Should I go see a Physical Therapist for my neck pain?
Should I go see a Physical therapist for my neck pain?
The answer again is YES! In fact a Physical Therapist should and can be your first and last stop for diagnosis and treatment of neck pain. For people dealing with neck pain for the first time, it can come on suddenly or even gradually. As well, the pain can be either mild or severe. Excluding times when your pain is so severe that you can’t move your head at all related to a traumatic incident or if you are presenting with major weakness on either arm in combination with instability and balance issues you can get an evaluation by a Physical Therapist.
The first step is the diagnosis of the neck pain, which your therapist should take you through a full physical exam. The purpose of this initial Physical Therapy examination is to see what if anything at all will increase or decrease your pain. If your Physical Therapist can reproduce or decrease your neck or arm symptoms with movement testing in the initial exam then they will be able to tailor your treatment to decrease the symptoms. In addition to getting you a specific exercise program, the ability to reproduce symptoms with movement testing will provide your Physical Therapist with clinical evidence to suggest this injury is within the Physical Therapy scope of care and can be effectively treated at the Physical therapist’s clinic.
The second step is started once your initial exam is complete and this phase is the actual treatment of your neck pain and/or arm pain that is caused by your neck injury. This should start on the first day and can vary from as little as 1-2 sessions or as long as a 8-12 sessions. Every patient presents differently in regards to levels of pain and those specific patients with high levels of pain can take a few weeks to reduce symptoms. The main aspect of treatment should be focused on educating the patient on what specific movement activity will centralize upper extremity/neck symptoms and reduce pain. These exercises and positions will be determined on the first visit and you should progress at each visit based on how you present.
There are some misconceptions out there about the type of stretches and positions that will help decrease neck pain. Many patients believe that doing a side bending neck stretch or pulling your head forward and down is the correct way to stretch and decrease neck/arm symptoms. Think of the cervical discs in your neck between each bone vertebra as a moveable substance that when you bend backward (look up the sky or make a double chin) you are actually pushing that bulging disc back into place and taking pressure off of the nerve root being compressed. When this exercise activity is preformed the patient should see their symptoms move closer to the middle of the neck and eventually decrease in intensity/frequency.
Below are a few examples of few simple neck extension exercises that you could do to reduce pain and centralize your symptoms. It is important to note to never continue these exercises if your radicular symptoms (arm symptoms) get worse in anyway. It is okay to continue if you see a presentation of more central (closer to the midline or spine) pain. Those central symptoms may increase at first but should subside after a few days.
In conclusion, if you and your therapist are unable to centralize and reduce your pain to a level that is manageable with conservative treatment after a few weeks than a visit to a pain management medical doctor may be the next step in order to get further evaluation and diagnostic testing.
by Frank Ruggiero DPT