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Neck and Shoulder Region Pain

Lifespan Osteopathy Essendon / Neck Pain  / Neck and Shoulder Region Pain

Neck and Shoulder Region Pain

We’ve all been there.

 

Neck pain.  

 

It’s literally a pain in the neck.  

 

It can start in a number of ways.  

 

Some people go to bed fine one night and wake up the next morning unable to turn their head.  Sometimes it’s only mild and seems to settle by itself within a few days, and other times the pain persists for longer than you’d like.  

 

For others, the onset may be more insidious.  Maybe it’s related to stress and tension? Maybe you know your posture isn’t quite up to scratch, and you’ve been meaning to ‘do something about it’.  

 

The most memorable time I’ve suffered from neck pain was only recently, after letting my inner ‘big kid’ come out while on holiday in Thailand.  

 

There was a ‘Wipeout’-style obstacle course in the pool, which I proceeded to slip on and give myself a proper case of whiplash.  This was then aggravated by attempting to sleep upright on an overnight flight home.

 

As happens to many of you, the demands of work and life got in the way of prioritising a treatment when we got home, and the pain lingered.  Once I made my health a priority though, and actually booked in the required treatments, as well as carrying out proper self-management techniques, the pain quickly subsided.  

 

Odds are if you’re reading this, that you’re suffering from some type of neck or ‘shoulder’ region pain.

 

Whatever type of pain you have, or how it started, read on to find out more about the risk factors for it, as well as some things you can do to help yourself.  

 

 

10 things you need to know about neck and shoulder region pain:

 

 

 

1. Up to 85% of the population will experience it at some stage of their lives. 

 

 

This explains why it’s one of the most common conditions we see here at Lifespan.

 

Neck pain is one of the top 5 chronic pain conditions in terms of prevalence and years lost to disability (1).

 

In the majority (50-80%) of cases, there is no identifiable pathological cause, and the neck pain may be labelled as ‘non-specific’. This means that if you were to get an X Ray, CT, MRI or blood test, they would come back ‘negative’.  

 

Osteopathically, we don’t often use this label, as through examination and treatment, we can often see or feel tissues that may be responsible for at least some of your pain.  

 

 

2. In any one year, up to 1 in 5 people will experience neck pain, and this is only getting worse over time (3). 

 

 

Multiple studies have concluded over the course of any given year, around 20% of people will suffer neck pain to some extent (1,2).

 

Since 1990, there has been a significant increase in disability recorded due to neck pain (3). More people are reporting more intense, long-lasting or incapacitating neck pain now than they have in the past.  

 

Our theory is that this reflects our fast-paced way of life, an increased use of technology, and our increasingly sedentary lifestyles.  

 

 

3. There is a higher incidence in computer and office workers.

 

 

The most common reason for work absenteeism among office workers is because of pain or tenderness in the neck region, inhibiting working abilities” (8).

 

In fact, compared to people who do not work at a desk, computer workers are two to three times more likely to develop chronic neck pain (8).

 

The reasons for this likely tie in with the points touched on in point number 2.  

 

Long work hours spent seated in the same position at a desk that is often poorly set up ergonomically, performing repetitive tasks, will take their toll.  

 

Often the first area to feel the strain is the upper back or neck area.  

 

 

4. Women are slightly more at risk than men.

 

 

Unfortunately it’s true- women are slightly more likely than men to suffer neck pain. 

 

The underlying reason for this though, is that women are at a greater risk for developing many musculoskeletal pain conditions (4).  

 

There are a number of possible reasons for this. 

 

Hormonal factors appear to play a role.  This is evidenced by the fact that the prevalence of a number of common pain conditions is equal between boys and girls before puberty, however, increase dramatically in girls as puberty progresses (4).

 

Additionally, the severity of many pain conditions has been shown to vary throughout the menstrual cycle, in line with hormonal fluctuations.  

 

There have also been some very interesting studies regarding gender roles in the development and expression of pain (4).  On a social and psychological level, males have historically been known to face pain in a “masculine” way, and as such, may demonstrate an increased pain tolerance.  

 

Females on the other hand, often accept pain as a part of everyday life and are “more permissive of pain expression” (4), so are more likely to voice their pain, and indeed to do something about it.

 

All of this adds up to a situation that makes we females more likely than males to suffer from neck pain.  

 

 

5. You’re more likely to suffer from neck pain if you live in a higher-income country like Australia, and even more so if you live in a larger city like Melbourne. 

 

 

Again, there are a number of possible reasons for this, including:

 

  • A faster-paced, more hectic way of life manifesting as higher stress levels and an increased expression of pain.

 

  •  A greater access to treatment services, meaning a higher likelihood of reporting symptoms.

It may well be that people who live in smaller towns, or less developed countries actually do suffer the same rate of neck pain, but don’t report it as often because there are less opportunities to do so.  

 

There is a need for further studies into the reasons behind this.

 

 

6. Most cases of acute neck pain will self-resolve, whether you seek treatment or not.  However, around 1/3 of people will still be suffering from low-grade symptoms or recurrences one year later.  

 

 

In fact, having experienced neck pain in the past is one of the most significant risk factors for experiencing it in the future.

 

At this stage, it is not completely clear why some people will experience one episode of pain and then no more, and why others will progress to sub-acute or chronic pain, however there is a lot of research going on in the field of pain science at the moment.  

 

 

7. The more children you have, the more likely you are to suffer from neck pain (5).

 

Who hasn’t thought their kids were a pain in the neck from time to time?

Turns out they were right!

Having children has been positively linked with developing neck pain, and the more of them you have, the more likely you are to experience it.  

The likely reasons for this include:

  • Physical strain of pregnancy, breastfeeding and caring for an infant on the mother
  • Less time for self-care
  • Disrupted sleep, which can affect mood, healing capacity and general health

Risk factors in any disease are usually classified as ‘modifiable’, and ‘non-modifiable’, i.e. things that you can change, and things that you can’t. 

Typical examples of modifiable risk factors include weight and activity levels, whereas non-modifiable risk factors include things like your age and family history.  

Obviously children fall into the non-modifiable risk category- they’re not going anywhere until they’re adults (at least)!  

So, if you are prone to experiencing neck pain, awareness of this factor is key, and it is crucial that you somehow find the time to put in place the steps needed to prevent or manage your neck pain.  

 

 

8. A past history of lower back pain increases your chance of developing neck pain.

 

If you have a history of lower back pain, your are more likely to develop neck pain (5).  

There are a number of possible reasons for this.  

When your brain becomes accustomed to experiencing pain, physical changes occur in your brain.  It actually becomes ‘hard-wired’ to perceive more input about pain. Once this change happens, then occurrences that wouldn’t normally cause you pain may become painful. A slight twinge in your neck can then become a full-blown episode of neck pain.  

It has also been found that suffering upper or lower back pain increases your chance not only of developing neck pain, but also of it persisting beyond 3 months (6).  

 

 

9. The worse your physical or mental health, the more likely you are to suffer neck pain.

 

Poor physical and mental health are unfortunately like snowballs.  Once they get rolling, they tend to get bigger.  

We are learning more every day about the interplay between physical and mental health. 

In the instance of neck pain, many people would be familiar with the notion of a stressed or anxious person ‘carrying tension’ in their neck and shoulder region. This is just one example of how mental health can be linked to physical symptoms. 

There are also a number of events that occur throughout the brain and nervous system to account for the linkage between physical and mental health that we won’t go into detail about here- stay tuned for an upcoming post!

 

 

10. The best thing you can do to help your neck pain is exercise (7).

 

Strength training in particular has been shown to be effective, especially in industrial or office workers (7,8).  

 

Studies have shown that completing just one hour per week of strengthening exercises for the neck and shoulder region can go a long way towards minimising pain in this area. 

 

After this, the next best thing are treatments, such as massage, manipulation and acupuncture (1).  That’s where we come in!

 

What can Lifespan Osteopathy do for my neck and shoulder region pain?

First of all, we’re always working to deliver resources about strategies you can try from home to help manage your pain. 

If you’re an office worker with neck pain and would like to view our “Stretch at your desk” series on Instagram, click here.  

We firmly believe that education and self-management are of the utmost importance when it comes to your health.  

However, there comes a time when we all need a helping hand.  

We’ve published this post and all of it’s statistics not to alarm or depress you, but to assure you that even if you have neck pain now, you’re not alone, and that we’ve seen cases like yours plenty of times before.  

 

So what happens when you come to our clinic?

When patients present to our clinic with neck and shoulder region pain, we’ll take the time to go through a full case history- making sure we note down things like:

  • exactly where the pain is,
  • what type of pain they have,
  • how and when it started,
  • the intensity of the pain,
  • any radiations or referrals (for example pain that runs down the arm, or pins and needles in your hands),
  • aggravating and relieving factors, and
  • any other associated symptoms.  
  • We’ll also want to know about your medical history, as this may have some relevance to your current symptoms.  

Once we’ve got your history down, we’ll leave the room to allow you to get changed into a robe, so that when we examine you, we can actually see your spine and other associated areas. 

 

Our examination may include things like:

  • Asking you to perform specific movements,
  • Orthopaedic tests, and
  • Neurological testing where appropriate.  

All of these are done in the consultation room.  

It’s pretty rare for us to refer for any imaging at this stage, unless we want to rule something out to make sure it’s safe to treat you.    

The examination is ultimately performed so we can piece our findings together with your case history, to arrive at a working diagnosis.  Once we’ve reached this, we’ll discuss what we’ve found with you, and work with you to devise a management plan.  You’ll have the opportunity to ask questions, set treatment goals, and make sure you understand your condition fully before going ahead.  

We pride ourselves on individualising each patient’s care, so it’s difficult to say exactly how many treatments each patient will need.  What we can say, however, is that we’ll always make it clear to you at the beginning how many treatments we expect you will need, and what the indicators will be if that doesn’t seem to be working out for any reason.  

Our emphasis on education and self-management also means that we don’t want you to keep coming back week after week with no end in sight.

We often start a treatment program with 2-4 treatments in the first couple of weeks or so, but then gradually space them out as your mobility improves and pain levels decrease.  

If you’re ready to take the next step and talk to us about your neck and shoulder region pain, call (03) 9372 7714 or book online now.  

If you’ve got any specific questions, feel free to send us an email and we’ll be sure to reply.  

Lauren.

 

References:

  1. Cohen Steven P, Hooten W Michael. Advances in the diagnosis and management of neck pain  BMJ 2017;  358 :j3221. Accessed 23/9/19
  2. Heintz MM, Hegedus EJ. Multimodal management of mechanical neck pain using a treatment based classification system. J Man Manip Ther. 2008;16(4):217–224. doi:10.1179/106698108790818260.  Accessed 23/9/19
  3. Hoy D, March L, Woolf A, et al.  The global burden of neck pain: estimates from the Global Burden of Disease 2010 study.  Annals of the Rheumatic Diseases 2014;73:1309-1315.
  4. Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL 3rd. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009;10(5):447–485. doi:10.1016/j.jpain.2008.12.001
  5. Peter R. Croft et al.  Risk Factors for Neck Pain- A longitudinal study in the general population.  Pain.  Volume 93, Issue 3, September 2001. Pages 317-325.
  6. Andrew M. Leaver et al.  People seeking treatment for a new episode of neck pain typically have rapid improvement in symptoms: an observational study.  Journal of Physiotherapy.  2013-03-01, Volume 59, Issue 1, Pages 31-3.  Accessed 27/9/19.
  7. Zebis MK, Andersen LL, Pedersen MT, et al. Implementation of neck/shoulder exercises for pain relief among industrial workers: a randomized controlled trial. BMC Musculoskelet Disord. 2011;12:205. Published 2011 Sep 21. doi:10.1186/1471-2474-12-205
  8. Louw S, Makwela S, Manas L, Meyer L, Terblanche D, Brink Y. Effectiveness of exercise in office workers with neck pain: A systematic review and meta-analysis. S Afr J Physiother. 2017;73(1):392. Published 2017 Nov 28. doi:10.4102/sajp.v73i1.392

 

Editor’s note: 

This article was originally published on April 23, 2018 and was refreshed in September 2019.