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       How is the neck structured?

  • Your neck and back are made up of small bones called vertebrae. These are stacked on top of each other to form the spinal column.
  • The spinal column supports your head and protects the spinal cord. This is the main structure which links the network of nerves throughout your body. Messages travel along this network sending sensations, such as pain, to your brain.
  • The top seven bones in the spinal column form your neck, and these are called the cervical vertebrae. The bones are linked together by facet joints. These are small joints between your vertebrae that, together with your neck muscles, allow you to move your head in any direction.
  • Between the vertebrae are discs of cartilage. The discs act as shock absorbers and give the spine its flexibility. A slipped disc occurs when one of these discs slips slightly out of its natural position in the spine.

Symptoms

The most common symptoms are:

Pain and stiffness

  • You may feel pain in the middle or on either side of your neck, but it may also extend to the shoulder or to the upper chest.
  • You may have pain or weakness in your arms.
  • You may have tension headaches, where the pain can travel to the back of your head and sometimes into your ear or behind your eye.
  • It may be painful to move your neck and your muscles may feel tight, especially if you’ve been sitting or sleeping in one position for a long time.
  • You may notice that your neck won’t turn as far as it normally does, for example when you try to look over your shoulder while reversing the car.

Numbness or tingling

A nerve can become pinched when the muscles, bones or tissues surrounding it apply too much pressure. As a result, you may feel numbness, pins and needles or a tingling sensation that can be felt down your arm, sometimes right down to your fingers.

You’ll find that numbness and tingling will go away once the problem resolves itself. However, if your symptoms are severe, talk to your doctor; they may be able to prescribe drugs that target the pinched nerve.

Clicking and grating noises

You may hear or feel clicking or grating as you move your head. This is called crepitus, and it can be caused by air bubbles popping, or tissues and bones moving over each other, in the joint. Other joints often do this too, but noises from your neck usually seem louder because they’re happening closer to your ears. You may also find they’re more noticeable at night.

Dizziness and blackouts

If you feel dizzy when looking up or turning your head, this may be due to pinching of the arteries that run alongside the spine, otherwise known as vertebral arteries. This can sometimes happen as a result of changes in the vertebrae. Pinching of these vertebral arteries can occasionally cause blackouts as the blood flow is temporarily reduced. However, blackouts can have other causes so it’s important to seek medical advice if this is happening to you.

Muscle spasms

Muscle spasms are the sudden stiffening of a muscle or groups of muscles in your body. Often there is no known cause and they can be very unpleasant. When it occurs in the neck it usually causes pain and stiffness down one side, which can make it difficult to turn your head.

It usually only lasts a few hours or days, although rarely it may continue for several weeks. You can try to ease the pain at home with gentle stretches, over-the-counter painkillers as well as heat or ice packs. People with muscle spasms report that applying heat is particularly soothing.

Other symptoms

If you have long-lasting neck pain and stiffness, particularly if your sleep is disturbed, then you may feel very tired and, not surprisingly, you may start to feel rather down or low in mood. Talking about your pain with friends, family or your doctor may help.

Causes

Neck pain is very common and most of us will have it at some point in our lives. Usually, neck pain is the result of holding your neck in the same position for too long. However, other things can also cause or contribute to neck pain, such as:

  • worry or stress
  • sleeping awkwardly
  • an accident, which can cause whiplash
  • a sprain or a strain
  • a flare-up of cervical spondylosis; which can happen as the discs and joints in the spine age.

Many people develop a stiff and painful neck for no obvious reason. This is called non-specific neck pain. This is the most common type of neck pain and usually disappears after a few days, providing you keep gently moving your neck and rest when you need to.

You can often manage short spells of neck pain yourself using over-the-counter painkillers and gentle stretches. However, if your neck problem persists or significantly affects your everyday activities then it’s sensible to see a doctor or other healthcare professional-Physiotherapist.

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Conditions related to neck pain

Cervical spondylosis

Spondylosis is quite normal as you get older and happens when the bones and discs in your spine change as they age. It’s caused by your body naturally adapting to the everyday use that occurs over many years.

In spondylosis, small lumps of new bone, called osteophytes, grow at the edges of the vertebrae and the facet joints. Over some time, the discs in your spine can also start to become thinner. These changes can be seen in x-rays and when they happen in the neck it’s known as cervical spondylosis. They may also occur at the bottom of the spine, where they’re known as lumbar spondylosis.

Spondylosis shouldn’t affect your everyday life, if you do the right exercises, seek advice from your Physiotherapist/GP and look after your general wellbeing, then your symptoms are more likely to improve. Almost everyone will have spondylosis somewhere in the spine at some point in their life and often it doesn’t cause any pain at all.

Although spondylosis doesn’t always cause pain, it may increase the risk of having spells of neck pain. However, because neck pain tends to come and go over several weeks, it’s not usually possible to identify spondylosis as a direct cause.

Occasionally, if you have spondylosis:

  • You may feel pain or numbness. This occurs if the nerves are irritated or pinched, either by bulging discs or osteophytes.
  • You may have blackouts or dizziness. This happens if the vertebral artery is pinched, as it controls the blood supply to your brain.

To ease the pain, try to go about your daily activities as usual. Improving your posture and performing regular neck exercises can also help. If you have long-term pain, your doctor may want to prescribe painkillers or drugs that relax the muscle, however muscle relaxants are rarely offered for more than a few days at a time. In rare cases, where there’s a problem with your spinal cord or a nerve is being pinched by a slipped disc, surgery may be considered to relieve the nerve pain.

Spondylosis shouldn’t be confused with ankylosing spondylitis, where inflammation of the spine leads to a build-up of calcium on the bones, causing pain and stiffness.

Poor Posture

Poor posture, especially when you slouch or hunch over, can put a lot of strain on your neck muscles. Over time, this can lead to chronic neck pain, stiffness, and even tension headaches. It’s often caused by long hours sitting at a desk or staring down at devices, creating stress on the cervical spine. Good posture aligns your body correctly and can help prevent these issues.

Whiplash

Whiplash occurs when your head is jerked violently forwards, backwards or sideways. This happens most commonly in car accidents and sports injuries. The pain is caused by the unnatural stretching of the tissues that hold the bones of your neck in place. There’s often a delay of 24-48 hours before you feel any pain or stiffness from whiplash.

Although whiplash can badly strain your neck, seat belts and properly adjusted headrests in cars help to prevent serious injuries. Try to ensure that your headrest, and that of everyone else in the car, isn’t too low or pushed too far back.

Most whiplash improves within a few days or weeks. Make sure you go about your normal daily activities and keep your neck mobile. You can take painkillers, such as paracetamol, and you can try physiotherapy or gentle exercises to prevent long-term problems and get you back to normal as soon as possible. Try to avoid using soft collars that prevent your neck from moving, as these can actually slow down your rate of recovery. If your pain lasts a long time, you may be referred for specialist treatment and support at an NHS pain clinic.

Tension

Most of your muscles relax completely when they’re not being used, but some muscles have to work all the time in order to keep your body upright. Muscles at the back of your neck must always be active, otherwise your head would fall forwards when you’re sitting or standing. When you’re worried or stressed you often tighten these muscles even more, which can cause neck pain and tension headaches.

Relaxation techniques are often a good way to treat tension. You might want to try meditating or joining a class that promotes mindfulness or self-awareness, such as yoga, tai chi and Pilates.

Slipped discs

A slipped or bulging disc occurs when the cartilage that cushions the vertebrae in the spine pushes out. Although discs are designed to move, occasionally they may slip or bulge out of their normal position. If a slipped disc is pressing on a nerve, the neck pain you feel can be accompanied by:

  • pain radiating down one or both arms
  • numbness
  • pins and needles
  • weakness

This will often settle by itself or following self-help treatments, but occasionally you may need further treatment, especially if symptoms persist after several weeks.

Stenosis and myelopathy

Rarely, disc bulges and osteophytes can cause narrowing of the spinal canal, which is called spinal stenosis. This can affect the spinal cord and cause weakness in arms and legs, a condition known as myelopathy.

As with most neck pain conditions, you should try to remain active. Over-the-counter painkillers are also often suitable to manage the pain. However, symptoms associated with myelopathy and stenosis can progress. It is therefore important to let your doctor know whether you are experiencing any symptoms which could be a sign of nerve problems; including walking difficulties, falls or clumsiness. Your doctor may send you for an MRI scan or refer you to a specialist.

Persistent neck pain

In some cases, persistent neck pain has a specific cause, such as a damaged facet joint or disc. However, neck pain quite often continues even after the original problem has settled down. Lack of movement can cause your neck muscles to become weak and stiff. They will then tire more easily and will be more likely to hurt when you move them.

Over time you may start avoiding more and more activities and this can start to affect your work, social life, personal relationships, hobbies and interests.

As you do less of the things you enjoy and start to lose confidence you may start to feel anxious or depressed. You may feel that family members and medical professionals appear unhelpful or unsympathetic. If you’re anxious or depressed, you may not feel like exercising or doing everyday activities, so your muscles become weaker still, and so it goes on. This can happen to anyone, and the longer it continues the harder it’ll be for you to recover your movement, activities and confidence.

If your neck pain lasts more than a few days, you should see a healthcare professional. You should also speak to them if you:

  • have symptoms other than pain and stiffness
  • have pain, tingling, numbness or weakness in your arms or legs
  • have sudden severe pain after a fall or injury
  • suddenly develop neck stiffness along with difficulty lifting both arms above your head.

Some rare causes of neck pain include:

  • a fracture
  • an infection
  • a tumor
  • inflammation – which can happen in  meningitis or ankylosing spondylitis

If you suspect you have any of the above, see your doctor urgently.

At Ellie Physiotherapy & Wellness, we specialize in treating neck pain with a comprehensive approach that includes personalized care, manual therapy, and customized exercise programs. Our goal is to alleviate pain, improve mobility, and provide long-term relief.

Our Physical Therapist begin with a  thorough assessment to determine the severity of your condition and recommend a tailored treatment plan.

Our comprehensive treatment may include:

  • Soft tissue treatment(massage)
  • joint manipulation to release tension and stiffness
  • Neck pain exercises and stretches
  • Electrotherapy for pain relief
  • Neck pain mobilisation

Our dedicated physiotherapist will provide expert advice, lifestyle adjustments, and ergonomic workstation setups to ensure you maintain a healthy neck.