Chronic PainNeck and Shoulder

Chronic Neck Pain – Causes and Treatments

Next to lower back pain, chronic neck pain is a bothersome condition which may be accompanied by equally distressing symptoms.

Causes of Chronic Neck Pain

There are many causes of neck pain. The most common cause of chronic neck pain, stress may develop on the neck when a patient sits at a desk job – such as writing or typing away on a computer – for a prolonged period of time with the head immobile or with minimal support. Chronic neck muscle pain may also occur as a result of muscle spasms with sudden jerky movements of the neck or in whiplash injuries.

NECK ANATOMY

Other causes of chronic neck pain include the following…

  1. Herniated disc = with the neck pain radiating to the shoulder, arm and hand
  2. Cervical foraminal stenosis = a slow-developing neck pain (usually taking a period of years), it usually manifests during or after certain activities like twisting or bending the neck forward or backward
  3. Cervical spinal stenosis with myelopathy = neck pain is accompanied by lack of coordination in the arms. It is characterized by shooting pains that start in the neck and radiates to the arm.
  4. Cervical disc degeneration = persistent low intensity neck pain that may suddenly flare up or worsen with performance of certain movements or activities. Character of pain is similar to that of cervical spinal stenosis with myelopathy.
  5. Osteoarthritis and facet joint cartilage degeneration = characterized by neck pain that is worse in the morning and at the end of the day. Pain is not observed in the middle of the day, with neck movement, or during warm, sunny days.
Cervical spine with both vertebral arteries in transverse foramen and the emerging spinal nerves

Chronic neck pain is commonly described as a dull ache which worsens with movement. Other descriptions for the pain include sharp and shooting, numbness or tingling, tenderness or tightness. Symptoms that accompany chronic neck pain are pulsations, difficulty in swallowing, dizziness or lightheadedness, swishing noises in the head and ears, and glandular swelling.

Treatment of Chronic Neck Pain

Chronic neck pain relief would require determination of the cause. Acute neck pain would benefit from bed rest and ice and hot compresses. A collar or brace may be needed to provide neck support. Topical preparations such as mentholated rubs, capsaicin creams, and anesthetic pain patches and creams have also been effective in relieving pain. In cases of muscle spasms, a patient may be prescribed analgesics and muscle relaxants. Patients with persistent pain may benefit from traction or local steroid and anesthetic injections.

Exercises for Chronic Neck Pain

Doctors and physical therapists alike have long debated on the effectiveness of exercise in treating neck pain. Recent studies have shown, however, that chronic neck pain exercises can reduce pain by strengthening and improving the flexibility of the trapezius, the large triangular-shaped muscle that stretches from the back of the head descending to the neck and upper back.

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There are five strengthening exercises that specifically target chronic neck pain that have been developed by the National Research Centre for the Working Environment (or RAMIN) in Denmark.

1. Dumbbell Shrug

  • Stand upright with hand weights at the sides of the body.
  • Lift the shoulders up toward the ears and lower them again slowly. This should be performed in a smooth, even – not jerky – motion.
  • While performing this move, keep the jaw and neck relaxed.
  • Beginners should start at 8 kg weights moving up to 12 kg.

2. One-Arm Row/One-Arm Pull

  • Stand with the left knee on the bench at the same time laying and leaning on the left hand on the front of the bench.
  • With the free right hand, lift the hand weight to the lower chest until it touches the chest and then slowly lower it. Keep the motions slow and controlled.
  • After 12 repetitions, do the same with the right side.
  • Beginners should start at 6 kg weights moving up to 10 kg.

3. Upright Row

  • Standing upright, stretch the arms forward with the hand weights in front of the body.
  • Lift the weights in a straight line, keeping them close to the body as possible until the middle of the chest is reached. The elbows should be pointing up and out.
  • Throughout the exercise, the position of the hand weights should be lower than the elbows.
  • Beginners should start at 2 kg weights moving up to 5 kg.

4. Reverse Fly

  • Lie down on a bench at a 45 degree forward bent angle. Hand weights should be hanging down towards the floor.
  • Lift the weights outward and upward until they reach a horizontal position and then slowly them in one smooth, controlled motion.
  • Throughout the exercise, the elbows should slightly bent at approximately 5 degrees or less.
  • Beginners should start at 1 kg weights moving up to 3 kg.

5. Shoulder Abduction

  • Stand upright with the hand weights hanging down at the sides of the body.
  • Lift the weights outward and upward until a horizontal position is achieved and then lower the weights in one smooth controlled motion.
  • Same as in reverse fly, the elbows should be slightly bent at approximately 5 degrees or less.

For optimum pain relief, the exercises should be performed three times a week (preferably Mondays, Wednesdays and Fridays), alternating between exercises 1, 2 and 5 on the first day, exercises 1, 3 and 4 on the second day, and repeating 1, 2 and 5 again on the third day.

Although starting weights are given for each exercise, it is an important rule to increase the weight as soon as the patient can comfortably perform all three sets of exercises. Usually, doubling of the weight is achieved after 10 weeks or regular exercise. After 4 weeks, a patient can reduce the number of repetitions in order to accommodate the increases in the weights.

An individual need not suffer from chronic neck pain, considering the many treatments and exercises that could help relieve it.

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