30 to 50% of the population will annually experience neck pain. These pains can either occur acutely or gradually over time, and they can come in many different forms. Neck pain is also associated with headaches.
Neck pain can come and go, but particular groups of people are especially susceptible to long term discomfort. Football players are an example of such a group. Many years of aerial duels, heading the ball and large amounts of physical stress on the neck are probable reasons why up to 30% of retired elite level players experience symptoms of persistent neck pain and decreased neck range of motion.
Acute injuries can become persistent
Acute neck pain is a result of an impact or quick twisting movement, for example from a fall or a traffic accident (whiplash). In some cases, pain can become persistent (lasting for more than 8 weeks).
However, persistent neck pain can often be explained as the result of a combination of factors. Having a lot of pain doesn’t necessarily mean that the injury is severe, and two athletes can experience the pain differently. One of the reasons for this is that many factors influence neck pain, amongst others the level of activity, sleep, mood, thoughts, feelings, stress levels, past experiences with injuries, as well as how one copes with the pain. All together, these factors create different conditions for how pain is experienced.
A common symptom is pain that gets worse with movement, or when the head is held in one position for long periods of time. Some will also experience headaches. Many factors contribute to neck pain. It can, therefore, be difficult to determine what is the source of the pain.
Pain can spread
Neck pain can travel down along the arm and hand, or up into the head. The latter can lead to two types of headaches: tension headaches, and neck headaches.
It is possible for tension headaches to occur without experiencing neck pain, but the pain is often located in both the head and neck together. The pain is perceived as pressure on one or both sides of the head.
With neck headaches or as it is known medically cervicogenic headaches, it is common with radiating pain that usually only occurs on one side of the head. It can be aggravated by turning the head and neck into end range, in other words as far as one can, or by applying pressure to the upper part of the neck. This type of headache usually results in a reduced range of motion in the neck.
Nerve root pain
The spine (including the neck) consists of, amongst other things, strong intervertebral discs. These discs are made up of a thick, liquid gel surrounded by strong fibrous rings. Discs are important shock absorbers and during one's life, it is common for changes to occur in the fibrous rings.
With time, the disc can bulge out or in some cases the liquid gel can leak out. This is known as a bulging- or herniated disc. They can occur anywhere along the spine, the neck as well. Why some people get them and others don’t is not known, but age and genetics probably play an important role.
The pain can arise suddenly, almost without warning. The event may seem acute, but is often the result of a long-term process. A disc bulge or herniation can put pressure directly on a nerve or create an inflammatory process that may irritate one or more nerves in the neck. This condition can cause radiating pain, reduced sensation, and tingling and numbness. Occasionally it can also cause paralysis of certain muscle groups. Nerve root pain in the neck is a relatively rare condition, and research has shown that there are 40-80 new cases per 100 000 people, per year.
Treatment and rehabilitation
Believe it or not, this condition gets better with time. It may, however, take up to three months until the pain is gone. In some cases, it may take even longer. Nerve pain is unpredictable, and it is normal for the symptoms to vary a lot over time. Treatments, such as massage, mobilisations and manipulations can give temporary pain relief but seldom have any long-term effect.
It is entirely normal to experience a small amount of pain during activity in the beginning, but the pain should not spread down into the arm and hand, or increase in intensity once the activity has stopped. Contact your physiotherapist if you are in any doubt as to how much activity you can tolerate.
If nerve root pain is not diagnosed, but neck pain is still present after a prolonged period, the symptoms are often more diffuse. In such cases, it can be difficult to make a precise diagnosis. The muscles can feel tight and sore. There are several treatments available for this such as stretching, massage, trigger point therapy, joint mobilisation, and various exercises for the neck and shoulders.
Can be complex
Neck pain is rarely an isolated incident. As far as sports goes there is often a correlation with non-physical conditions such as a conflict with the trainer, lack of motivation, poor results, burnout, and depression. In such cases, it can be useful to speak with a psychologist or coach in addition to carrying out physical exercises.