Common Neck Injuries

An Acute Wry Neck often occurs after sleeping awkwardly is associated with pain. It can occur in other situations but is less frequent. Movement limitation is common with the inability to side bend and rotate the neck in one direction being the most common presentation. A high velocity low amplitude manipulation is often applied to decrease the pain and improve range of motion in these cases.

Discogenic Pain in the neck can occur through trauma or may develop gradually over time. The cervical discs are fibrous in most adults so the disc does not commonly bulge but rather becomes damaged with circumferential tears in the annulus or outer fibres of the disc progressing to radial tears. A common feature with discogenic pain is limitation in flexion and extension as the disc is compressed to a greater extent in these positions. Discogenic pain can also produce pain called clowards signs in the region of the shoulder blade .

Cervical Radiculopathy occurs when a structure in the neck compresses a nerve root commonly causing radiating pain into the arm with a loss of strength, reflexes or light touch. This can be quite serious if the issue progresses, but for many cases can be managed conservatively. Your physiotherapist will assess the degree of loss and determine the best route of action for your case. This most commonly involves manual therapy and exercises to improve strength in the neck and mobility in the nerves that are affected.

Cervical Nerve Root Neuropathic Pain is pain that is generated by a damaged nerve. In these cases damage to the nerve has occurred through direct trauma to the nerve resulting in damage to its physical structure. Neuropathic pain of any sort is defined clinically by the presence of both positive and negative sensory findings. This means that lights touch in a given distribution of a nerve may be maintained but hot and cold sensitivity may be increased versus the unaffected side. This situation arises because of changes in both the peripheral and central nervous systems which can result in ectopic firing (unprovoked firing) of the nerve and a heightened response to both painful stimuli and stimuli that are not normally painful. Common management of neuropathic pain includes the administration of drugs such as GABA reuptake inhibitors and physical therapy within a multimodal team environment.

Osteoarthritis refers to the degeneration of the joint that occurs with use. Most people over the age of thirty will show some degree of "wear and tear" in their joints from the stresses of everyday life. Osteoarthritis cannot be repaired but further damage can be minimised by improving the muscles that surround the joint. In the lumbar spine this refers to the "core musculature" and specifically refers to the force, timing and sequencing of muscle activation rather than the strength of the muscles in this region. The pain from osteoarthritis can also be improved through various manual techniques such as myofascial release and mobilisation.