SILVER LINING Neck pain might be complex, but recovery can be surprisingly simple.
When was the last time someone told you that you were being a pain in the neck? I reckon my mum may have told me to stop being a pain in the neck in about 1990. It’s not that I stopped; I just went away to boarding school and kind of forgot to go home. Now on the very odd occasion that she’s annoyed with her golden child, she uses terms that are less suited to The Mayo News. Is it just me, or is nobody a pain in the neck anymore?
The analogy may have disappeared but the problem has not. Research suggests that at any one point in time, 5 percent of the population have neck pain, with somewhere between 30 and 50 percent of people having an episode each year.
The Global Burden of Disease Study of 2010 found that neck pain ranked fourth out of 291 conditions for disability in terms of days lost. The prevalence is higher in high-income countries and in city dwellers compared to those living in rural areas and, sorry ladies, but women tend to be more affected than men.
Neck pain is a complex issue with no single cause and no defined set of symptoms, so the following is a guideline only; if you have symptoms, you should consult a chartered physiotherapist or your GP.
A perfect example is the tension that people experience in their neck when stressed. Poor posture is often cited as a cause of neck pain, although that has never been truly backed up by research. However, given that stress is often work-related, it could be that being stuck in one position for hours makes the neck feel stiffer than normal. It is more likely that the sustained posture feeds the problem, than stress itself. Stress also lowers your tolerance to irritants, so there may be no physical injury, but you feel it more.
Whiplash is another common cause of neck pain and one that is further proof of the complex nature of pain. We usually hear of whiplash injuries after car accidents, but they can also happen with falls or playing sport.
The prognosis for someone with a whiplash injury is affected by numerous factors, including whether they had any pre-existing conditions, their socio-economic status, their age and whether the injury has resulted in legal proceedings. Most whiplash patients show little beyond normal age-related changes on X-ray or MRI, yet the average insurance pay out for a whiplash related injury in 2018 was €20,000.
Are there any simple types of neck pain then? Well, sort of.
Remember the old ‘crick’ in the neck? Usually there’s a clicking sensation followed by pain and increasing stiffness in the neck that could last for anything from a few days to a few weeks. It’s not clear what triggers an episode like this; given that it often happens early in the morning, a lot of people equate the issue with sleeping position, but again that hasn’t ever been borne out in research. While the pain of a cricked neck can be severe, it’s not necessarily a sign of significant injury and usually settles quite quickly.
So, if three of the most common types of neck pain are complex in their nature, surely they need high-tech complex treatments? No. As for most injuries, the best treatment for neck pain is actually a combination of education and encouragement to keep moving as much as possible.
The education aspect is key. Most acute neck pain, regardless of how severe it is at onset, will settle within about six weeks. It’s also important to note that pain doesn’t necessarily equate to physical damage, as evidenced by the MRI findings of whiplash patients. It follows then that if the pain is probably going to improve relatively quickly, and isn’t a sign of physical damage, trying to keep moving is crucial – use it or lose it.
Most incidences of neck pain don’t require any further investigation, but the presence of referred pain or neurological signs like pins and needles might warrant X-ray or MRI. If you have such symptoms, you should consult your GP and a chartered physiotherapist for a treatment plan.
Andrew O’Brien is a chartered physiotherapist and the owner of Wannarun Physiotherapy and Running Clinic at Westport Leisure Park. He can be contacted on 083 1593200 or at www.wannarun.ie.