Neck
pain is a common complaint in healthcare offices. Whereas 8/10 people will experience low back
pain throughout their life, up to 70% of people will experience neck pain. Thankfully, only 1/10 neck pain sufferers
report that it is serious enough to limit their ability to work or enjoy other
daily activities. However, like low back
pain, neck pain will commonly recur. In
fact, between 50% to 85% of people will experience neck pain again within 1-5
years of the initial episode and how quickly symptoms improve is variable with
each episode.
Due
to the global impact of musculo-skeletal complaints, The United Nations and
World Health Organization had an initiative from 2000-2010 titled "The
Bone and Joint Decade". A component
of this was a Neck Pain Task Force that screened an enormous amount of research,
nearly 32,000 citations, on its way to including 552 papers in a summary of
best evidence with respect to neck pain.
As stated by the Task Force, "...the most productive use of this
review is to inform and empower the public - more specifically people with neck
pain or who are at risk of developing neck pain. The most valuable outcome and contribution will be a change of attitudes and
beliefs about neck pain and its prevention, diagnosis, treatment, and
management."
Starting with cause, neck pain most often comes
out of nowhere and does not involve trauma or a specific mechanism. In these cases, there are multiple factors
that can contribute to developing neck pain.
There are things you cannot change, such as being female, the genetic
make-up you inherit from your parents (i.e. if there is a family history of
neck pain), and getting older, all of which increase your risk. However, there are things that increase your
risk which are modifiable. These include
smoking, exposure to environmental tobacco, prolonged sedentary positions,
repetitive work, and work that is very precision oriented. Having degenerative changes in the neck,
which are often seen on x-ray and are not modifiable with conservative measures,
had no supporting evidence as a risk factor for neck pain. This reminds us that structural changes shown
on medical imaging, which are common with many painful conditions, need to be
interpreted carefully and not easily scape-goated as the cause of pain. As for protective factors for neck pain, physical
activity participation had a positive influence.
If
you have neck pain, how quickly you recover is also dependent on many
factors. Younger age was helpful. In contrast, poor overall health, a history
of neck pain, and poor psychological health were associated with a poorer
prognosis. With respect to the psychological
aspect, worrying or becoming angry in response to neck pain, avoiding any
activity that causes pain, and receiving only passive treatments were
associated with a slower improvement.
Optimism, being confident in your abilities, and taking an active role
in therapy, on the other hand, help you resume normal activities more quickly.
Non-surgical treatment options found to have benefit include educational videos, mobilization, manipulation, manual therapy, exercises, low-level laser therapy, and acupuncture. Manual techniques combined with exercises are superior to hands on only approaches.
As
you can see, there are many options which can be used based on appropriateness
and personal preference. Either way, due
to its recurring nature, management of neck pain should involve therapies that
are effective at managing your symptoms, empower you to take a role in
self-management, and aim for prevention.
This article is for general
information purposes only and is not to be taken as professional medical advice.
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