Sometimes simple home interventions are enough to treat cervical disc disease, in which an abnormality in one or more discs that lie between the vertebrae cause neck pain. Often, though, it helps to see a physical therapist that can show you how to stretch and strengthen your neck and vertebrae, improve your posture, and prevent neck pain from recurring. You may also consider going to see a chiropractor. In the majority of people, certain exercises and manipulations used by these health care providers can help relieve discomfort and restore movement.
When you visit a physical therapist, you’ll first have a complete evaluation. The physical therapist will examine your neck and assess how well you can move your neck. You may be asked about symptoms such as pain in the neck or between the shoulder blades, pain that radiates down the arm to the hand or fingers, or numbness or tingling in the shoulder or arm. The exam will also check your strength and reflexes.
Start with your primary-care physician; back pain is so common that most
family docs have seen lots of it. Your PCP is also a good person to return to
if, later, you get conflicting treatment advice from specialists. He or she can
help you evaluate what would be your best next step.
There are several types of manipulations and exercises your physical therapist or chiropractor can use to relieve stiffness, strengthen the area, and restore normal function of the neck. Treatments such as cold or heat application, deep tissue massage, electrical stimulation, and ultrasound may be used prior to exercise.
During physical therapy, you will practice a range of exercises to stretch and strengthen the muscles that support your neck. You’ll also learn how to improve your posture and range of motion. To help you learn proper postures, the physical therapist might have you stand in front of a mirror while exercising so that you can see your mistakes and correct them.
Chiropractors use some of the same techniques as physical therapists. Gentle adjustments may help restore normal neck function and help alleviate pain. As with physical therapy, chiropractors manipulate the neck joints to reduce stiffness, improve mobility, and increase range of motion. These adjustments might be unsuitable and potentially risky for people with vascular problems in the neck, such as carotid artery stenosis, or advanced osteoarthritis.
Speak with your doctor first before having any spinal adjustments done, particularly in the neck.
Neck Traction for Cervical Disc Disease
One technique used by physical therapists and chiropractors to provide pain relief and improve motion is cervical traction. Traction gently extends the neck, opening the spaces between the cervical vertebrae and temporarily alleviating pressure on the affected discs. Neck traction can either be done continuously or intermittently, alternating between short periods of pulling and resting.
It’s also possible to do cervical traction at home. There are pulley systems that you can hook up to a doorway, or devices that will enable you to perform cervical traction while lying down. It’s important if you do cervical traction on your own to see your physical therapist first to make sure that you buy the right equipment and learn how to set it up correctly.
Cervical Pillows and Collars for Cervical Disc Disease
Cervical pillows (neck pillows) are designed to partially immobilize the neck while you sleep. However there is no research to support the effectiveness of cervical pillows. It’s a good idea to ask your physical therapist for a recommendation.
Soft cervical collars do not stabilize the neck as much as serve as a reminder of use good posture and range of motion techniques. Rigid cervical collars do immobilize the neck but are uncomfortable for long-term use.
SOURCES: Korthals-de Bos, I.B., et al. British Medical Journal, 2003; vol 326: pp 911-916. Hoving, J.L., et al. Annals of Internal Medicine, 2002; vol 136: pp 713-722. American Chiropractic Association web site: "Chiropractic and Neck Pain: Conservative Care of Cervical Pain, Injury."
Smith, W.S., et al. Neurology, 2003; vol 60: pp 1424-1428.
Chung, T., et al. Radiology, 2002; vol 225: pp 895-900.
Anthony Delitto, PhD, PT, FAPTA, professor and chairman, department of physical therapy, University of Pittsburgh.