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Cervical Spine – Neck Pain

Neck pain is very common and is the second most common complaint after low back pain, varying from a mild ache after heavy work to a severe and disabling pain with headaches. Further resources on neck pain can be found at Arthritis Research UK with a symptom checker at

The cervical spine is an amazing structure which has to accomplish several objectives at once, balancing the weight of the head on top of a narrow bony and ligamentous column. It not only has to carry the head and keep it stable so our eyes can see things correctly, it also has to be very mobile so we can look about and has to cope with large forces as the upper limbs do heavy or fast work.

Postural Neck Pain

Postural neck pain is very common and related to the poor postures we see people sitting in all the time. Young people who have no pain problems can often be seen slumped with the head forward and workers at a desk with a computer or at a bench often have poor posture for long periods.

Poor posture over the years can cause changes in the discs, ligaments, joints and muscles of the neck and the upper body which can lead to pain problems, limiting the amount of time in a poor sitting position more and more greatly. Neck pain relief can be achieved better the sooner the person pays attention to their posture and constantly corrects themselves. It may take three months of careful monitoring to get the body to change naturally to a better posture.

Joint Pain

The neck joints are a known source of pain and the facet joints may become painful and lose some of their range of motion, leading to a stiff neck as well as a painful one. The facet joints are known to be able to refer pain out into the sides of the neck and down the spine over the shoulder blade down to its tip.

Disc Pain

The cervical discs are also a potential source of pain, with cervical disc prolapses able to refer severe pain into the neck, shoulder and arm. This is known as a cervical nerve root lesion and is similar to sciatica in the leg and is sometimes called a “shoulder pain trapped nerve”.

Torticollis Neck Pain

Torticollis neck pain is a condition which results from automatic contraction of some of the neck muscles which results in the head being kept in an abnormal posture, or in some cases to move abnormally. There can be a number of underlying diagnoses and there are a number of names given to this presenting symptom – wry neck, acute wryneck, cervical dystonia and torsion dystonia.

The most common type of torticollis is acquired, in the sense that it was not there initially but the person developed it at some point. Congenital torticollis is thought to be caused by birth trauma to the neck muscle which then tightens up and pulls the head into a rotated position. Physiotherapy can be performed daily to loosen up the neck gradually to return the neck to normal posture and motion.

Adults may have short lived torticollis due to presumed neck joint strain such as sleeping awkwardly and waking with neck pain, distorted posture and limited movement. This usually responds to rest, painkillers and gentle movement. Physiotherapy is rarely required unless the time of recovery is extended and there is some joint stiffness.

Pillows for Neck Pain

People often ask which is the best pillow for neck pain, a difficult question to answer. Sleep is often disturbed with neck pain and as we do not stay still at night it is difficult to get a pillow which will be ideal if your neck does not tolerate much movement.

As most of us sleep on our sides it is important that the thickness of the pillow or pillows is enough to keep our heads in the “neutral” position, neither tilted to one side or another. Sometimes this is best achieved by a thicker pillow overlaid by a much thinner one, so the thickness can be adjusted. Some people swear by the neck pillows advertised for just this purpose, V-shaped pillows which may be helpful in some cases.

Neck exercises for neck pain are easier to recommend and should be done every day several times as this helps with reduced movement, muscle relaxation and pain relied. Simple neck exercises are really important to continue with as an easy self-help method.

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