Frustrated with Chronic Neck Pain? What Your Recovery Plan Might Be Missing
Neck pain is a common issue for many people, whether it’s due to posture, stress, or an injury. But when neck pain becomes long-standing or chronic, it can affect your daily life in ways you may not have anticipated. While most people turn to standard treatments like physiotherapy, massage, or over-the-counter pain relief, many rehab plans might be missing key components that could provide lasting relief. If your neck pain seems to persist despite treatment, below is what your rehab plan might be missing.
1. Posture Re-Education
Many rehab programs address neck pain by focusing on the muscles and joints directly involved. However, long-standing neck pain is often the result of your muscles being held in certain positions for long periods of time. If your daily posture—whether at work, while driving, or sitting at home—is contributing to the pain, no amount of therapy will provide lasting relief.
Solution: Posture re-education techniques. This involves exercises to strengthen your postural muscles, ergonomic adjustments to your workspace, and learning how to set boundaries on how long you are sitting or standing on one position for. Next posture is the best posture!
2. Breathing Techniques
It might seem unrelated, but improper breathing mechanics can significantly affect neck pain. When people experience stress or tension, they tend to breathe shallowly, which activates the neck and shoulder muscles more than necessary, contributing to tightness and pain. We call these the “secondary muscles of breathing,” or accessory muscles of respiration, because they are muscles that assist in breathing, usually only during situations when the body requires more oxygen, like during intense physical activity, or when primary breathing muscles are impaired. These muscles are not normally used in relaxed or quiet breathing but may become overactive in individuals who practice shallow breathing techniques.
Solution: Practice diaphragmatic breathing, where you breath into your belly instead of your chest. This reduces unnecessary tension in the neck and shoulders, allowing those muscles to relax.
3. Neck and Shoulder Mobility
Sometimes rehab focuses too much on strengthening the neck muscles but neglects mobility. Without proper mobility in the neck and shoulders, tightness can build up, leading to restricted movement and increased pain.
Solution: Incorporate mobility exercises into your plan. These may include gentle neck stretches, yoga poses that focus on flexibility, and shoulder rolls to encourage better movement patterns. Mobility exercises should be a staple in your routine to loosen tight muscles and improve range of motion.
4. Dry Needling/IMS
One overlooked aspect of treating chronic neck pain is addressing problems in neuromuscular communication. Dry needling can help in two aspects:
Trigger Point Deactivation: Dry needling targets myofascial trigger points, which are hyperirritable spots in the muscle that can cause pain, tightness, and disrupted muscle function. These trigger points often interfere with normal neuromuscular communication, causing the muscle to remain in a shortened or tight state. By inserting a needle into the trigger point, the technique helps release this tension, restoring normal muscle length and reducing pain. This allows the muscle to function more effectively and communicate better with the nervous system.
Local Twitch Response: When the needle hits a trigger point, it often elicits a local twitch response—a quick, involuntary contraction of the muscle. This response is thought to disrupt the dysfunctional motor endplate activity (the junction where nerves meet muscle fibers) associated with the trigger point. By doing so, dry needling "resets" the neuromuscular junction, helping to re-establish normal communication between the nerve and muscle. Afterward, the muscle is more likely to respond appropriately to signals from the nervous system.
When trigger points are deactivated, and muscle tension is relieved, the nervous system can better control muscle movement. By re-establishing proper length-tension relationships in muscles, dry needling enhances proprioception (the body's ability to sense its position and movement). This leads to improved motor control, where the muscles respond more accurately to the brain's commands, improving overall movement efficiency.
Solution: Work with a physiotherapist trained in dry needling/IMS to see if this intervention is right for you!
5. Stress Management
Chronic neck pain isn’t always caused by physical factors alone. Mental and emotional stress plays a major role in muscle tension and pain perception. If your rehab plan doesn’t address stress, you might be missing a critical piece of the puzzle.
Solution: Integrate stress management techniques into your daily routine. Mindfulness practices, meditation, or even short relaxation breaks during the day can reduce muscle tension and improve your overall pain levels. Therapy or counselling can also help if emotional stress is a significant factor in your pain.
7. Consistent Self-Care Routine
It’s easy to think that once the neck pain starts improving, the rehab can stop. But consistency is key to long-term recovery and prevention. Many people find relief only to see their neck pain return because they stopped their exercises too soon or neglected their self-care.
Solution: Make your rehab a lifestyle habit. Even when your pain subsides, continue with maintenance exercises, regular stretching, and self-massage techniques to keep your neck healthy and strong.
8. Nervous System Reset
The nervous system plays a huge role in how we perceive pain. Chronic neck pain can sometimes create a cycle where your brain continues to send pain signals even after the initial injury or issue has been resolved.
Solution: Techniques such as neuromuscular re-education and mindfulness can help reset the nervous system and break the chronic pain cycle. A skilled physical therapist may incorporate these advanced techniques into your treatment.
Conclusion
Long-standing neck pain requires a multifaceted approach. If your current rehab plan isn’t working, it might be time to look at the bigger picture. By addressing posture, breathing, mobility, trigger points, stress, surrounding muscle strength, consistency, and the nervous system, you can create a comprehensive plan that not only treats your pain but prevents it from coming back. Don’t settle for temporary relief—tackle the root causes of your neck pain for lasting recovery.
Bri Hicks Physio & Performance is dedicated to providing evidence based physiotherapy care.
Are you dealing with chronic neck pain? Book a Physiotherapy appointment today or reach out if you have any questions.