Non-specific Neck Pain

• Non-specific Neck Pain - Pathology/Anatomy:

  • Diagnosis often attributed to neck pain of postural and mechanical origin - where no specific pathology can explain the pain
  • 2/3 of people thought to be affected during lifetime
  • Risk factors include: job demand ergonomics, low levels activity, duration of sitting e.g. office
  • History: Commonly insidious
• Non-specific Neck Pain - Pathology/Anatomy:

  • Subjective Features: neck pain going into shoulders/arms, related to movement, postures or activities
  • Objective findings: restricted ROM, tenderness on palpation, muscle spasm, asymmetry
  • Key impairments: pain and/or limited ROM
  • Investigations: Not routinely required
• Non-specific Neck Pain - Management:

  • acute (6 weeks) and sub-acute (6 - 12 weeks) phases: Advice and education: reassurance (should resolve in a few weeks), pacing
  • prognosis: generally good recovery within 2 months, but low level symptoms can reoccur for over a year, and can become chronic, postural advice
  • Symptom control: pain management/analgesia, heat, onward referral if symptoms are not improving, ergonomic assessment
  • Build capacity: restore movement of cervical spine, strengthen cervical spine flexors and extensors as per assessment
• Non-specific Neck Pain - Management:

  • if high SIN, treat pts in easing positions, if low SIN, can go into more provocative positions, to go through full ROM
  • problems with sleep - look at sleeping positions
  • Return to function: specific to patient goals, consider work and graded return, encourage a quick return