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Neck pain

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What is neck pain

This is a broad term encompassing pain, discomfort or stiffness felt anywhere from the base of the head, into the back and sides of the neck and can refer across the tops of the shoulders and shoulder girdle.  

Increasingly, sedentary lifestyles and adopting prolonged positions in work or leisure pursuits can lead to structures of the neck (muscles, joints and ligaments) becoming sensitised and stiff. We often do not train these structures to the capacity of being able to tolerate sustained loading, but this can be achieved with appropriate exercise. 

Other, less frequently considered factors such as stress and tiredness can strongly contribute to ongoing or persistent neck pain. This can lead to pain being felt in the muscles that frequently tighten up when we are stressed leading to the feeling of reduced movement in the neck.   

An irritated nerve in your neck can cause some arm pain going down into the hand and may be accompanied by pins and needles and numbness.

Dealing with neck pain

Be reassured that most incidences of neck pain will ease within a few weeks. 

Keeping active is important and neck pain can be easethrough movement. 

Movement may be sore, but this is not doing any harm and painkillers like paracetamol can reduce pain allowing you to move more freely. 

It is important you take your pain relief regularly in order to manage and get in control of your pain.  When taking medication please follow the instructions on the packet and inform the pharmacist of any other conditions that you suffer with. 

If your neck pain doesn’t settle, you may need some help from your local physiotherapist.

Some gentle exercises to try:

If your pain is acute, you may find that exercises are best done lying on your back with your head supported by one pillow.

1. Bend your head forward until you feel a stretch behind your neck, bring your head back to neutral repeat this little and often throughout the day.

2. Tilt your head toward one shoulder until you feel the stretch on the opposite side. Bring your head back to neutral. Repeat this little and often throughout the day.

3. Pull your chin in, keeping your neck and back straight (not tipping your head forwards). Hold at the end position and feel the stretch in your neck. Repeat this exercise little and often throughout the day.

 

 

 

 4. In sitting pull your chin in as far as you can. When you reach the limit bend your head back as far as possible. Do the   exercise slowly and carefully repeat this little and often throughout the day.

 

 

 

 

    5. In sitting. Turn your head to one side until you feel a stretch. Repeat to other side. Repeat this exercise little and often throughout the day.

Avoiding neck pain

Today’s lifestyles can involve a lot of static postures, holding our bodies in sustained positions leading to increased muscle tension and sensitising the structures around the neck. By identifying these points in our day and breaking up these patterns with regular movement, we can help prevent the onset of neck pain. 

Emotional stress for whatever reason in our lives will also increase tension in our body and make us more prone to perceiving pain in sentised structures. We are becoming more aware of the need to look after our mental health and there are many resources available to help with mindfulness and relaxation. Making something like abdominal breathing a regular part of your day could be an essential tool to reduce the buildup of tension. 

Another factor in the cause of neck pain can be poor sleep patterns.  Getting into good sleep hygiene patterns (such as getting into a good routine for sleep, or mindfulness at bedtime) will have an impact on decreasing your sensitivity to pain. 

Increased general exercise is good for our physical and mental health as well as helping to manage specific neck pain. Using the government guidelines of at least 150 minutes of moderate intensity (or 75 minutes vigorous such as running) cardiovascular exercise over a week as well as 2 days of strength and balance exercise, is a good way to help judge if you are as active as you could/should be. 

On some rare occasions the nerves in your neck may become more severely trapped. This may lead to: 

  • unexplained (and possibly painfree) arm weakness. 
  • finding it difficult for you to use your hands for tasks such as undoing and doing up buttons or unscrewing jars 
  • experiencing a loss of balance when walking. 

 If any of these symptoms occur, you should see your doctor. 

There are other rare but serious causes of neck and arm pain and you need to seek medical advice if: 

you feel generally unwell and suffer symptoms such as fever, night sweats or unexplained weight loss 

you experience pain at night, possibly worse than during the day that prevents you from sleeping due to increasing pain and/or difficulty lying flat. 

If any of these symptoms occur, you should see your doctor. 

When to seek medical advice

On some rare occasions the nerves in the spinal canal may become compromised. This may lead to a variety of symptoms: 

  • unexplained (and possibly painfree) arm weakness. 
  • finding it difficult for you to use your hands for tasks such as undoing and doing up buttons or unscrewing jars 
  • experiencing a loss of balance when walking. 

Thankfully these are rare but if you feel you are experiencing a combination of these, you should contact to your GP (or spinal clinician if you have already been seen in the spinal service). If the symptoms are severe or progressing rapidly you should seek urgent medical advice and attend ED.

There are other rare but serious causes of neck and arm pain and you need to seek medical advice if: 

  • you feel generally unwell and suffer symptoms such as fever, night sweats or unexplained weight loss
  • you experience pain at night, possibly worse than during the day that prevents you from sleeping due to increasing pain and/or difficulty lying flat. 

If any of these symptoms occur, you should contact your GP. 

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Additional resources

Managing Pain

Versus Arthritis guide to neck pain  https://www.versusarthritis.org/about-arthritis/conditions/neck-pain/ 

Chartered Society of Physiotherapy guide to neck pain https://www.csp.org.uk/conditions/neck-pain 

Pain explanation 

Below are links to different online resources looking at explaining pain and our thoughts 

and beliefs around pain and back pain specifically. 

  • ‘Understanding pain in less than 5 minutes’ – Online video looking at the complexity of pain and the brain. 

www.youtube.com/watch?v=C_3phB93rvI 

  • ‘Why things hurt’ – Online explain pain video from Lorimer Mosley www.youtube.com/watch?v=gwd-wLdIHjs  
  • Tame the Beast – Website with information on persistent pain. www.tamethebeast.org/  
  • Pain Tool Kit – Website created by a patient to help manage persistent pain providing education and knowledge on how to improve self-management. www.paintoolkit.org   
  • Pain-ed – Website providing patient and clinician information regarding pain and specifically back pain and Cognitive Functional Therapy www.pain-ed.com  

How to make changes 

Below are links to online resources providing evidenced based advice on the how we should be managing neck pain and keep moving. 

  • Exercises and advice if you spend time sedentary – not just for desk workers. 

https://www.poole.nhs.uk/pdf/Sit%20at%20Desk%20CSP.pdf 

  • Information about back pain and simple exercises that might help (Chartered Society of Physiotherapy) 

http://www.csp.org.uk/publications/back-pain-exercises    

Abdominal breathing, relaxation and sleep 

Stress and tension are common with persistent pain. For some it may be part of the underlying cause for many it’s a consequence as pain itself causes more stress and anxiety. What we know is that if we can use tools to help reduce our muscle tension and stress this can help with pain, sleep and function. Below are links you may find useful 

Local Services 

LiveWell Dorset – Weight management, stop smoking, exercise advice, lifestyle change www.livewelldorset.co.uk  0800 8401628/ 01305 233105 

Steps to wellbeing – for help with feelings of anxiety, depression, bereavement and trauma/PTSD www.steps2wellbeing.co.uk   

Welcome to the moodzone – for help with selfmanagement of stress, anxiety and depression www.nhs.uk/Conditions/stress-anxiety-depression  

Dorset Community Pain Service website – http://dorsetpain.org.uk 

Understanding persistent pain – Booklet on persistent pain www.knowpain.co.uk/wp-content/uploads/2018/11/TazzyPersistentPainBooklet.pdf this booklet is commonly used by the Dorset Service 

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