First and foremost neck pain is frustrating and I’m sorry you’re going through this right now. Sometimes even lifting your arm can cause you to activate a muscle in your neck that can trigger your pain. Now for the good news... you’re not alone! Anywhere between 20 -60 % of people will experience neck pain at some point in their lives and, with the right advice, the vast majority make a full recovery.
What are the main symptoms of discogenic neck pain?
This will depend on the exact location of the disc dysfunction and the severity but in general symptoms will include:
- Neck pain. Pain is typically felt toward the back or side of the neck. It can range from a mild pain to a sharp or burning pain.
- Radiating Pain. The pain can radiate down to the shoulder, arm and hands. Can often range from a mild ache to sharp shooting type pain.
- Numbness/Weakness. If the disc is irritating the nerve it may result in weakness in your shoulder, arm or hands for example reduced strength whilst making a fist.
- Worsening pain with certain head movements. For example looking over your shoulder when you check your blind spot whilst driving
- Neck stiffness.
What is a disc?
A disc has two main parts that you need to know about. The first part is like a water balloon (nucleus pulposus for us nerds) which takes most of the shock absorption and load when you are standing upright. The second part of the disc is really just a web of ligaments (like ligaments in your ankle, knee etc) that act to hold the water balloon in place known as the annulus fibrosus. So “disc” is really a ridiculous term to describe a really cool piece of anatomy. The “cervical discs” are just the discs that sit between the 7 neck (cervical) vertebrae. These cushiony discs have three main roles:
- Absorb shock that goes through the body
- Transmit load
- Allow movement between the vertebrae
How can they get injured?
Given enough forceful load, the water balloon can exert enough pressure on the ligaments to stretch and tear them. The water balloon is normally pushed towards the back of the spine when you are doing activities that involve bending the neck forward like sitting for long periods or gardening with your neck in a forward head posture. If you do this often enough or add weight to the activities the balloon can stretch the ligaments holding it in place. At the back of the disc there are bundles of nerves when these are irritated the pain or sensation can radiate out towards the shoulder, arm and hand.
What can I expect during my first Physio session?
Physiotherapy for discogenic neck pain is something we see every day. It’s our bread and butter and something that we pride ourselves on fixing here at Fixio. We’ll enquire as to the nature of how the injury came about and how long you’ve had it and what tends to irritate your disc. Next we will ask you to do certain movements so we can measure your neck range of motion and we may press gently on specific parts of your neck that will give us further information and allow us to make an accurate diagnosis.
At Fixio here we will begin treatment right away. First and foremost we need to try and get the discomfort under control. This may include simple advice regarding pain medication (in conjunction with your G.P) that you could take to reduce the pain, certain positions to avoid so as not to aggravate your back pain, the best sleeping positions. Additionally certain manual therapies like massage, spinal mobilisation, heat, ice, acupuncture can be beneficial to help settle the pain as well as gentle neck range of motion exercises.
The second part is crucial, which is regaining your range of motion of your neck, while ensuring the nerves move freely. We are constantly testing and retesting your nerve mobility each and every session and you will be doing exercises at home to ensure the disc ligaments do not adhere to the nerve. This must be done in order to prevent longstanding neck pain. Most patients who present with chronic disc pain have never been through this step.
The next stage is to progressively strengthen your neck and muscles surrounding it. This is where it’s important to realise that once you’ve had neck pain once you’re more likely to get it again. Just ask your parents or Grandparents they’ll tell you just as much. That’s why It’s important to do a individually tailored exercise program focusing on important muscles around your neck and upper back depending on your goals. For instance if you want to get back to touch football, we would need to map out a gradual strength and training program that would include a return to run program and look at side stepping whilst ensuring you can maintain your neck in a neutral position and the surrounding neck muscles are accurately firing the whole time.