Chronic Neck Pain
Chronic neck pain is a more complicated, longer lasting and sometimes more debilitating type of neck pain.
Chronic in this context refers to the length of time the problem has been there, not the severity. It possible to have long standing but not severe neck pain, this is still chronic neck pain. In this article we are concentrating on musculo-skeletal chronic pain, that is pain associated with the muscles, connective tissue and joints of the body.
Chronic pain is more complex as it can often originate from multiple sources, for example an external trauma or a condition such as osteoarthritis (cervical spondylosis) or fibromyalgia.
It may also have what is called an insidious onset, that is, one which has no obvious cause or trigger and may be described as non-specific neck pain. This term non-specific isn’t a dismissal of the pain you are in, instead, its more to do with the complexity of chronic pain.
The pain may be constant or come in flare ups or occur periodically. It may have neurological type symptoms (pain radiating down the arms, fizzing, pins and needles or numbness) or may be very specific and local.
Chronic neck pain is often characterised by a history of multiple trips to various health professionals such as doctors or orthopaedic surgeons and physios, sometimes people end up with feeling of going round in circles or not being listened to. People can also be hyper-protective or vigilant, having been shown MRI’s or Xrays of their neck sometimes with attention drawn to disk protrusions compressing the spinal cord or other frightening pathologies such as bone or joint changes (more on that later).
Often people will have tried a variety of treatments including but limited to steroid injections, acupuncture or dry needling and various exercise programs with varying degree’s of effectiveness.
Chronic pain can be complex in character because the presence of pain over time can an effect on our nervous system which means it tends more towards sensitivity to pain, that is, it becomes more easily triggered. It can also have a negative affect on mood provoking other problems like irritability, tiredness, poor sleep, even anxiety and depression.
Each of these areas interacts with each to cause what we come to know of as chronic pain and are the reason why it can be complex and sometimes slow to resolve.
What can your physio do?
As part of your assessment major pathologies will be ruled out and then following a series of physical tests you and your physio will be begin to build a positive, proactive and realistic plan to begin to take steps forward.
The approach we take is build a partnership with you in your rehabilitation. To find a route through that works for you and helps you to achieve your goals. We won’t promise miracle cures, in fact, our first step is often just to try and assert some control over your pain through positive pain management techniques before setting the next goal.
We will draw upon a number of tools, including some hands on therapy for short term relief, while building the scaffolding for the longer term resolution of your pain, through exercise therapy and other techniques like pain management or even aspects of Cognitive behavioural therapy.
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