neck pain treatment baltimore

Neck pain is a widespread complaint - with a prevalence rate exceeding 30% of the population. It stands that neck pain is the fourth leading cause of disability, with nearly 50% of individuals suffering from some degree of consistent and chronic neck pain.

While these numbers are concerning, neck pain is rarely the result of serious pathology (absent a high-impact or traumatic event).

Neck Pain can oftentimes be treated non-operatively through physical therapy. 

What factors contribute to neck pain?

Non-traumatic neck pain is more common in females and for those in middle age. Sedentary occupation (desk work,) sleep disorders, obesity, as well as other factors such as depression, anxiety, and low job satisfaction all increase the risk for developing neck pain. 

Are there different types of neck pain?

As with any part of the body, pain can develop from multiple sources - the neck is no different. Typically, we classify neck pain as mechanical, neurologic, or visceral-referral (pain coming from a structure unrelated to the pain such as the heart or vasculature.) In physical therapy, we are particularly effective in treating mechanical and neurologic disorders of the neck that do not require surgery. 

Mechanical neck pain:

Mechanical neck pain refers to pain from the joints, bones, ligaments, or muscles attaching to or surrounding the neck. Patients with mechanical neck pain often report a limited range of motion (you may feel like you have a stiff or “tight” neck), achy and painful muscles, difficulty sleeping, and a  “nagging” or “dull” pain that is constantly with them. These issues can stem from prolonged positioning (such as sedentary desk work,) repetitive movement, a sport-related injury, or a traumatic incident such as a fall or accident. 

Physical therapy for mechanical neck pain often includes an initial phase focusing on pain management interventions to decrease pain and irritation - such as soft tissue massage, muscle energy techniques, dry needling, and education as to what you can do on your own to improve your pain quickly. Once your pain levels are down, your course of physical therapy will shift towards interventions that help prevent the onset of pain in the future. Depending on the impairments found, this may include a strengthening or neuromuscular reeducation program targeting the muscles around your neck and upper back, mobility exercises for the joints surrounding your neck, as well as education on what you can do at home to prevent future episodes of pain. 

Neurogenic neck pain:

Neurogenic neck pain is related to irritation of the nerves either within the spinal cord (such as myelopathy or cervical stenosis) as they leave the spinal cord (known as radiculopathy) or somewhere along the tract of the nerve (known as peripheral nerve irritation.) Neurogenic neck pain complaints will differ depending on where the irritation exists.

Irritation within the spinal cord (e.g., stenosis, myelopathy) will often lead to symptoms on both sides of your neck, both arms, or even sometimes in your legs, depending on which nerves are irritated. This can result in numbness, tingling, pain as well as difficulty moving and walking. If you have these symptoms, you should contact your primary care provider - particularly if you notice weakness, bowel or bladder issues, or difficulty moving. 

Physical therapy for neurogenic neck pain that is likely the result of an issue inside the spinal cord will vary depending on the severity of your symptoms and will always be conducted hand in hand with your other medical providers to ensure that you are appropriate for physical therapy and not a surgical candidate.

Neurogenic neck pain that results from irritation to nerves outside the spinal cord will typically only result in unilateral (or one-sided) problems, e.g., pain/numbness/tingling on your left OR your right side. The pain of this variety is typically reported to be sharp in nature. It can oftentimes travel down your neck and arm and is exacerbated by the different neck and arm movements. 

The pain of this nature is less likely to require surgical intervention (unless symptoms are severe); however, ChapmanPT always works hand in hand with all your medical providers to make sure you are receiving wrap-around care that is multidisciplinary and provides you with continuity in your rehabilitation. Physical therapy interventions will differ widely depending on the issue that is causing your pain. However, typically your care will include mobilization of the cervical and thoracic vertebrae related to the irritated nerve, sliding (or gliding/stretching) the nerve that is causing your pain, soft tissue massage, and mobilization to the muscles along that nerve tract, as well as strengthening and neuromuscular reeducation to any muscle groups which may be related to your pain.

Take-home messages:

If you suffer from neck pain, do not worry, the vast majority of neck pain complaints can be thoroughly treated with physical therapy.

When combined into a comprehensive program, strengthening, neuromuscular reeducation, joint mobilization & manipulation, dry needling, soft tissue massage, and ergonomic changes effectively treat most forms of neck pain. 

You do not need a prescription or referral to receive care from a physical therapist in Maryland. Call ChapmanPT to start your rehabilitation today (410.995.8178.)

If you are suddenly having difficulty with bowel or bladder movements, or are losing sensation in your groin region, contact your provider and go to the emergency room immediately.