Mechanical Neck Pain

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Introduction[edit | edit source]

Individuals with neck pain that lack an identifiable pathoanatomic cause for their symptoms are usually classified as having mechanical neck pain. Direct pathoanatomic cause of mechanical neck pain is rarely identifiable[1]. Although the cause of neck pain may be associated with degenerative processes or pathology identified during diagnostic imaging, the tissue that is causing a patient’s neck pain is most often unknown[1]

Mechanical neck pain commonly arises insidiously and is generally multifactorial in origin, including one or more of the following: poor posture, anxiety, depression, neck strain, and sporting or occupational activities[2].

Causes[edit | edit source]

Poor posture -[edit | edit source]

Most common abnormal posture seen in the region of neck is forward head posture. There is shortening(tightness) of the postural muscles like upper trapezius, levator scapulae and pectoral muscles and weakness in deep neck flexors, rhomboids and serratus anterior. This leads to restricted neck mobility. Such kind of muscle imbalance and abormal posture is found in the population who work on laptops/computers for long hours. This creates stress and pain in the cervical region.[3]Poor posture is considered the greatest cause of mechanical neck pain when there is no trauma or major injury.[4]

Thoracic alignment[edit | edit source]

The cervical ,thoracic and the lumbar spine are interrelated biomechanically. There has to be proper motion (concomitant motion) occuring at the thoracic spine inorder to get full ROM at the cervical spine. Thoracic spine acts as the supporting base for the cervical spine and it has an influence on cervical joint kinematics via the cervicothoracic junction. Because of the close kinetic link, any mechanical dysfuntion at the thoracic spine will create associated effect on the cervical spine.[5]

Management[edit | edit source]

Despite the prevalence, less-than optimal prognosis, associated risk of disability, and economic consequences of individuals suffering from mechanical neck pain, there remains a significant gap in the literature, which fails to provide sufficient, high-quality evidence to effectively guide the conservative treatment of this patient population[2]. Heintz et al[2] suggest that this lack of quality evidence largely stems from the poorly understood clinical course of neck pain in conjunction with the inconclusive results related to the efficacy of commonly used interventions.

Physiotherapy approach the management of mechanical neck pain is with a plethora of interventions such as manual therapy, therapeutic exercises, modalities, massage, and functional training.

References[edit | edit source]

  1. 1.0 1.1 Childs, J.D., Cleland, J.A., Elliott, J.M., Teyhen, D.S., Wainner, R.S., Whitman, J.M., Sopky, B.J., Godges, J.J., Flynn, T.W., Delitto, A. and Dyriw, G.M., 2008. Neck pain: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy AssociationJournal of Orthopaedic & Sports Physical Therapy38(9), pp.A1-A34.
  2. 2.0 2.1 2.2 Heintz MM, Hegedus EJ. Multimodal management of mechanical neck pain using a treatment based classification system. Journal of Manual & Manipulative Therapy. 2008 Oct 1;16(4):217-24.
  3. Richa Mahajan, Chitra Kataria, Kshitija Bansal. .2012.Comparative Effectiveness of Muscle Energy Technique and Static Stretching for Treatment of Subacute Mechanical Neck Pain. International Journal of Health and Rehabilitation Sciences. 1 (1)
  4. Jasmita Kaur Chaudhery, Ajit Dabholkar. Efficacy of Spinal Mobilization with Arm movements (SMWAMS) in Mechanical Neck pain patients: Case-Controlled Trial. International Journal of Therapies & Rehabilitation Research. IJTRR 2017; 6 (1): 18-23
  5. Shriya Joshi, Ganesh Balthillaya, Y. V. Raghava Neelapala. Thoracic Posture and Mobility in Mechanical Neck Pain Population: A Review of the Literature .Asian Spine J 2019;13(5):849-860