Almost everyone has been faced with a ‘pain in the neck’literally. And for about 10 percent of the population each year, that pain, if left untreated, can become a chronic health problem. “The most common causes of neck pain come in two forms, acute and chronic,” says Jennifer McCleary, a chiropractic physician with Triad Sports & Family Chiropractic. Injury or trauma may cause acute neck pain, while repetitive movement or postures that stress neck and shoulder muscles typically lead to chronic pain. “And because the nerves from the neck merge into a bundle and travel down the arm and to the hand, many times arm pain can come from the neck,” she explains.
Whiplash as a result of an auto accident is one of the most commonly cited causes of acute neck pain. But many more people create an ongoing neck condition by misusing the muscles in the neck and shoulders. “Sitting, typing, calling, reading…it’s not what you do but how you do it that matters,” McCleary says. The first line of defense against chronic neck pain is proper posture. She instructs patients to imagine their head as a golf ball atop a tee. The goal is to keep your head directly over your shoulders without allowing it to jut forward, which puts strain on your vertebrae and muscles.
“The difference is that the head is more like a bowling ball,” she says. Computer screens should be at eye-level to avoid prolonged periods of bending the neck forward to look down or tilting it back to look up. “People let small problems go for so long, they can become permanent,” McCleary warns. “If the pain comes and goes but doesn’t disappear, it’s best to seek professional care.”
Chiropractic and primary-care physicians generally begin by asking detailed questions regarding the location, persistence and nature of the pain. A physical exam provides information about posture, range of motion, muscle strength and spinal alignment. Imaging tests, such as X-rays or MRIs, are often used to pinpoint musculoskeletal problems and rule out serious concerns, such as disc rupture or degeneration.
Chiropractic adjustment and manual manipulation are primary treatments for neck pain, explains Matthew Berman, a chiropractic physician at Berman Chiropractic and Wellness. “Manipulation to the cervical (upper) portion of the spine usually improves motion and spinal mobility,” he says. Berman also uses heat and electrical stimulation to help release muscle tension and encourage healing. If the discs between vertebrae are compressed or damaged, Berman employs a technique called cervical decompression that increases the space between vertebrae, easing pressure on discs and providing pain relief with just a few treatments.
Such noninvasive treatments can be helpful, but there are cases in which surgical interventions are needed. Heidi Prather, a doctor of osteopathy specializing in physical medicine and rehabilitation with Washington University Orthopedics, says there are only a few neck pain conditions that warrant surgery: instability of the spine, bowel or bladder incontinence, and progressive weakness. “For everything else, surgery is really a last resort if other treatments don’t work,” she notes.
Prather approaches each case with an eye to tailoring treatments based on the specific cause of pain and the patient’s circumstances. Medication, therapeutic exercises or physical therapy, and injections are all useful treatments for many people, she says. Simply strengthening and stretching the muscles can be very beneficial for long-term pain relief. “People don’t have to put up with neck pain, especially when the vast majority of problems arise from wear and tear or overuse,” Prather says. “If you’re having a problem that’s impairing your everyday function, see a doctor. There’s usually a simple solution.”