The musculoskeletal component of the neck consists of the cervical spine, muscles, ligaments and discs. The cervical spine, comprising seven vertebrae situated below the skull, together with the muscles attached to it, enable one to perform complex neck movements required for normal daily function.

One soon realises the importance of this mechanical system in the body when neck injury limits daily activities, making reading, driving, walking and even simple conversation difficult to perform.

This part of the spinal column is richly supplied with nerve receptors which have a great importance in optimal neck function. The disks found between each vertebra also play a very important part along with the many small joints and ligaments, all of which work together providing co-ordinated pain-free neck movement.

Maintaining a healthy neck is the single, most important action to preventing problems

These important structures are subject to suffer damage either through direct or indirect trauma, as well as improper use of the neck, such as bad posture or repetitive strain injuries.

When this happens, the neck initially responds with stiffness in the surrounding muscles, followed with a progressive decrease in neck mobility. These symptoms are often overlooked and most people disregard them as simple tiredness or generalised stiffness.

In fact, this is the beginning of potential long-standing neck problems. The nerve receptors in this area start to dysfunction, leading to a significant alteration in the way the mechanical structure of the neck works. Left untreated, this problem tends to get worse and very often makes neck rehabilitation more complex.

In between each neck vertebra there is an inter-vertebral disc. One function of this structure is to create an element of cushioning, allowing smooth force transfer between one vertebra and another. Damage to cervical discs is one important cause of neck pain that often spreads to the upper limbs. It is also frequently associated with weakness or a feeling of numbness in the upper limbs.

Neck discomfort may also be attributed to neck arthritis, which in the majority of cases is the result of a degenerative process in the multitude of joints within this area caused by frequent improper use of the neck.

Bad neck posture and frequent injures to the area are among the main contributors of neck arthritis. Arthritic joints do not function optimally and the little nerve endings in the neck start to malfunction leading to a vicious circle of events.

The lesson to learn is that maintaining a healthy neck is the single, most important action to preventing problems. This is achieved through maintenance of correct neck posture through utilising the correct neck muscles. Posture screening is very important to make sure that one is not unknowingly stressing one’s neck potentially leading to the mentioned neck problems.

Latest research shows that treating neck problems successfully is best achieved through the use of various modalities of treatment commonly referred to as a multimodal approach. Neck exercises targeting specific deep neck muscles that contribute to individual joint and vertebra control, providing correct feedback to the system through correct movement, is a prime contributor in rehabilitating this part of the body.

Furthermore, the exercises should form part of an overall concept of total body movement, whereby one does not just specifically focus on the neck but also on other areas of the body, combining neck movements with arm, trunk and lower limb movements.

The use of manual therapy, acupuncture, magnetic therapy and electrotherapy, such as laser, ultrasound and electrical currents used by physiotherapists, are also major contributors towards neck rehabilitation.

Ultimately, as the old adage goes, prevention is better than cure. In general, however, there is a wrong tendency to wait for one’s body to fail before one does something about it. This is in sharp contrast to the manner in which one treats a newly purchased car. The first service is often booked before one even drives it for the first time.

Contrary to this, one does not book a screening session or a service of one’s most important possession, one’s health, until one starts to feel it fail.

The use of analgesics and anti-inflammatory medication is useful and has its role in the management of neck pain. This, however, has a tendency to remove the initial pain, giving one the wrong impression that the problem has been solved.

Very often, the problem is a result of mechanical issues that would have accumulated over time due to bad postural habits. Unless this is corrected, the problems will resurface and it is here that the combination of exercise therapy, posture correction and pain management must co-exist.

Seeking the correct professional advice from health care professionals must be emphasised.

pacejosef@gmail.com

Josef Pace is a physiotherapist.