Neck pain and motor control impairments
While neck pain is the most common sign, patients frequently have dizziness, nausea, headaches, concentration difficulties in addition to neck pain. This often occurs following motor vehicle accidents (whiplash) and sports injuries, even when several years ago. Often these patients present with impairments in neck motor control, strength and endurance. Many patients have difficulty holding up their head when lying on their back and have irritable areas in their muscle and a feeling of tightness around their neck.
These patients do best with a graded strengthening approach with manual therapy and dry needling to relieve tension.
The neck is rich in little receptors that feed your brain information about where your head is in space and sometimes these receptors get out of sync with trauma to the neck. If this occurs, you may experience symptoms such as dizziness and guarding of your neck muscles, as your body’s protective mechanism.
- “Neck Pain Guidelines: Revision 2017: Using The Evidence To Guide Physical Therapist Practice,.”. Vol 47, no. 7, 2017, pp. 511-512. Journal Of Orthopaedic & Sports Physical Therapy (JOSPT), https://doi.org/10.2519/jospt.2017.0507.
There are conditions that may result in neck pain and/or headaches that are medical emergencies and not candidates for PT. These are cervical artery dissections (stroke), upper cervical instability and cervical myelopathy.
Neck pain often times occurs with headaches which maybe on one side or both sides of the head and are precipitated/aggravated by neck movements and/or sustained positions/postures.
We often see patients with both neck pain and difficulty moving (often turning) their necks. The first question we ask is whether this person truly stiff or are their muscles guarding as a protective mechanism, limiting neck motion?