Neck stiffness, pain, and headaches are some of the most common ailments people experience today. So common, in fact, that many people have come to accept them as just another part of daily life. But what if they don’t have to be?
In this comprehensive guide, we’ll walk you through why these issues occur and how our unique three-phase approach can help you break free from the cycle of pain.
The Prevalence of Neck Pain and Headaches
Neck pain and headaches are widespread issues affecting a significant portion of the population both in Australia and worldwide.
- In Australia, it’s estimated that up to 70% of people will experience neck pain at some point in their lives. [1]
- Chronic neck pain affects approximately 10-20% of the population. [2]
- Headaches are among the most common disorders of the nervous system, with almost half of the adult population experiencing a headache in any given year. [3]
- Tension-type headaches, often linked to neck issues, have a global prevalence of about 38%. [3]
While neck pain and headaches are common, they shouldn’t be considered normal or something you have to live with.
The Common Misconception: Medication as a Cure
When that familiar ache sets in, reaching for over-the-counter painkillers might seem like the easiest solution. Australians spend over $600 million annually on over-the-counter pain medications. [4]
While these may temporarily ease your symptoms, they don’t address the underlying issues causing your neck pain and headaches. Relying solely on medications can lead to a cycle of temporary relief followed by recurring discomfort.
What’s Really Going On: The Root Causes
Neck pain and headaches often stem from a combination of factors:
- Joint Stiffness: Reduced movement in the neck joints can lead to discomfort and limited mobility. Stiff joints cause pain. The upper three cervical vertebral joints refer pain to the head – often around the forehead, biased towards one side.
- Nerve Irritation and Tightness: Nerves exiting the spine need to move freely. Any restriction can cause pain and hypersensitivity. This will often lead to a severe, all over headache.
- Muscular Weakness and Tightness: Weak muscles can become tight or go into spasm, leading to further pain and stiffness. The muscle attachments at the base of the skull can become inflamed and tender causing a back of the head headache, often referring to the forehead.
Understanding these root causes is essential for effective treatment. Instead of masking the symptoms, we focus on addressing these underlying issues.
PhysioCentral’s Three-Phase Treatment Approach
Mobility | Flexibility | Strength
We’ve developed a unique, step-by-step process to tackle neck pain and headaches at their source. Our approach ensures that each phase builds upon the previous one, setting you up for long-term success.
1. Mobility: Getting Things Moving Again
Why Mobility Matters
The joints in the neck stiffen and tighten with inactivity – long hours of sitting. The fluid in these joints thickens over time, turning into a jelly-like substance and ultimately fibrosing into an adhesive scar tissue within the joint. This shrinks and tightens as it gets older, binding the joint together. This can severely restrict movement, causing tightness and compression, and nerve irritation.
This lack of joint movement also leads to muscle tightness, as the muscle can no longer contract and relax over its full range.
Furthermore, nerves that exit the spine can slide along their pathways by up to 20-30mm with each movement of your head or arm. [5] Any restriction—be it from stiff joints or tight muscles – can limit this essential mobility, leading to irritation and pain.
How We Improve Mobility
- Gentle Movements: We start with exercises that promote gentle movement of the neck and surrounding structures.
- Reducing Hypersensitivity: Movement helps to calm hypersensitive nerves and muscles, reducing protective muscle spasms.
- Decompression: Mobilising the neck structures begins the process of decompressing the spine, which can alleviate pain.
- loosen up the joints and muscles of the neck first, the nerves second.
Expect Some Pushback
As you begin mobility exercises, you might notice that your symptoms temporarily increase. This is a normal part of the healing process. You’re introducing stress to areas that have tightened during the initial phase of injury. Don’t worry—you’re not causing more damage. The body might give you some pushback, but it will soon realise that the movements are safe and beneficial.
The Turning Point
Movement will start to become soothing and relieving. You’ll look forward to it as symptoms begin to settle at an accelerated rate. Neck pain and and any associated headaches, start to become less intense.
2. Flexibility: Restoring Full Range of Motion
The Importance of Flexibility
Once mobility improves, the next step is to restore your neck’s full range of motion. Flexibility allows muscles to contract and relax effectively, which is essential for both movement and strength.
Our Approach to Flexibility
- Repetitive Movements: Engaging in exercises that take the neck through its full range helps to improve flexibility.
- Sustained Stretching: Holding stretches allows muscles and joints to lengthen and adapt, reducing tightness.
Transitioning Phases
As we transition from mobility to flexibility, symptoms might once again temporarily worsen. This ebb and flow is normal and expected. We have a lot of control over it because we know it’s going to happen and can pre-empt it. Towards the end of this phase, pain becomes less intense, and less frequent.
Caution with Nerves
It’s crucial to address nerve tightness with Mobility before stretching during the Flexibility phase, as sustained stretching can aggravate nerves and lead to protective muscular spasm.
3. Strength: Building a Resilient Neck
Why Strength Is the Root Cause
Weak supportive muscles in the neck and upper shoulders are more prone to tension and painful knots. Studies have shown that targeted strength training can reduce neck pain by up to 75%. [6] Strengthening these muscles provides the support your neck needs to prevent future flare-ups.
Strengthening the Right Way
- Timing Is Everything: Strength training should only begin after achieving adequate mobility and flexibility to avoid exacerbating symptoms.
- Handling Tightness: The first thing a muscle does when we apply strength-based exercises is to tighten up. All muscles do this, injured or not. That’s why we need sufficient mobility and flexibility first. We need the neck to be as mobile and flexible as possible to accommodate the tightening that strengthening triggers.
- Gradual Progression: We introduce strengthening exercises that gradually build muscle without triggering protective spasm.
Avoiding a World of Pain
Jumping straight into strength work without the proper foundation can lead to significant discomfort. By following the correct phase sequence, we ensure your muscles can handle the tightening that occurs during strengthening.
Loosen up the tight bits before you strengthen the weak bits.
As you begin to strengthen, pain and headache, starts to become mild and infrequent.
As you reach full strength. Pain completely resolves.
Long-Term Benefits
Strengthening not only alleviates current pain but also minimises the likelihood of future episodes by providing better support for your neck and head.
The Cyclical Nature of Recovery
Understanding Flare-Ups
Recovery isn’t always a straight path. You might notice that some days you feel better, and other days symptoms seem worse—three steps forward, one or two steps back. This can be frustrating until you understand how the body recovers.
Why Symptoms Fluctuate
As you progress through the phases of Mobility, Flexibility, and Strength, you’re introducing new stresses to your body:
- Mobility Phase: Initial exercises may irritate inflamed and tightened areas, temporarily increasing symptoms. Gentle regular mobility exercise is key.
- Flexibility Phase: Pushing for a full range of motion can cause minor flare-ups as your body adapts. Take your time. Loosen up with mobility work first. Do these less frequently than mobility work.
- Strength Phase: Muscles naturally tighten when strengthening, which can lead to temporary discomfort. Follow a graduated program. Incrementally increase resistance.
Navigating the Cycle
- Accept the Ebbs and Flows: Recognise that symptom fluctuation is a normal part of healing.
- Pre-empting Setbacks: By anticipating these changes, we can adjust your treatment plan to minimise discomfort.
- Trend Toward Improvement: Each flare-up should be less intense and shorter-lived, with longer periods of relief in between.
The Physiotherapist’s Role
We’ll provide the treatment, but you’ll be doing all the hard work.
We’ll guide you through this process, ensuring that the overall trend in your symptoms is a downward one—towards normal mobility, flexibility, and strength.
That leads to a complete relief of pain.
All you have to do, as with any injury, is simply loosen up the tight bits, and then strengthen the weak bits.
Over-Engineering Your Neck: Making It Bulletproof
Beyond Recovery
Our aim isn’t just to get you back to where you were before the injury. We want to improve upon your pre-injury state—over-engineer it, make it bulletproof, and prevent any further problems or re-injury.
The Final Outcome
By diligently following our three-phase approach, you’re setting yourself up for long-term success. Strong, flexible, and mobile necks provide better support, and are under less tension, significantly reducing the risk of future neck pain and headaches.
Timing Is Everything: Avoiding Common Pitfalls
The Dangers of Premature Treatments
Applying the right treatment at the wrong time can worsen your symptoms. For example:
- Massage Before Mobility: Getting a massage on tight shoulder muscles before addressing neck mobility can temporarily feel good but may lead to increased nerve irritation and muscle spasm in the days following treatment.
- Strength Training Too Early: Jumping into strength exercises without proper mobility and flexibility can tighten already tight muscles further, triggering more severe pain.
Our Step-by-Step Solution
We ensure that each phase of treatment is introduced at the right time, maximising benefits and minimising setbacks.
Summing It Up: Your Path to Lasting Relief
Step 1: Mobility
- Goal: Loosen tight structures and reduce hypersensitivity.
- Actions: Gentle neck movements and exercises to restore joint mobility, nerve sliding, and getting muscles to contract gently and relax, rather than just holding contracted in spasm.
- Expectations: Temporary increase in symptoms is normal; movement becomes soothing over time.
Step 2: Flexibility
- Goal: Achieve full range of motion in the neck and related structures.
- Actions: Repetitive movements and sustained stretching
- Expectations: Be prepared for minor flare-ups as your body adapts.
Step 3: Strength
- Goal: Build strong, supportive muscles to prevent future flare-ups.
- Actions: Gradual strengthening exercises are introduced after mobility and flexibility are established.
- Expectations: Muscles may tighten initially; this is normal and temporary.
Recovery time
Each phase takes 1-2 weeks on average, before we can launch into the next phase.
All exercises from each phase are continued along with the strengthening phase for at least another 6-8 weeks (3 months minimum in total).
During this time those daily headaches can expected to become weekly headaches, then fortnightly, and then monthly, until they eventually peter out as strength of the neck and shoulders returns to normal.
At PhysioCentral, we’re committed to providing personalised care that addresses the root causes of your neck pain and headaches. Our experienced physiotherapists, with a special interest in neck pain, headaches, and migraines, utilise this three-phase approach to ensure you receive the right treatment at the right time.
Ashleigh McDonald. Physiotherapist at PhysioCentral. Miranda. The Sutherland Shire.
Graeme Curran. Physiotherapist at PhysioCentral. Miranda.The Sutherland Shire.
Jack Keegan. Physiotherapist at PhysioCentral. Miranda.The Sutherland Shire.
Disclaimer: This blog post is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalised recommendations.
Sources
1. Australian Institute of Health and Welfare. (2020). Musculoskeletal conditions and injury in Australia.
2. Australian Bureau of Statistics. (2018). National Health Survey: First Results, 2017-18.
3. World Health Organisation. (2016). Headache disorders.
4. Consumer Healthcare Products Australia. (2018). Annual Report.
5. Shacklock, M. (2005). Clinical Neurodynamics: A New System of Musculoskeletal Treatment. Elsevier.
6. Ylinen, J. (2007). Physical exercises and functional rehabilitation for the management of chronic neck pain. Eura Medicophys, 43(1), 119-132.
7. Safe Work Australia. (2016). Work-related musculoskeletal disorders in Australia.
8. Access Economics. (2007). The high price of pain: the economic impact of persistent pain in Australia.
9. Australian Institute of Health and Welfare. (2020). Chronic pain in Australia.