Monday, January 5, 2015

Understanding Neck Pain

 
By Dr. John A. Papa, DC, FCCPOR(C)
 
Neck pain is a widespread experience among the general population, with 30-50% of adults reporting pain symptoms at any given time.  Once an episode of neck pain happens, most individuals will find it is a persistent or recurrent condition.  The purpose of this article is to outline our current scientific understanding of neck pain.
 
The cause of neck pain is usually multi-factorial, meaning that there is usually no single cause.  Factors such as overall physical and mental health, along with work and daily activities are just a few factors that can contribute to the development of neck pain.  Most causes are not the result of serious injury or disease.
 
Neck pain can affect people in different ways and is usually classified into the following categories:
 
GRADE 1: Neck pain with no signs or symptoms suggestive of major structural pathology, and little or no interference with daily activities.
 
GRADE 2:  Neck pain with no signs or symptoms suggestive of major structural pathology that limits daily activities.
 
GRADE 3:  Neck pain with no signs or symptoms suggestive of major structural pathology, with presence of neurologic signs of nerve compression (i.e. radiculopathy or "pinched nerve") and may include pain, weakness and/or numbness in the arm.
 
GRADE 4:  Neck pain with signs or symptoms suggestive of serious structural pathology (i.e. tumor, fracture, infection, systemic or visceral disease).
 
Evaluation of neck pain should include a proper medical history, along with a physical examination consisting of inspection, range of motion testing, and palpation for tenderness, along with strength, neurological, orthopaedic and functional testing.  Diagnostic tests such as x-rays, CT or MRI scans are only required in a minority of cases.
 
The majority of neck pain is classified as Grade 1 or 2.  There is scientific evidence to support the following treatments for Grades 1 and 2 neck pain: education, exercise, mobilization, manipulation, acupuncture, soft tissue therapy, and analgesics.  Conservative treatment of Grade 3 neck pain should proceed with caution.  The majority of Grade 4 neck pain will require specialty medical management.
 
Due to the persistent and recurring nature of neck pain, individuals need to have realistic expectations hen addressing their symptoms as pain relief is often modest and short-lived.  The scientific literature does not identify any “best” treatment that is effective for everyone.  Trying a variety of therapies or combination of therapies may be required to find relief and help manage neck pain.  It is important that individuals play an active role in managing their symptoms by participating in their usual daily activities as tolerated, exercising, and reducing mental stress.
 
Most people can expect to experience some neck pain in their lifetime that may or may  not limit daily activities.  For those with neck pain that may be interfering with their activities of daily living, a qualified health professional can prescribe appropriate conservative therapy, rehabilitation and self-management strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.
 
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.