Physical Therapy and Other Options for Neck Pain

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 treat abnormalities, 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 or chiropractor, you’ll first have a complete evaluation. He or she will 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. Your strength, reflexes, and other potential sources of pain will be checked. The therapist or chiropractor will also assess joint function in your neck and back to identify limitations or dysfunctions that may contribute to your pain.

Stretch, Strengthen, and Straighten Up

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 and thoracic 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.

Your physical therapist, chiropractor, or medical doctor should determine whether you are at risk of further injury from manipulations before treating you.

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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 first see your physical therapist or chiropractor 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 or chiropractor for a recommendation.

Soft cervical collars do not stabilize the neck as much as serve as a reminder to use good posture and range of motion techniques. Rigid cervical collars do immobilize the neck but are uncomfortable for long-term use.

WebMD Medical Reference Reviewed by Ross Brakeville, DPT on January 21, 2017

Sources

SOURCES: 

Korthals-de Bos, I. British Medical Journal, 2003. 

Hoving, J. Annals of Internal Medicine, 2002. 

American Chiropractic Association: "Chiropractic and Neck Pain: Conservative Care of Cervical Pain, Injury."

Smith, W. Neurology, 2003.

Chung, T. Radiology, 2002.

Anthony Delitto, PhD, PT, FAPTA, professor and chairman, department of physical therapy, University of Pittsburgh.

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