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Treatments

Rehabilitation for neck pain

What is rehabilitation for neck pain?

If you have chronic neck pain, your doctor may have you see a physical therapist who will design a neck-care program just for you. Your physical therapist will evaluate your condition to determine the best way to help ease your pain and help your neck move better. You will also be given ways to take care of your neck so you can avoid pain and prevent further injury to your neck.

Conditions

The most common causes of neck pain are strains and sprains. A strain is when a muscle or tendon has been irritated by overuse or overextension, while a sprain occurs when a ligament has been irritated by overuse or overextension. Common causes of neck strains and sprains include:

  • Sleeping in the wrong position (commonly referred to as a “crick” in the neck)
  • Sports injury
  • Poor posture
  • Repetitive motions
  • Holding the head in an unusual position for an extended period of time
  • Whiplash

How rehabilitation for neck pain works

Below is a high-level description of what you can expect when working with a physical therapist to correct the chronic pain in your neck.

Consultation

On your first visit, your physical therapist will begin by asking your questions about your neck problem. You may be given a questionnaire, which will help your physical therapist gauge how much pain you have now and how your pain changes once you've had treatment. Here are some typical questions your therapist may ask you:

  • How long have you had neck pain?
  • Where do you feel the pain?
  • What makes the pain better or worse?
  • How does your pain affect your daily activities?
  • Do you have headaches?
  • Do you have pain in your shoulder, arm, or hand?
  • Do you have any numbness or tingling?

Evaluation

Once your physical therapist has the right information, your neck condition will be evaluated in the following ways:

  • Posture/observation: Your physical therapist will begin by checking your posture to see if your soreness is coming from changes in posture. Imbalances in the position of your spine can put pressure on sore joints, nerves, and muscles.
  • Range of motion: This is a measurement of how far you can move your neck in different directions.
  • Neurological screen: This part of the evaluation looks at your reflexes, sensation, and strength in your neck, shoulders, and arms.
  • Manual examination: Your physical therapist will carefully move your neck in different positions to make sure that the joints are moving smoothly at each level of the neck.
  • Special tests: Other special tests may be done if your physical therapist thinks your neck pain is coming from other areas or causes (i.e. - nerve tension, ergonomics, etc).
  • Palpation: Palpation is when your physical therapist feels the soft tissues around the neck to identify locations of tenderness and pain.

Treatment plan

Once the examination is done, your therapist will put together a treatment plan, which includes an indication of how many visits you will need and how long you may need therapy. It also includes the goals that you and your therapist think will be the most helpful for getting your activities done safely and with the least amount of soreness. Finally, it will include a prognosis, which is how your therapist feels the treatment will help you improve.

Your therapist may choose from one or more of the following tools, or modalities, to help control the symptoms you are having:

  • Rest: avoiding activity or movement that cause irritation/pain.
  • Specific rest: select exercises that encourage the safe movement of the shoulders and upper back.
  • Positioning: using special pillows or special ways to rest your head and neck.
  • Ice: using ice can help control inflammation
  • Heat: using heat can help to flush away chemicals that are causing pain and can help speed up healing by bringing nutrients and oxygen to the problem area.
  • Ultrasound: the use of ultrasound causes friction and warmth to pass through tissues. This heating effect helps flush the sore area and bring in a new supply of nutrient and oxygen-rich blood.
  • Phoresis: Phonophoresis uses the high-frequency sound waves of ultrasound to "push" a steroid medication (cortisone) through the skin.
  • Electrical stimulation: This treatment stimulates nerves by sending an electrical current gently through your skin.
  • Soft tissue mobilization/massage: Massage has been shown to calm pain and spasm by helping muscles relax, by bringing in a fresh supply of oxygen and nutrient-rich blood, and by flushing the area of chemical irritants that come from inflammation. Soft tissue treatments can help tight muscles relax, getting them back to a normal length.
  • Joint mobilization: These are graded pressures and movements that are done by skilled physical therapists. Gently graded pressures help lubricate joint surfaces, easing stiffness and helping you begin moving with less pain.
  • Traction: Sore joints and muscles in the neck often feel better when a traction "pull" is used. Your therapist will test at first to see if you can get relief with this type of treatment.

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