OrthoNeuroSpine & Pain Institute
Conservative care can be very effective in treating most symptoms related to disorders of the neck and cervical spine. Flare-ups of mechanical neck pain from muscle strains,as well as arm pain from a herniated disc causing a "pinched nerve" typically respond very successfully to nonoperative care. The most basic and simplest is a brief period of activity modification or rest. This can involve taking a break from routine daily activities or work to allow an acute or recent problem to resolve. On occasion, a cervical collar can be helpful for a short period of time to help the neck muscles relax or to act as a reminder to minimize neck motion or activity. Medications such as anti-inflammatories, pain relievers, steroids, muscle relaxants or narcotic pain relievers may be used.
Physical therapy (PT) is commonly used in the conservative care of cervical spine disorders. PT includes pain relieving modalities such as ultrasound, heat, electric stimulation and massage. In order for PT to be effective in the long term, it should involve not only these modalities but also stretching, therapeutic strengthening exercises for the neck and surrounding muscles, postural retraining, education and progression to a home exercise program. Traction may also be used if approved by your physician.
Chiropractic care or adjustments to the neck can be successful in many cases. You should discuss this with your doctor if you choose this method of treatment, as certain conditions should not be manipulated. You should maintain a treatment strategy that is consistent with your physician's experience.
Injection procedures can be used to help relieve painful symptoms arising from disorders of the neck and cervical spine. These fall into two categories: those done into muscular regions and those around neurologic structures. Muscular injections, or trigger point injections, can be use to relieve painful spasm and tightness in the neck muscles. They typically involve the injection of an anesthetic medication similar to Novocain, and an anti-inflammatory steroid. Injections around the neurologic structures include epidural injections and nerve root blocks. Epidural injections involve placing medication around the region and tissue the covers the spinal cord. Nerve root blocks involve placing medication around the spinal nerves after they have split off the spinal cord and are just exiting the spinal column. Medication that is injected around neurologic structures includes an anti-inflammatory steroid and frequently a local anesthetic. Physicians who perform epidural or nerve root blocks may require x-ray guidance to perform these procedures. Injections are not for everybody: usefulness and long-term benefit need to be evaluated on a case-by-case basis and are also dependent on your actual diagnosis.
Conservative care for cervical spine problems can be very effective in the vast majority of patients. The exact mode of treatment is dependent on your actual symptoms, history of prior treatment, structural problems, and diagnosis. Many patients can also benefit from combining one or more treatment options. Your particular treatment strategy will arise from a combination of these principles, your specific needs, and your physician's experience and assessment of your particular condition.
Physiotherapists use a combination of “hands on” (manual therapy) techniques, massage, exercises and education to help your body achieve its prime healing potential. Physiotherapy can help in the repair of injuries by optimising the healing process, reducing pain/stiffness and improving function and mobility.
Common problems treated by a Physiotherapist
Virtually any condition that affects your muscles, joints or nerves, lungs, heart and brain can be helped with Physiotherapy. Common problems include, back and neck pain, shoulder and knee injuries, whiplash, sports injuries, arthritis, tendinitis/over use injuries, strains and sprains and both women’s or men’s specific health issues.
Before any treatment is undertaken, the Physiotherapist performs a comprehensive assessment (see assessment procedure) to assist with diagnosis of the problem and to help you to understand what the underlying causes of your injury may be. After this initial assessment a variety of treatments may be appropriate, this may include the
- Joint Mobilisation/ Manipulation
- Postural Retraining and movement awareness
- Specific exercises for scoliosis
- Massage, Trigger Point Release, Myofascial Release
- Exercise Therapy to improve muscle recruitment and pain
- Pilates and core control training
- Taping to reduce load on structures, protect joints, prevent injury or facilitate
- Nerve tissue mobilisation
- Pain Education
- Strength Training
- Laser therapy for Lymphoedema, ulcers, problems with wound healing
- Dry Needling to release muscle tension/neural sensitivity
- Use of biofeedback to retrain specific muscles e.g. after knee surgery
- Pelvic floor muscle retraining
- Ergonomic education
- Education about your condition
- Epley manoeuvre to relieve dizziness
- Ante-natal advice and recovery
- Balance training e.g. falls prevention
- Construction of splints
- Treatment of Lymphoedema
- Airway clearance and breathing exercises for lung problems
- Rehabilitation for Neurological problems effecting the brain and spinal cord e.g. Stroke, MS, Parkinsons Disease
- Cardiac Rehabilitation/advice
- supply and fitting of orthotic devices such as knee braces, crutches, shoe orthotics, splints, stability belts, posture and back supports
- Physiotherapists can refer for x-ray, MRI and Ultrasound imaging
- Lifestyle advice and management of chronic health problems
- Bike frame and seating setup
- Sports pre-season screening
NASS Cervical Exercises