Neck Pain

Ryan LaCorte Treatments

Due to considerable demands placed on the neck, it is a common site for pain and injury.  Many of have woken up with a “crick” in our neck or stiff neck, but why does this occur?  Your Cervical Spine consists of 7 cervical vertebrae and the connection to the occiput.  The primary purpose of the Cervical Spine is housing and protecting the Brain Stem and Spinal Cord.  The Spinal Cord connects the brain to the rest of the body, transmitting information to and from the extremities.  Additionally, the Cervical Spine must support the head (weighing 10 to 13 lbs.) and is responsible for allowing us to quickly look up, down, turn, side bend or retract.  Finally, openings in the vertebrae allow for the vertebral arteries to carry blood to the brain.

While motion occurs at all levels of the cervical spine, the greatest motion occurs between the occiput and top cervical vertabra (C1 or Atlas) and between the first and second vertebrae (C1 or Atlas and C2 or Axis.)  Approximately 50% of the cervical flexion and extension (looking up and down) occurs between the occiput and C1.  Additionally, 50% of cervical rotation (turning side to side) occurs between C1 and C2.  The 3rd to 7th vertebrae (C3-C7) work together to produce the additional 50% or cervical flexion and extension as well as rotation.

All cervical vertebrae contact the segment above and below through a pair of facet joints, or Zagopophyseal Joints, on the left and right side of the Spinal Cord.  Additionally a disc will separate each vertebral body to allow for cushioning and shock absorption.   Finally there are dozens of muscles running throughout the cervical spine controlling motion and stabilizing the head.

Arthritis of the Neck

Arthritic conditions of the neck can be a result of many different mechanisms, including but not limited to, Degenerative Disc Disease(DDD,) Bone Spurring, Systemic Conditions or prior injury.  Arthritic Conditions of the spine will limit cervical motion with greatest pain reported with cervical extension (looking up) or side bending to the involved side.  Most patients report greatest symptoms when first getting out of bed.  Fortunately, Arthritic conditions of the neck are commonly treated conservatively.  As with most arthritic conditions, the primary focus is to restore joint health through gentle range of motion activities.   Additionally, your therapist may employ manual techniques to restore motion and reduce muscle spasm as well as employ modalities to control pain levels.  Your physical therapist will perform a thorough evaluation to assess your condition and devise a treatment plan to best address your symptoms.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

***For more information on Arthritis and Treatments interventions, please see the Arthritis section above

Herniated or Bulging Discs

As described above, the 7 vertebrae of the neck are separated by discs. The discs of the cervical spine tend to be very pliable, allowing for motion between vertebral segments and acting as a shock absorber.  A disc is comprised of 2 parts; the Annulus Fibrosis and the Nucleus Pulposus.  The Annulus Fibrosis is the outer portion of the disc.  It is comprised primarily of collagen fibers and creates a tough circular exterior of the disc.  The Nucleus Pulposus is the inner portion of the disc.  It is loose network of fibers contained in a gel like substance.  At birth, the disc is comprised of 80% water, however this reduces throughout your life time due to loading of the disc.  In a bulging or herniated disc, the Nucleus Pulposus (Central Portion of the Disc) begins to press into the Annulus Fibrosis causing the disc to bulge, crack or tear.  As this injury occurs, the body responds through an inflammatory process in hopes to help the disc heal.  Unfortunately this greater irritates the situation and can create pressure on a nerve root and possibly result in pain, numbness or tingling down the arm.  Due to the limited spacing of the cervical vertebrae, even a small herniation or bulge can create pressure on the nerve root and cause considerable discomfort.

The symptoms experienced are dependent upon the level of herniation.  For example, a herniation at the C5-C6 level can result in weakness of the biceps as well as tingling or numbness down the arm to the thumb side of the hand.  While a herniation at the C6-C7 level will commonly result in weakness of the muscles that straighten the fingers and the triceps (muscle that straightens the elbow) as well as pain, numbness and tingling down the back of the arm to the middle finger.   Many herniated or bulging discs can be treated conservatively through physical therapy.  Your physical therapist will perform a thorough evaluation to assess whether or not your condition is appropriate for non-invasive measures and devise a treatment plan to best combat your symptoms.    With the implementation of state of the art modalities and equipment along with manual interventions, your therapist will work to centralize the herniation or bulge and reduce your symptoms.  Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

Whiplash

Whiplash is a neck injury following a rapid forward/backward motion of the neck.  It most commonly occurs following a motor vehicle accident when one is struck from behind, however, this is not the only mechanism for whiplash.  The injury can also be a result of falls, sports injury or abuse.  With whiplash, the forceful forward motion of the head will cause trauma to the muscles supporting the neck.  The sub-occipital muscles (small muscles at the top of the neck controlling head motion) are usually injured due to the nature of the injury.  The most common symptoms of whiplash include neck pain, stiffness and headaches.  Most cases of whiplash are treated conservatively with gentle stretching, soft tissue mobilization and the use of modalities to control muscle spasm and reduce pain levels.   Whiplash injuries can result in a loss of the natural curvature of the cervical spine (lordosis.)  This will result in a forward posture of the neck.  With the implementation of state of the art modalities and equipment along with manual interventions, your therapist will work to restore the natural curvature of the spine as well as regain ROM and postural stability while reducing pain levels.  Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

Torticollis

There are two common types of Torticollis; Congenital Muscular Torticollis and Cervical Dystonia.  Both involve a tilting of the head in one direction as well as limited cervical range of motion.

o   Congenital Muscular Torticollis is commonly seen in new born children due to the baby’s positioning while in the womb, abnormal development of the muscles of the neck and/or trauma that occurs during birth.  However, some cases of Congenital Muscular Torticollis can be linked to other underlying conditions including dwarfism, congenital skeletal abnormalities or other congenital abnormalities.  Fortunately, most cases of Congenital Muscular Torticollis can be treated conservative through gentle stretching, positioning  and the possible use of a “TOT Collar,”  a device designed to your child keep their head up and reduce head tilting.  Your physical therapist will assess your child’s needs through a thorough evaluation and develop a treatment plan to correct postural abnormalities.  All of our facilities are equipped with state of the art modalities and equipment to meet your child’s needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities.

Cervical Dystonia, also known a Spasmodic Torticollis, involves neck muscles involuntarily contracting resulting in abnormal movement patterns and posturing of the neck.  The muscle contractions can either be constant, intermittent or a combination of the two, resulting in considerable pain and postural abnormalities.  Cervical Dystonia can be congenital or a result of cervical trauma.  Treatment of Cervical Dystonia can range from Botox injections, Selective Denervation Surgery, Deep Brain Stimulation and/or Physical Therapy.  Your physical therapist will assess your spasmodic muscles and design a treatment plan including gentle stretching, the use of modalities as well as manual interventions to improve your range of motion, improve postural stability and reduce pain levels.    All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

***For more information, please see the article “Torticollis: What is it and How Do You Treat It?” written by Allison Elbeblawy in our publications.

Degenerative Disc Disease

A common cause of neck pain is Degenerative Disc Disease.  As stated earlier, at birth the discs are comprised of approximately 80% water.  Through wear and tear as well as a life time of loading and compression on the discs, this percentage drops as we age.  The discs will have a tendency to become more fibrotic and less pliable over time.  While we are unable to “pump” the discs back up, through Physical Therapy we are able to help the body adapt to the structural changes that have occurred over time.  Through postural training including stabilization exercises as well as ensuring muscle and joint flexibility, we are able to help restore prior levels of function while controlling pain.  Your physical therapist will perform a thorough evaluation to devise a treatment plan to best address your symptoms.  All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

Cervical Spine Stenosis

As Degenerative Disc Disease sets in, there will be less spacing between vertebrae creating a smaller space for nerve roots to exit the spinal canal resulting in Spinal Stenosis.  Most commonly, spinal stenosis refers to the narrowing of the intervertebral foramina (space where nerve root exits the spine.)  However, some cases of spinal stenosis can create a narrowing of the central canal surrounding the spinal cord.  This will generally be referred to as central canal stenosis.  This can be secondary to congenital defects (ankylosing spondylitis) or thickening of spinal ligaments encroaching upon the spinal cord.  Through physical therapy, we can help to restore proper postural alignment through stabilization exercises as well as free up any restrictions related to limited flexibility or joint motion.  Your physical therapist will perform a thorough evaluation to assess your condition and devise a treatment plan to best address your symptoms.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

Cervicogenic Headaches

While there are many different causes of headaches, neck injury can frequently result in what is termed a cervicogenic headache.  A cervicogenic headache is a referred pain from the soft tissue and/or bony structures of the cervical spine.  Irritated or inflamed nerves or muscles in the neck can refer pain to the head.  Postural issues can lead to cervicogenic headaches as well due to the strains placed on the muscles in the face and neck.  Additionally, as we encounter stressful situations, we have a tendency to tense up the muscles of the shoulders, neck and face.  This can create referred pain to the head as well.  Your physical therapist will perform a thorough evaluation to assess your condition and devise a treatment plan to best address your symptoms.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

***For more information, please see the article “Where’s My Headache Coming From?” written by Craig Michael’s in our publications.

Thoracic Outlet Syndrome

Thoracic Outlet Syndrome is term used to describe entrapment of the nerves and blood vessels as they pass through the muscles of the front of your neck and proceed under the clavicle or collar bone.  Due to the nature of the injury and structures involved, symptoms can vary from case to case.  Patients will generally report numbness or tingling in the arms or fingers, neck, shoulder or arm pain, grip weakness and possible muscle atrophy in the thumb.  Cases involving entrapment of the blood vessels will also present with discoloration in the hand or fingers, weakened pulse, and/or throbbing along the clavicle.  While there are many causes of thoracic outlet syndrome, injury is frequently reported following a car accident (due to compression of the clavicle by the seat belt,) repetitive overhead activity, postural issues, congenital abnormalities (Cervical Rib,) or possibly pregnancy.  Most cases of thoracic outlet syndrome can be treated conservatively through physical therapy.  Your therapists will identify the mechanism of the nerve entrapment and isolate the underlying causes. They will perform a thorough evaluation to assess your condition and devise a treatment plan to best address your symptoms and alleviate the cause.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

Cervical Strains and Sprains

Acute neck pain is frequently accompanies muscle strain or sprain of supporting structures of the lumbar spine.  Twisting, bending and lifting can frequently over burden the muscles and support structures of the neck and create tissue damage.  Through physical therapy, we are able to reduce acute neck pain through soft tissue mobilization, stretching and joint mobilization techniques along with the modalities and topical analgesics.  These interventions can expedite recovery and return you to your prior level of activity.  Your physical therapist will perform a thorough evaluation to assess your condition and devise a treatment plan to best address your symptoms.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

Post-Surgical Care

Some conditions involving the neck are appropriate for surgical intervention.  Whether you underwent a Fusion, Laminectomy, Disc Replacement, Spacer, Discectomy or minimally invasive or micro procedure, your therapist will work hand and hand with your surgeon to expedite recovery and reduce pain levels.  Effective post-operative care following neck surgery is essential to maximize surgical results.  Your therapist will help the body to heal as well as prevent future injury from occurring.  Your physical therapist will perform a thorough evaluation to assess your condition and devise a treatment plan to best address your symptoms based upon the surgeon’s post-operative orders.   All of our facilities are equipped with state of the art modalities and equipment to meet your needs.   Please visit our Toms River, Whiting, Manchester, Brick, Forked River, Freehold, Jackson, or Barnegat facilities and allow us to “give you your life back.”

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