whiplash injury happens in a car crash, when your head whips forward, pulling on the muscles, ligaments, and tendons, and then quickly jerks backwards, compressing the discs and joints.
Degeneration: The neck joints can be prone to arthritis, just like knees and fingers. The discs can become herniated, or spinal stenosis can set in. An MRI that shows disc problems might be followed with a discogram, when dye injected into the discs and scrutinized under x-ray reveals the problem areas, says Haueisen.
3. Examine your bad habits
Your doctor or physical therapist will look for an underlying cause by asking about your daytime and nighttime routines. “There has to be something that’s aggravating it,” says Ramsey. “You can treat something all you want, but if you’re not getting to the root cause, it’s never going to go away.”
Consider these bad habits that can cause neck pain:
• Poor posture: Sitting and typing all day can lead to chronic upper back problems. Hunched shoulders and a head that’s always looking down put undue pressure on the spine. Your neck wants to be in neutral, with ears over the shoulders, says Ramsey. Your shoulders should be down and back to keep the chest opened up.
• Poor sleeping position: Your neck wants to be in neutral during sleep, too. “Most people have the best relief if they sleep on a pillow that’s relatively flat,” says Conly. Don’t forget that sleeping on a recliner or sofa can also strain the neck.
4. Review your options
Doctors determine next steps by categorizing the patient into surgical or non-surgical, says Haueisen. Patients with nerve symptoms down the arm—such as pain, numbness, and tingling—might improve with epidurals that calm inflammation and help them participate fully in physical therapy. Patients with those symptoms might also be candidates for surgery.
The non-surgical patients “just unfortunately have a lot of soft tissue injury,” Haueisen says. Physical therapy, chiropractic treatment, and injections can ease symptoms, but healing can take six months to one year.
If symptoms and history point to a specific cause, patients can start with exercise, physical therapy, anti-inflammatory medications, and muscle relaxants before undergoing x-rays and imaging, says Conly. “Very commonly, neck pain will be self-resolved or resolved with conservative treatments,” he says. “Only a small fraction need injections or surgery.”
Some patients with severe arthritis might be candidates for rhizotomy, which diminishes pain by deadening nerves. A spinal cord stimulation device can send electric impulses to block nerve signals. “When it comes to chronic pain, the technology for spinal cord stimulation is getting better and better,” says Haueisen.
5. Prevent neck pain
Want to avoid that pain in the neck entirely? Consider these tips:
• Add strengthening exercises for the shoulder blades to your workout. The exercises to build strong chest muscles can also shorten them, which can lead to weakness and overstretching in the shoulder blade muscles. “We have to keep a balanced approach when it comes to stretches and exercises,” says Conly.
• Maintain your core strength and flexibility. “Movement, walking, flexibility, and core strengthening are the best things you can do not only for your spine but for your cardiovascular fitness,” says Haueisen.
• Improve your cellphone habits. Use earpieces for long conversations, and text with the phone held up, instead of constantly looking down at the screen.
• Raise the computer monitor or use a standing desk part of the day. Get out of the chair every thirty minutes and pull your shoulders back.
• Sleep safely. Don’t use several pillows, and don’t sleep on your stomach, which makes you twist your head. Try rolled-up towels to put “some sort of cushioning under the curvature in the neck,” says Ramsey.
