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 when 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.
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