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Acute & Chronic Neck Pain

Acute & Chronic Neck Pain

Acute Neck Pain

Acute neck pain is generally caused by an unexpected force on the neck area resulting in a muscle, ligament, or joint sprain. This unexpected force can be either a large force acting quickly on the neck, such as whiplash from a car accident or a fall, or a smaller force acting on the neck for a prolonged period, such as sleeping in a strange position at night or having poor workplace ergonomics. 

The good news is that because the neck area is so highly vascularised (blood flow), it heals and recovers relatively quickly. Physiotherapy can be used to hasten the healing process through the neck, by determining the exact cause of the neck pain and treating that area specifically, rather than using heat/ice to treat the neck in a more general manner. 

Chronic neck pain

Chronic neck pain is defined as pain that lasts longer than the time that an acute injury would take to fully heal. The generally accepted length of time is around the 12week mark, where things generally tend to move towards the chronic neck pain area. 

The causes behind chronic neck pain are a little more complicated than those of an acute neck injury, however, they generally are only concerned with the passive structures in the cervical spine (bony anatomy, discs, & nerves). 

A disc injury or irritation is usually due to one of two seperate reasons; degeneration of the disc, or a herniation of the disc. Throughout life we are placing different pressures and stresses on the joints and discs in our spine, meaning that we are slowly degrading them – this is a normal process of aging. However, sometimes we will have excessive wear and tear on the discs in the spine, resulting in “abnormal” disc degeneration. This abnormal degeneration of the discs can result in pain through irritation of the joints in the area, or an irritation in the nerve in the same area – both of which can be quite painful. A herniated disc is usually caused by some form of trauma to the neck, resulting in the outer layer of the disc tearing and the inner layer of the disc protruding into the thecal space – causing irritation or compression of the nerves in the area. 

A cervical joint irritation or injury is slightly different to a disc injury. A joint irritation generally affects the nerves a little more closely, but only in certain positions or directions. The reason joint injuries affect the nerves more closely is due to the anatomical proximity they have to the joints, and the lack of available space. 

 

 

Chronic neck joint injuries are generally caused by osteoarthritis in the joints in the neck, with or without spinal stenosis. Osteoarthritis without spinal stenosis is abnormal growth within the joint space, while osteoarthritis with spinal stenosis is abnormal bone growth within the joint space that also expands into the foraminal space. The foraminal space is where the nerves exit the spinal column and move into their distributions. The abnormal growth within the foraminal space may or may not result in nerve root compression or irritation. 

Compression of the nerve root within the foraminal space is known as myelopathy. Myelopathy can be caused by either the stenosis (abnormal bone growth), or by disc compression through a herniation. Both of which narrow the foraminal space where the nerve exits the spinal column. Compression of the nerve roots may result in problems with coordination and strength throughout the distribution of that particular nerve root.

Physiotherapy has been a proven treatment method for many clients with chronic neck pain to avoid more invasive procedures such as steroid injections, nerve root ablation, & surgery. The main focus of Physiotherapy in chronic neck pain is to improve pain-free range of motion, and motion through the thoracic spine to alleviate some painful symptoms and movements.