Neck and upper back pain

Neck pain is very common nowadays. There are many reasons which cause pain in the upper back and neck area. These include:

  • Poor posture
  • Trauma/whiplash injury
  • Stress
  • Torticollis/wry neck

Poor posture can inevitably lead to pain in the neck and upper back. Spending hours hunched over your phone, at the desk or at school can cause muscular tightness in the upper back and shoulders and reduce the movement in your neck. This can even lead to further complications like jaw pain, shoulder pain or headaches.

Trauma frequently involves the neck. As the car goes through a rapid accelaration/deceleration, it can cause whiplash. The neck bends forward and backward very quickly, putting enormous abnormal forces through your neck.

A lot of patients report that they "carry their stress on their shoulders". When we are stressed, we tend to tense the neck and upper back muscles and round our shoulders. This can lead to tight knots in the trapezius muscles and cause further stiffness of the neck and upper back.

And sometimes, if you have been sleeping badly or in a different bed, you can wake up in pain with your neck in an uncomfortable position. 

With all the above neck complaints, osteopathic treatment can reduce muscular tension, joint stiffness, inflammation and offer advice on posture, stress-coping strategies, exercises and stretching to help manage the pain and prevent future episodes. It is also important to check the lower back and pelvis.

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Research:

Bischoffa A, Nürnbergera A, Voigta P, Schwerla F

Published in the International Journal of Osteopathic Medicine Volume 9, Issue 1, March 2006

A series of osteopathic interventions seems a promising therapeutic regimen for CNP sufferers. Further studies will have to demonstrate whether (a) these findings are reproducible and (b) positive long term outcomes can be achieved.

Fryer G, Alvizatos J, Lamaro J

Published in the International Journal of Osteopathic Medicine Volume 8, Issue 2, June 2005

Self-rated pain and disability significantly reduced during the course of osteopathic treatment, and reductions were evident regardless of the chronicity of the pain. This pilot study suggests that osteopathic treatment may be effective for the management of neck pain. Recommendations are made for further studies.

Haller H, Lauche R, Cramer H, Gass F, Rampp T, Saha F, Dobos G

Published in the Clinical Journal of Pain: May 2016 - Volume 32 - Issue 5 - p 441–449 doi: 10.1097/AJP.0000000000000290

 CST was shown to be specifically effective and safe in reducing neck pain intensity and may improve the functional disability and the quality of life up to 3 months after the intervention. Particularly in chronic and recurrent neck pain, CST may be a worthwhile treatment option in addition to standard medical care. Further studies with rigorous methodological designs and long-term follow ups are needed to confirm CST efficacy in neck pain treatment.

McReynolds TM, Sheridan BJ.

 Published in the J Am Osteopath Assoc Feb;105(2):57-68 2005

The authors found that, at one hour posttreatment, OMT is as efficacious as IM ketorolac in providing pain relief and significantly better in reducing pain intensity. The authors conclude that OMT is a reasonable alternative to parenteral nonsteroidal anti-inflammatory medication for patients with acute neck pain in the ED setting.

Genese JS

Published in the  J Am Osteopath Assoc Jul;113(7):564-7 2013

Whiplash injury is often caused by rear-end motor vehicle collisions. Symptoms such as neck pain and stiffness or arm pain or numbness are common with whiplash injury. The author reports a case of right facial numbness and right cheek pain after a whiplash injury. Osteopathic manipulative treatment techniques applied at the level of the cervical spine, suboccipital region, and cranial region alleviated the patient's facial symptoms by treating the right-sided strain of the trigeminal nerve.

Published in the Man Ther Jun 1 2010

Schwerla F, Kaiser AK, Gietz R, Kastner R. 2013

Moderate quality evidence supports this treatment combination for pain reduction and improved quality of life over manual therapy alone for chronic neck pain; and suggests greater short-term pain reduction when compared to traditional care for acute whiplash. Evidence regarding radiculopathy was sparse. Specific research recommendations are made.

Miller J, Gross A, D'Sylva J, Burnie SJ, Goldsmith CH, Graham N, Haines T, Brønfort G, Hoving JL 

Published in the J Altern Complement Med Jun;19(6):543-9 2013

Five (5) osteopathic treatments had a beneficial effect on the physical as well as the mental aspects of LWS and lives up to its claim of being a complementary modality in the treatment regimen of this condition. Based on these preliminary findings, rigorous randomized controlled studies are warranted.