WHAT IS IT? POSTURAL NECK PAIN

Postural neck pain is pain which is caused due to poor posture. This pain can come on after prolonged periods of poorly adopted posture. This puts stress on the surrounding structures supporting your head. Postural neck pain can radiate down the back and also into the arm.

Consult your Doctor

If you experience any of the following symptoms then please contact your doctor or GP:

  • Persistent, unexplained dizziness, nausea, and vomiting

  • Severe headaches

  • Feel feverish or generally unwell

  • Unexplained weight loss

  • Double-vision.

  • Any violent trauma- e.g. fall from height/ road traffic accident

  • Have a history of Cancer

  • Problems with swallowing or speech

Signs & Symptoms

  • Neck ache which may extend to the shoulders and shoulder blades

  • Stiffness of neck movements

  • Headaches

  • Pain has gradual onset, worsening throughout day

  • Aggravated by sitting, prolonged postures, repetitive work duties

  • Eased with heat, movement, and pain medication

What Causes It?

  • Pain can be attributed to abnormal positioning of the body in conjunction with poor ergonomics- sitting at a desk with the incorrect workstation set-up.

  • Weak deep neck flexor, lower trapezius and other relevant muscles

  • Increased lordosis of neck (chin poking position)

  • Forward head posture

  • Protracted or rounded shoulders

  • Unsupportive seating

  • Incorrect work-station set up (computer, chair, table)

  • Activities involving sustained postures

  • Repetitive activities

  • Increased neural tension

  • Tight muscles

  • Hypomobile vertebrae and joints

How to Self Manage

  • Heat- hot water bottles/ heat packs around the neck to help relax muscles.

  • Ice (no direct ice to skin) can be used to treat severe pain ad swelling.

  • Gentle neck stretches and movements in all directions, but not to extremes.

  • Gentle chin tucks- keeping the head level and tucking the chin backwards- holding this for 5-10 seconds and repeating 5 times regularly throughout day.

  • Muscle relaxants with ease muscle spasm.

  • Use a pillow or 2 to bridge the gap between the head and shoulders if sleeping on your side- or a small pillow if sleeping on your back.

  • Refrain from using a neck collar.

  • Do not drive if you are severely restricted in moving your head or neck.

  • Try to be aware of your posture when pain comes on, to identify contributing factors.

  • Reduce the time spent in one position or duty.

  • Organise occupational health to do a work station assessment.

  • Seek postural assessment and exercises to address contributing factors.

Prognosis

  • Most symptoms can be improved with conservative management (physiotherapy).

  • It is likely that if posture is not addressed, or aggravating activities modified, then pain will be on going.

  • Education and awareness are vital for self-correction.  Pilates is an ideal method of improving stability and correcting posture.

How Physio Helps

  • Joint mobilisation

  • Massage and trigger point release

  • Acupuncture or dry needling

  • Taping

  • Ergonomic assessment

  • Pilates education

  • Deep cervical flexor muscle retraining

  • Posture assessment and education (cervical and thoracic spine, scapular position)

  • Stretches (neck, pec muscles)

References

  • Kjaer, P. et al (2017) National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy. European Spine Journal. Springer. www.ncbi.nlm.nih.gov/pubmed/28523381

  • Williams,N.H. and Hoving,J.L. (2004) Oxford textbook of primary medical care. In: Jones,R., Britten,N., Culpepper,L., Gass,D., Grol,R., Mant,D., Silagy,C. (Eds.) Neck pain.Oxford: Oxford University Press., 1111-1116.

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