Do you get a sore neck sat at your computer?
Do you wake up with a stiff neck?
Do you get headaches when your neck hurts?
Fix Physio can help!
A sore neck can really get you down and be quite distracting- amongst other symptoms it can contribute to a restriction in your neck movement, headaches, visual problems, jaw pain and arm symptoms. At Fix Physio just off Martin Place, in Sydney’s CBD, we’ve seen the disc bulges, dealt with the wry necks, managed the whiplash injuries and completed the spinal surgery post op rehab.
The science part….The Cervical spine or the neck as it is more commonly known is comprised of 7 bony vertebrae aptly named Cervical 1 (C1) to Cervical 7 (C7).
Cervical Facet joints
Each Cervical vertebrae articulates with the vertebrae above and below by a left and right sided facet joint. These facet joints are covered with a thin layer of cartilage. Due to day to day stresses, poor postures, repetitive movements or trauma, these joints commonly suffer from wear and tear or Osteoarthritis (OA) as it is medically known which can cause symptoms of pain and restricted movement.
The Cervical vertebrae are separated by jelly like structures called intervertebral discs. These discs act as shock absorbers and allow the vertebrae to move segmentally rather than just as one block. Unfortunately discs are prone to injury and typically dehydrate (disc dessication) as we age therefore providing less shock absorbance and cushioning.
Furthermore, discs can suffer from bulging (layman term is a “slipped disc”), protrusions and extrusions which typically result in the patient being in significant pain and having a reduction in neck movement. Bulging discs can also lead to nerve impingement or a ‘trapped nerve” as they are commonly called- see below
Trapped Cervical nerve injury
When a Cervical nerve root impingement occurs, a person may experience symptoms of pain, tightness in their neck and pins & needles or numbness anywhere along the length of their arm. Symptoms can be present at any section of this nerves pathway and occasionally in severe cases the whole length of the nerve from the neck to the hand is affected.
Cervical nerve root impingement is experienced if the nerve root is compressed near its exit from the neck. This typically occurs if there is a bulging disc, irritation of the facet joint or muscle spasm. The aim of physiotherapy treatment is to normalise whatever structure is compressing the sciatic nerve to alleviate this pressure through manual and exercise therapy.Typical muscle weakness of the Cervical spine Everybody has two different types of muscles in their body: a. Movement muscles b. Stability muscles
a. Movement muscles
Movement muscles are more superficial in the body, they switch on when they are needed and switch off when they are not needed. They are fast twitch in nature and as such are designed for more explosive types of movements. In the neck the SternoCleido Mastoid (SCM), upper trapezius, Levator scapulae and the Scalenes are types of movement muscles.
b. Stability muscles
Stability muscles sit deep inside the body close to the joint that they stabilise. They should be working constantly with our breathing and they are slow twitch in nature therefore work to maintain our posture.Around the Cervical spine, the major stabilising muscle of the neck are the Deep Neck Flexors (DNF).
When an injury of any type occurs in the neck, it is the deep neck flexor muscles which are inhibited by pain and therefore switch off. When these stabilisers switch off, the brain automatically goes to the fast twitch movement muscles to try and stabilise the spine. Unfortunately, these movement muscles are not designed for posture or endurance and so fatigue pretty quickly trying to do this job. Muscle spasm of these movement muscles ensues and so the cycle of pain continues.
The final factor to mention is that once stability muscles have been inhibited by pain they stay at this level of weakness unless they are retrained even after the injury has resolved. This explains why people often get recurrent neck if they do not strengthen the neck stabilisers sufficiently.