FAQs

Managing Severe Neck Pain

When Should You Be Concerned About Neck Pain?

Experiencing neck pain or stiffness is a common issue that can significantly impact your daily life. This discomfort might manifest as sharp pain, dull aches, headaches, or even complete restriction in moving your head. However, it's reassuring to know that most neck pain is mild and often resolves with simple treatments.

Identifying Serious Neck Conditions

While it's true that most neck pain isn’t serious, it’s crucial to properly diagnose its cause. This step ensures that your physiotherapist or doctor can provide the most effective treatment. In cases of severe neck pain, immediate professional consultation is advised.

Urgent Cases: When Immediate Action is Needed

In certain situations, neck pain can signify a more severe condition, such as spinal fractures or nerve damage. If you’ve been in an accident or experience intense pain, immediate medical attention is necessary.

The 3 General Red Flags of Neck Pain

Be alert to these warning signs:

1. Persistent or worsening pain.
2. Discomfort lasting several weeks.
3. Presence of at least one other red flag symptom.

Red Flags: Symptoms to Watch For

If you experience any of the following, seek professional advice promptly:

• Pain upon light tapping on the spine.
• Unexplained dizziness, nausea, or vomiting.
• Sudden severe headaches or “thunderclap headaches”.
• Symptoms of meningitis such as severe headache, neck stiffness, fever, or altered mental state.
• Unexplained fevers or chills.
• Remote symptoms like poor hand coordination, weakness, numbness, or gait awkwardness.

Understanding Remote Symptoms

Neck pain may be accompanied by symptoms affecting other parts of the body. These include coordination issues, weakness, numbness, or unusual pains. Weight loss without dieting can also be a concern, potentially indicating a more serious condition like cancer.

Recognising Vascular and Autoimmune Symptoms

Neck pain could be a precursor to more severe conditions like strokes or autoimmune diseases. Key indicators include throbbing pain, family history of autoimmune diseases, morning stiffness, and symptoms in various joints.

What to Do: Seeking Professional Advice

If your neck pain is accompanied by any of the aforementioned symptoms, or if you feel generally unwell, it's important to seek professional medical advice. Your doctor or physiotherapist can offer tailored advice and treatment options, addressing both the pain and its underlying causes.

Conclusion

Neck pain, while common, can sometimes be a symptom of more serious health issues. Recognising the warning signs and seeking timely professional advice is crucial for effective treatment and recovery.

For more detailed information and to book an appointment, visit PhysioWorks.

Remember: Your health is important. Don't ignore persistent or severe neck pain. Consult a physiotherapist to understand the best course of action for your specific condition.

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Related Articles

For more information and to understand the latest research and treatments for neck pain, refer to the articles available on the PhysioWorks website: Neck Pain Articles.

Neck Treatment

How Can You Relieve Your Neck Pain?

Neck pain is a prevalent issue that affects a large portion of the population at some point in their lives. The discomfort can arise from various sources, making a comprehensive evaluation and neck treatment by a healthcare professional essential.

Diving Deeper into the Causes of Neck Pain

Neck pain can originate from numerous factors including muscle strain, joint degeneration, nerve compression, or even stress and poor posture. In some cases, it may also be a symptom of a more serious condition such as arthritis or disc disease. Understanding the specific cause is crucial as it guides the treatment approach.

The Role of Posture in Neck Health

Poor posture is a significant contributor to neck pain. Spending long hours in front of a computer, looking down at your phone, or even reading in bed can lead to posture-related discomfort. Improving posture through ergonomic adjustments and regular posture-awareness exercises can mitigate these risks. Neck treatment starts with posture improvement.

How Do You Treat Neck Pain?

Physiotherapists often use a combination of manual therapies such as massage, mobilisation, and manipulation alongside exercise programs tailored to strengthen the neck and improve flexibility. These neck treatments not only alleviate pain but also address the root cause of the discomfort.

The Importance of Regular Exercise

Specific exercises designed to strengthen the neck muscles and improve range of motion are vital. These exercises can be simple neck stretches or strength-building activities that focus on the neck and upper back. Consistently integrating these exercises into your daily routine can significantly improve neck health over time.

Immediate Actions for Acute Pain

For sudden and severe neck pain, such as from a neck spasm or after an injury, immediate care is crucial. While a neck collar might be used in the very short term to stabilise the neck, it's generally recommended to avoid long-term use as it may weaken neck muscles. Instead, physiotherapeutic intervention should be sought to assess the injury and begin appropriate neck treatments.

Chronic Neck Pain Management

If neck pain persists for more than three months, it is considered chronic and requires a more structured neck treatment approach. Early and consistent treatment can prevent the pain from becoming a permanent issue, with strategies tailored to the individual’s specific needs and lifestyle.

Selecting the Right Pillow

The choice of pillow is critical in preventing and managing neck pain. The right pillow should align the neck comfortably with the rest of the spine. Various pillows are designed for different sleeping positions and personal preferences, ensuring that the neck remains in a neutral position throughout the night.

Consulting a Professional

It is always advisable to consult with a physiotherapist for a personalised assessment and tailored neck treatment plan. They can provide specific advice and interventions based on the individual's condition, lifestyle, and overall health goals.

Conclusion

Managing neck pain effectively requires a holistic approach that includes understanding the underlying causes, improving posture, engaging in targeted exercises, and choosing the right ergonomic tools. By addressing these key areas, individuals can significantly enhance their neck health and overall quality of life.

Related Articles

1. Understanding Neck Pain: Causes, Symptoms, and Treatments
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2. How to Manage Chronic Neck Pain
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3. The Role of Physiotherapy in Treating Neck Pain
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4. Best Practices for Neck Posture Correction
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What Causes Neck Pain Without Injury?

Neck pain without injury frequently plagues the clinic. Experiencing neck pain without any apparent triggering event can be particularly vexing.

This discomfort can often be attributed to microtraumas resulting from factors such as poor posture, inadequate sleeping positions, or repeated strenuous movements throughout the day that exert significant strain on the neck. This pain typically emanates from issues like muscle strains, sprained facet joints, or bulging discs. Rather than stemming from a single injury, these structures suffer injury due to persistent microtrauma.

So, how can one rectify their posture?

The spinal column comprises three distinct curves: a concave curve in the lower back, a convex curve in the mid-back, and another concave curve in the neck. Research has revealed that individuals with neck pain tend to flatten the curve in their neck, leading to a forward head posture.

Injuries in any part of the spine can lead to changes in spinal alignment, which often extend to affect the neck. For instance, lower back pain can result in a flattened lower back curve—a common postural adaptation. This increased demand on the muscles that support the head can eventually lead to muscle spasms, pain, or even muscle failure, allowing the head to shift forward. This is just one of several potential mechanisms, and your physiotherapist can pinpoint previous injuries that may contribute to your neck pain and its impact on your neck.

Furthermore, sustained positions like frequently looking down at a phone, laptops, or during gaming can also lead to a forward head posture. This phenomenon is commonly referred to as "text neck" and is on the rise in our community.

What, then, are the consequences of a forward head posture?

The neck's vertebral level comprises three joints: the vertebral bodies and discs in the front and facet joints in the back, located on either side of the spinal cord.

A forward head posture shifts the weight of the head forward, subjecting the vertebral bodies and neck discs to undue stress. The loss of the neck's natural curve has been associated with conditions like cervical spondylosis, bulging discs, and chronic neck pain.

This condition has garnered the nickname "Nerd Neck."

How should one sleep when experiencing neck pain?

To minimise strain on the front joints of the neck, which include the vertebral body and disc, consider sleeping in a side-lying position as upright as possible, avoiding the fetal position, which can promote a forward head posture. You can achieve this by adjusting your pillow a few inches higher and stretching your neck to meet it.

For those who sleep on their back, choosing a pillow that fully supports the neck is crucial to prevent rotation. The pillow should not be overly thick to prevent encouraging a forward head posture. Nevertheless, sleeping on your back is generally not recommended due to the sustained neck positions required throughout the night.

More Info: Recommended & Healthy Sleeping Postures

Resolving Your Neck Pain

Whether your neck pain arises from sleep positioning, poor posture, or repetitive neck-related movements, a trained physiotherapist is equipped to identify and address the underlying causes. Book to see your physiotherapist for an individualised assessment.

More info: Neck Pain

Neck Pain Products & FAQs

Understanding the Root Causes of TMJ Dysfunction

Temporomandibular Joint (TMJ) dysfunction is a complex musculoskeletal disorder that can bring about a range of discomforts, affecting various aspects of daily life. This condition arises from a combination of factors that impact the intricate workings of the jaw joint and associated muscles.

Unravelling the Complexity of TMJ Dysfunction

TMJ dysfunction, a term encompassing a multitude of symptoms, is not simply rooted in a singular cause. Rather, it emerges from a symphony of factors that influence the mechanics of the jaw joint. Masticatory muscle dysfunction, derangement or displacement of the TMJ articular disc, and the grinding of teeth (bruxism) all play pivotal roles. Occlusal issues, characterised by poor bite alignment or asymmetry, further contribute to the intricate web of causes. Additionally, contributing factors like mandibular malalignment resulting from occlusal appliances or orthodontic treatments, wisdom teeth extraction, prolonged mouth opening during dental procedures, poor cervical posture, myofascial pain, neuropsychological elements, stress, and less common triggers such as trauma and anatomical anomalies add to the complexity.

What Causes TMJ?

TMJ dysfunction arises from various factors that impact the musculoskeletal system. It's a multifaceted disorder encompassing diverse causes, including:

• Masticatory muscle dysfunction,
• Derangement or displacement of the TMJ articular disc,
• Nocturnal teeth grinding (bruxism) leading to heightened TMJ pressure and uneven movement,
• Occlusal problems like poor bite, asymmetry, or retrognathic conditions.

Contributing elements consist of:

• Secondary mandibular misalignment due to orthodontic treatment or occlusal appliance,
• Wisdom teeth extraction,
• Prolonged mouth opening during dental procedures,
• Suboptimal cervical posture,
• Myofascial pain,
• Neuropsychological factors,
• Stress,
• Less common triggers like whiplash, trauma, infection, polyarthritic conditions, tumours, and anatomical irregularities.

Categorising TMJ Dysfunction for Better Understanding

To better comprehend the manifestations of TMJ dysfunction, it's essential to classify them into distinct clinical categories. These classifications include painful jaw muscle movement, articular disc displacement, and arthralgia or arthritis. Each category represents a facet of the intricate dysfunction that can arise within the TMJ structure. With these classifications in mind, TMJ healthcare professionals can develop targeted treatment plans tailored to each individual's specific symptoms and needs.

The typical presentations of TMJ dysfunction fall into three clinical diagnostic categories:

• Painful jaw muscle movement,
• Articular disc displacement,
• Arthralgia or arthritis.

(Source: Dworkin SF, LeResche L., 1992)

What Triggers Jaw Clicking?

Jaw clicking signifies articular disc displacement, often managed by a TMJ physiotherapist. Clicking might occur while opening, closing, or both. Seek assessment from a TMJ physiotherapist for precise diagnosis and a tailored treatment plan.

Common Causes of TMJ Dysfunction and Jaw Pain

TMJ or jaw discomfort stems from multifaceted origins. Two primary culprits stand out: abnormal jaw opening or closing.

TMJ Dysfunction - Irregular Opening

Most cases of TMJ dysfunction result in incomplete or uneven jaw opening. Fortunately, physiotherapy assessment and intervention yield swift and positive outcomes in these instances, as teeth occlusion isn't a concern.

TMJ Dysfunction - Abnormal Closing

Closing issues can stem from both teeth occlusion and TMJ incapacity to close seamlessly. If it's primarily joint stiffness or muscle timing, physiotherapy proves highly effective. However, occlusion-related matters warrant evaluation by a dental surgeon to assess bite alignment.

Conclusion

In conclusion, TMJ dysfunction is a multifaceted condition that stems from a combination of intricate factors impacting the temporomandibular joint. From muscle dysfunction to occlusal problems and various contributory elements, the causes of TMJ dysfunction are wide-ranging and interconnected. By understanding these underlying causes and classifications, individuals and healthcare practitioners alike can better navigate the complexities of this condition. Whether through physiotherapy, dental assessment, or other interventions, addressing the multifaceted origins of TMJ dysfunction holds the key to alleviating discomfort and enhancing quality of life.

TMJ & Jaw Pain FAQs

• TMJ FAQs
• Jaw Pain
• What Causes TMJ?
• TMJ Dysfunction
• TMJ Headache
• TMJ Treatment
• Jaw, Neck & Headache Conditions
• Tension Headache

When Should You Worry About Dizziness?

Dizziness, a common complaint among patients of all ages, can be a disconcerting experience. While often not a sign of a severe condition, certain symptoms accompanying dizziness warrant closer attention. This article, from a physiotherapist's perspective, aims to guide you through understanding and managing dizziness.

What is Dizziness?

Dizziness is a sensation of unsteadiness or a feeling of movement within the head. It encompasses various feelings, such as light-headedness, imbalance, or a false sense of spinning. Understanding the nature of your dizziness is the first step in addressing it.

Recognising Serious Symptoms

Dizziness typically isn't a cause for alarm. However, if accompanied by symptoms like double vision, difficulty speaking, sudden leg weakness, or persistent nausea, it’s crucial to seek medical attention. These could indicate more serious underlying health issues.

When to Seek Help

If your dizziness is recurrent, worsening, or accompanied by the aforementioned symptoms, consult a healthcare professional. Physiotherapists can play a crucial role in diagnosing and treating balance-related issues. They offer exercises and strategies to manage and alleviate symptoms.

Latest Research

Recent studies indicate that targeted physiotherapy can significantly improve balance and reduce dizziness-related symptoms. Techniques such as vestibular rehabilitation have shown promise in treating conditions like benign paroxysmal positional vertigo (BPPV).

Consulting Your Physiotherapist or Doctor

When experiencing persistent dizziness, a physiotherapist or doctor can provide a tailored treatment plan. They may perform specific assessments to determine the cause of your dizziness and suggest appropriate exercises or treatments.

What to Do?

1. Monitor your symptoms and note any triggers or patterns.
2. Schedule a consultation with your physiotherapist or doctor.
3. Follow prescribed exercises and attend regular follow-up sessions.

Conclusion

Dizziness, while common, can sometimes signal more serious conditions. Understanding when to seek help is crucial. With the guidance of a physiotherapist, managing and overcoming dizziness is achievable.

Related Articles

1. Dealing with Persistent Dizziness: Physiotherapy Approaches
2. Understanding Vertigo: Causes and Treatments
3. Navigating Balance Issues: Physiotherapy Insights

Vertigo and Dizziness: A Physiotherapist's Guide

How Do You Know If You Have Vertigo or Dizziness?

Experiencing dizziness can be both unsettling and confusing. This feeling often raises the question: Is it vertigo or just dizziness? Dizziness encompasses a range of sensations, including feeling faint, woozy, weak, or unsteady. Vertigo, however, is a specific type of dizziness that gives you the sensation that you or your surroundings are spinning or moving.

To determine the specific cause of dizziness, a healthcare professional must conduct a proper evaluation and diagnosis.

What are the Top 3 Causes of Dizziness?

1. Inner Ear Disorders: The most common culprits include Benign Paroxysmal Positional Vertigo (BPPV), Meniere’s disease, and vestibular neuritis, which directly impact your balance.
2. Neurological Issues: Conditions such as migraines and strokes affect the brain's processing of balance and spatial orientation, leading to dizziness.
3. Blood Pressure Changes: Both high and low blood pressure can disrupt your equilibrium, causing a dizzy sensation.

What are the Red Flags for Dizziness?

It's crucial to recognise when dizziness might signify a more serious issue. Pay attention to these warning signs:

• Sudden, severe headache
• Chest pain or heart palpitations
• Difficulty speaking or understanding speech
• Vision changes, including double vision
• Weakness or numbness, especially on one side of the body
• Loss of consciousness or fainting

How to Stop Feeling Dizzy

Here are some immediate actions you can take:

• Sit or lie down to prevent falls and rest until the dizziness passes.
• Hydrate, as dehydration can exacerbate dizziness.
• Avoid sudden movements, especially rapid changes in position.
• Focus on a fixed point to help stabilise your surroundings.

When Dizziness is Serious!

Dizziness warrants professional attention when it's:

• Accompanied by any of the red flags mentioned above.
• Persistent, recurring, or progressively worsening.
• Impacting your ability to perform daily activities.

What is Vertigo?

Vertigo is a specific type of dizziness characterised by the sensation that you, or the environment around you, is spinning or moving. Unlike general dizziness, which can include feeling faint, lightheaded, or unsteady, vertigo gives a false sense of rotational movement. This condition can be quite disorienting and is often accompanied by other symptoms such as nausea, vomiting, balance problems, and sometimes hearing loss.

Vertigo is usually a symptom of an underlying condition, often related to problems in the inner ear or vestibular system, which is responsible for helping the brain process information about motion, equilibrium, and spatial orientation. Disorders in this system can lead to vertigo, giving the affected individual the disturbing sense of spinning or moving, even when they are perfectly still.

Why Do People Get Vertigo?

Vertigo can stem from various causes, including:

• Inner Ear Disorders: The most common cause is BPPV, where tiny calcium particles clump up in canals of the inner ear. Other causes include Meniere's disease (inner ear fluid build-up) and vestibular neuritis (inner ear nerve inflammation).
• Neurological Issues: Such as a stroke or multiple sclerosis affecting the parts of the brain that interpret balance and spatial information.
• Head or Neck Injuries: Trauma to the head or neck can damage the inner ear or brain, leading to vertigo.
• Medications: Some drugs can cause vertigo as a side effect.

How Long Does Vertigo Usually Last?

The duration of vertigo depends on its cause:

• BPPV: Episodes are brief, typically lasting less than one minute. However, the condition might recur sporadically.
• Meniere's Disease: Attacks can last from 20 minutes to 24 hours.
• Vestibular Neuritis: Symptoms may be more persistent, gradually improving over several days to weeks.

What Is the Best Therapy for Vertigo?

The best therapy depends on the underlying cause but generally includes:

• Vestibular Rehabilitation Therapy (VRT): This is considered one of the most effective treatments for many types of vertigo. It involves exercises designed to retrain the brain to recognise and process signals from the vestibular system and coordinate with visual and proprioceptive cues.
• Canalith Repositioning Maneuvers (like the Epley Manoeuver): Specifically effective for BPPV, these manoeuvers help to move the dislodged calcium crystals that cause vertigo.
• Dietary Changes and Lifestyle Adjustments: For conditions like Meniere's disease, reducing salt intake and managing stress can be beneficial.
• Medication: In some cases, medications are used to reduce symptoms like nausea or to address underlying conditions.

How Do You Get Vertigo to Go Away?

To alleviate vertigo, treatments focus on the underlying cause. Here are some common approaches:

• Epley Manoeuver: The Epley manoeuvre is one of several BPPV treatment options. It involves a series of head and body movements performed by a healthcare professional to reposition crystals in the inner ear that cause BPPV. However there are three vestibular canals in each ear. While the Epley manoeuvre is highly successful for resolving the otolith crystals for the posterior canal, it may not assist crystal within the horizontal or anterior canals. For the best and quickest solution, please seek the advice of a vestibular physiotherapist.
• Medication: Drugs to relieve symptoms like nausea or to treat underlying conditions causing vertigo.
• Vestibular Rehabilitation Therapy (VRT): A specialised form of physiotherapy designed to strengthen the vestibular system and improve balance.
• Lifestyle Adjustments: Reducing intake of caffeine, alcohol, and tobacco; staying hydrated; and managing stress.

Related Articles

1. Cervicogenic Dizziness & Cervical Vertigo - Tips & Treatment: Offers insights into how neck disorders can cause dizziness and vertigo​​.
2. Vestibular Rehabilitation Therapy (VRT): Explains how vestibular physiotherapy can assist in managing balance issues and dizziness​​.
3. What Are The Symptoms Of BPPV?: Details the symptoms of Benign Paroxysmal Positional Vertigo and its treatment​​.
4. Vestibular Migraine: Discusses the challenges in diagnosing and treating vestibular migraines, which affect balance and spatial orientation​​.
5. Vertigo Causes & Dizziness Causes - Advice & Managing Tips: Provides information on various causes of vertigo and dizziness, along with management tips​​.
6. Vestibular FAQs: Offers answers to frequently asked questions about vertigo and dizziness, enhancing understanding of these conditions​​.
7. How to Improve Balance: A guide on improving balance through exercises, highlighting the significance of balance assessments and fall prevention​​.
8. What Are The Four Types Of Dizziness?: Explains the four distinct types of dizziness, their causes, and symptoms​​.

What are the Symptoms of BPPV?

The symptoms of Benign Paroxysmal Positional Vertigo (BPPV) can include the following:

• Sudden episodes of violent vertigo.
• Dizziness and nausea.
• Movements of your head trigger vertigo.
• Your eyes may drift and flick uncontrollably (nystagmus).
• Your vertigo may last half a minute or more.

What Causes BPPV?

Inside your inner ear, there is a series of canals filled with fluid. These vestibular canals are at different angles. When your head is moved, the liquid rolling inside these vestibular canals tells the brain exactly how far, how fast and in what direction your head is moving.

BPPV is caused by little 'ear rocks' or otoconia (calcium carbonate crystals) within the vestibular canals.

Usually, these crystals are held in unique reservoirs within other inner ear structures (saccule and utricle). It is thought that injury or degeneration of the utricle may allow the 'ear rocks' to dislodge and escape into the balance organ and interfere with your vestibular system.

What Causes Your 'Ear Rocks' to Dislodge?

Factors that may cause or allow 'ear rocks' to migrate into your vestibular canals include:

• Head or ear injury.
• Ear surgery or ear infection, such as otitis media.
• Degeneration of the inner ear structures.
• Vestibular neuritis (viral infection of the inner ear).
• Meniere's disease (a disorder of the inner ear).
• Some types of minor strokes.

In around half of BPPV cases, you can't find the cause of your BPPV, known as idiopathic BPPV.

How is BPPV Diagnosed?

Dizziness and vertigo are common to many medical conditions, so careful differential diagnoses are essential. Your physiotherapist or doctor may use several tests to diagnose BPPV.

What is the Treatment for BPPV?

'Ear Rock' Relocation Techniques

After assessing you and confirming BPPV, your BPPV-trained physiotherapist will apply specific techniques to relocate the "ear rocks" to an area in the inner ear that doesn't stimulate your feelings of dizziness or vertigo.

How Successful is BPPV Treatment?

When performed correctly, BPPV techniques immediately reduce your vertigo, dizziness, and other symptoms of BPPV is immediate in 80% or more cases. Quality BPPV practitioners have a 90%+ success rate within three applications of the techniques.

Other BPPV Treatment Options?

Due to the physical presence of ear rocks within your vestibular canal, only the relocation of these ear rocks will clear your BPPV symptoms. You may find some drugs that can help you mask your BPPV symptoms by diminishing your sensitivity to your vestibular symptoms, and they work similarly to seasickness medications. Would you please discuss this medicated option with your doctor?

Who Performs BPPV Treatment?

Some vestibular physiotherapists and doctors are trained in assessing and treating BPPV. BPPV-trained physiotherapists undertake specific training to diagnose and successfully treat BPPV.

PhysioWorks has several BPPV-trained physiotherapists. Please call them to book your appointment with a BPPV physiotherapist.

More Info

• BPPV - Benign Paroxysmal Positional Vertigo
• Vestibular Physiotherapy
• Common Causes of Vertigo & Dizziness

More information: Balance, Dizziness & Vertigo FAQs and Health Products

What Are The Four Types Of Dizziness?

The four types of dizziness are vertigo, dysequilibrium, presyncope and lightheadedness.

Vertigo refers to a spinning sensation, or a false sense of movement, even when the body remains still. There are numerous possible causes of this, though it is frequently associated with conditions that affect the vestibular system, a group of structures within your ears that help work out the position of your body in space.

More info: What is Vertigo?

Dysequilibrium is the feeling of being off balance or wobbly and has numerous causes. Contributing factors include brain changes, nerve pathologies, and musculoskeletal disorders. The dysfunction will affect your ability to feel steady in space.

Presyncope refers to feeling faint or as if you are going to black out. This is commonly associated with conditions that involve the heart and blood supply of the body. One example is orthostatic hypotension, or dizziness brought on by a change in posture, e.g. from lying down to standing up.

Lightheadedness is a general feeling of giddiness as if you are disconnected from your environment. This is sometimes attributed to hyperventilation, a process where the amount of breathing is greater than what the body needs, and can be related to anxiety disorders.

The assessment and diagnosis that is causing your dizziness can be complicated. Please consult your trusted doctor or a vestibular physiotherapist.

More information: Balance, Dizziness & Vertigo FAQs and Health Products