Neck conditions
Common Diagnoses
Postural Strain
Often the result of poor spine alignment. Often this is cause by the head coming forward and increasing the load on the head, neck, and shoulders. Physical therapy improves this condition through education, corrective exercise, and ergonomic adjustments.
Stenosis
The narrowing of canals and spaces of the spine where the nerves exit the spinal cord. Typical presentation involves difficulty bending backward and relief of pain when bending forward. Therapy provides manual traction, instructive self traction techniques, and supports development of a stronger neck to help support the head and cervical spine.
Disc Herniation/Bulging
Occur when the intervertebral disc moves out of its position and puts pressure on other structures in the neck. A bulge is typically minor and symptoms tend to be minor. A herniation can be more significant and can lead to neurovascular compression causing weakness in specific muscles down shoulders or arms. Herniation can also lead to altered sensation in specific areas of your neck shoulders and hands. Depending on the severity of the herniation, patients may experience some, both, or neither of these symptoms. Typical presentation involves neck pain with referral down into the arms. A slouching forward head position or prolonged sitting tend to aggravate this discomfort. Bending backward may eliminate symptoms but it can also aggravate depending on how severe the herniation is. Therapy will create a stronger, more stable neck and improve the positioning of the disc through corrective exercise and activity modification.
Facet Dysfunction
Pain emanating from the facet joints, this may also be called “facet syndrome.” The facet joints can become irritated and inflamed and may cause pain soreness and stiffness that is reproduced with a certain movement. Patients often report increased pain with extension or prolonged periods of inactivity like sitting or standing too long. Changing positions often improves pain.
Cervicogenic Headaches
These are headaches that are the result of dysfunction going on the neck. Usually the upper cervical spine is in a state not moving well and this is causing a referred headache up. Trigger points in the muscles of the neck can also refer pain up into the head as well. Physical therapy can be used to eliminate trigger points improve postural alignment and restore mechanics of the upper cervical spine.
Cervical Radiculopathy
A pinched or irritated nerve in the neck causing pain, numbness, or weakness radiating into the chest or arm. May also be associated with stenosis or disc bulge/herniation. Physical therapy minimizes pressure on the area and supports education in self care and corrective exercise to help support the irritated region.
Post Surgical
Laminectomy
Typically performed on patients suffering from significant stenosis (see above), laminectomy involves removal of the lamina from the vertebrae. This reduces compression of nerves in the spine, and often results in excellent prognosis for symptom resolution and a return to prior level of activity. It’s important to note that laminectomy result in a decrease of protection in the region where the surgery was performed (frequently the lumbar spine).
Discectomy
Part of the intervertebral disc is removed to eliminate pressure on a nerve as it leaves the spinal canal. Typically, a discectomy is performed when conservative treatment has been ineffective at reducing nerve compression. Recovery time varies depending on the duration of time that the nerve was compressed and the overall health of the client prior to surgery. Physical therapy will stabilize the surgical area, increase safety with movement and transfers. The goal being to support the gradual progression of range of motion, strength, and flexibility of the soft tissue muscles and nerve mobility.
Fusion
Typically performed when all other treatments have been unsuccessful and the patient’s function is significantly limited. The area of pain is fused to the joints surrounding it to create more inert stability. This can be helpful in the short term and can reduce pain, but it is imperative that patients receive support in performing tasks differently to reduce strain going through the surgical site. Failing this, the area above or below the fusion site may break down leading to potential future surgery. Physical therapy strengthens and stabilizes movement while educating new patterns of movement to reduce the risk of future fusions.
Disclosure: the information presented here does not substitute a thorough medical examination. It is for information purposes only. If you have any questions about the information presented above, please contact us and we can schedule a time to talk about any of the conditions listed above in more detail.