So you are having neck pain… Well, you are not alone. It is estimated that around 20% of the adult population will suffer from neck pain in any given year. You may be wondering how long it will last and if it will keep coming back. You may be wondering what sort of treatment to seek?
I will try to answer these questions and more in this post.
What is neck pain?
It has been defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage in the neck region.”. However, all neck pain disorders are not the same. In fact, there are a few different types and severity levels that should be considered, as they will require different types of management.
Types of neck pain
The two main types of neck pain are those that are work-related (pain brought on by typical daily activities) and those that are trauma-related (such as whiplash-associated disorder). The prognosis for each type is different.
For example, 50% of trauma related neck problems recover in the first 3 months, and the other 50% continue to have some degree of pain for 6-12 months afterwards if not indefinitely. In contrast, 50% of work related neck pain suffers will resolve their pain and disability within 6 weeks of the onset of pain. However 60-80% of these work related neck pain sufferers will have recurrent episodes within 1 year.
4 level classification of neck pain
The Neck Pain Task Force developed a 4-level classification of neck pain based on severity to aid in appropriate management:
Level I: neck pain and associated disorders with no signs or symptoms suggestive of major structural pathology and no or minor interference with activities of daily living.
Level II: No signs or symptoms of major structural pathology but major interference with activities of daily living.
Level III: No signs or symptoms of major structural pathology but the presence of neurologic signs, such as decreased deep tendon reflexes, weakness, or sensory deficits.
Level IV: Symptoms or signs of a major structural pathology. Examples of major structural pathologies are fractures, dislocated vertebrae, spinal cord injuries, infections, tumors, or systemic diseases such as inflammatory arthropathies.
Level I, II, and III neck pain is appropriate for physical therapy evaluation and treatment. Although a significant percentage of level III neck pain patients will likely require referrals for specialty consultations (i.e., surgery),. Patients with Level IV neck pain should not receive physical therapy treatment; instead, they should go straight to the ER or see the appropriate doctor after receiving an initial evaluation from a PT.
What sort of treatment should I seek for my neck pain?
In order to help clinicians manage patients with neck pain, expert panels have created clinical guidelines based on a thorough review of the medical literature. These reviews consistently advocate treatment with a combination of exercise and manual therapy techniques (mobilization and manipulation) for work-related neck pain levels I–III.
Those with trauma related neck pain should seek medical attention to rule out serious pathology such as fracture/dislocation (Level IV). They should also seek medical advice regarding appropriate activity early in the onset (within the first few days) to aid in full recovery and lessen the likelihood of developing chronic neck pain (persistent pain beyond 3 months).
In these same reviews there has been very low evidence supporting the use of electro therapy (i.e. TENS), ultrasound, laser, dry needling, and cervical collars for work related and trauma related neck pain level I- III. So basically, if it plugs into a wall or does not involve some type of movement, it probably will not help. So don’t waste your time and resources on these ineffective treatments for your neck pain.
I hope this helped clarify what you should do about your neck pain.
