Neck Pain

Michelle Fritz, PT, DPT

The neck, or cervical spine, is the uppermost part of the spine consisting of the first 7 vertebrae (C1-C7) and the ligaments, intervertebral discs, joints and muscles that help to support loads to the head and neck, protect the brain and spinal cord and allow for neck movement.

The prevalence of neck pain is high in the general population. It has been reported that at any given time, 10% to 20% of the population reports neck problems, with 54% of individuals having experienced neck pain within the last 6 months (Childs et al., 2008). In that study, it was suggested that 30% of patients with neck pain will develop chronic symptoms and 37% of individuals who experience neck pain will report persistent problems for at least 12 months. The good news is that for managing neck pain, evidence support exercise as the first line of defence.

Neck pain can occur in the neck itself but it can also cause symptoms in the shoulder(s) or shoulder blade(s), elbow(s), wrist(s) or hand(s). This is known as radicular or peripheral pain/symptoms. This is commonly caused by nerve compression or from prolonged flexing or bending of the neck. In fact, most of our lives are spent with our necks in a flexed position. Right now, you are probably reading this on your phone with your neck/head bent forward. Many of our daily tasks require forward bending of the neck, so it is perfectly fine to have your neck bent forward. The problem arises when your neck is bent forward for the majority of the time, which can lead to poor posture and eventual neck pain.

One of the first exercises to try if you have neck pain (or peripheral symptoms in your shoulder, elbow, wrist or hand) is to perform a chin tuck or cervical retraction exercise. A chin tuck is a misnomer, so I prefer to call it a cervical retraction. The purpose of this exercise is to reduce the load on the neck from the prolonged flexing or bending by bringing your ears directly over your shoulders.

Sitting up tall, retract your head as if you were going to push your head against a wall without moving your neck up or down. Another analogy I use in the clinic to teach this to my patients is to “pretend someone is close-talking to you and you can only use your head to get away from them.” Perform this exercise at least 20 times and reassess your symptoms.

If you have pain during the movement that goes away or has improved when you finish the exercise, that is considered fine. If your pain worsens after performing the exercise or if the peripheral symptoms are worsened, stop immediately.

This exercise can and should be used regularly whether you have neck pain or not. This is one of those “do as many as you can” exercises. I usually encourage my patients to do 10 reps, 10 x per day or more. This is not an exercise you can overdo.

This is the first of many blog posts I will do on rehab and injury prevention. If you have any specific questions or concerns or have other ideas/exercises/body parts you’d like to see highlighted, please feel free to email me at mfritz1773@gmail.com

** Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Reference:

Childs, J.D., Cleland, J.A., Elliott, J.M., Teyhen, D.S., Wainner, R.S., Whitman, J.M.,

Sopky, B.J., Godges, J.J., Flynn, T.W., Delitto, A. and Dyriw, G.M., 2008. Neck

pain: clinical practice guidelines linked to the International Classification o

Functioning, Disability, and Health from the Orthopaedic Section of the American

Physical Therapy Association. Journal of Orthopaedic & Sports Physical

Therapy, 38(9), pp.A1-A34.