Idiopathic neck pain is neck pain of no specific origin. It often comes on gradually and can be related to poor posture, or prolonged and repetitive activities. It may or may not be associated with changes visible on radiological investigation although pain intensity and problems with neck function are often not associated with visible changes on scans. Good evidence suggests that with specific neck strengthening exercises complemented by manual therapy people with non-specific neck pain can experience significant and lasting reductions in pain and improved function. Physiotherapists are key providers of these rehab management strategies as they understand the role of specific muscle synergies across the neck and shoulder region and are highly trained in manual therapy techniques suitable for neck conditions.
While traumatic neck pain often produces pain similar in intensity or location as non-specific neck pain, the incident leading to the resulting impairment is quite different. Research has shown that, not unlike injuries in other areas of the body, trauma in the neck can have a significant impact on the small nerve endings and receptors in the neck soft tissue that help keep the head oriented in space. As a result trauma to the neck can result not only in pain, but dizziness, difficulties with reading inducing neck pain, vision changes and headaches. By retraining the sensory functions of the tissues in the neck it is possible to improve these symptoms and reduce neck dysfunction and pain. Also with gentle manual therapy the effect of any amplified pain response due to increased nerve excitability can be modulated for reductions in pain quite quickly. Finally with a strengthening program to address changes to muscle structure following trauma to the neck, it is possible to maintain improvements.
Radiculopathies occur when something structural (bone, disc material or swelling) encroaches on a nerve root as it exits the spine (several of these nerve roots make up the individual nerves supplying sensation and movement to the trunk and head, and arms and legs). This condition is often extremely painful as the chemicals from any local inflammation or that are in the disc material are aggravating to nerve fibres. With proper management including reducing aggravating activities, medication where indicated and prescribed by your doctor, and manual therapy to assist with pain relief, these conditions are often successfully managed conservatively. Physiotherapy in consultation with your GP or specialist (where necessary) can see your pain reduced, neck arm and shoulder mobility improved and functional capacity regained. Additionally we can assist with helping you to identify when re-introduction of any reduced activity levels are safe and beneficial.