Neck

*If you are experiencing persistent pain, diminished function, loss of strength, range of motion, and/or sensation, BCPT recommends that you contact your physician, as a serious underlying physical condition may be present.

Facet Syndrome

One of the more common complaints of pain in the cervical spine, facet syndrome is often described as a "kink" in the neck. The pain is usually localized to one side, and brought on with side bending toward that side. Often the surrounding muscles go into a reflexive spasm in an effort to splint and guard the cervical spine. The symptoms can usually be reduced with manual distraction and mobilization of the involved cervical segment, however, several symptomatic modalities (heat, electrical stimulation, ultrasound, or cold laser therapy) may be needed prior to manual mobilization, in order to relax the spasm. Patients usually feel immediate relief of pain with return of full range of motion, after mobilization. It should be noted that repeated mobilization (i.e.. cracking) of the spine at any level can lead to hypermobility (too much motion) and place the segment at risk for further impingement and injury.

Degenerative Disc Disease (DDD)/Stenosis

Stenosis is a term synonymous with narrowing. Stenosis of the cervical spine can occur at various locations of the vertebral segment, including the central region (area of spinal cord), the lateral recesses (where the nerve root travels), or the intervertebral foramen (where the nerve root exits the spine). This syndrome is most common in the elderly population who demonstrate age related spinal degeneration and arthritis. The narrowing can be caused by bony changes, and/or space-occupying lesions, and typically results in neurological compression. Symptoms can include pain and sensory changes in one or both arms, and is often exacerbated with extension of the cervical spine (i.e., looking up at the sky). Symptomatic modalities, including cervical traction, with exercises which are based on postural and positional education, may help to manage symptoms related to stenosis.

Disc Lesions

As in the lumbar spine, the discs of the cervical spine are susceptible to bulging, herniation, or rupture, if exposed to traumatic forces. If the inner liquid portion of the disc, known as the nucleus pulposus (see lumbar spine below), presses upon an exiting nerve root in the cervical spine, radiating pain, numbness, or muscle weakness in one or both of the upper extremities can result. Depending on the severity of the injury, traction and positional based physical therapy can help to reduce or possibly relieve the symptoms. Persistent or progressive symptoms may require surgical intervention, followed by physical therapy to help restore range of motion.

References: Norkin, CC and Levangie, PK: Joint Structure and Function, A Comprehensive Analysis Magee, DJ: Orthopedic Physical Assessment Richardson, JK and Iglarsh ZA: Clinical Orthopaedic Physical Therapy