Neck pain is one of the most common reasons why people seek care with chiropractors in Singapore.
While it may be a scary experience, most of the time neck pain is benign and will resolve by itself.
For those of you who have been living with neck aches or stiffness, today we will discuss everything you need to know about neck pain:
- What is neck pain?
- What is pain?
- What causes neck pain?
- Is neck pain a sign of something serious?
- Should I see a chiropractor for neck pain?
- What neck pain treatments are available in Singapore?
Neck, shoulder, and elbow pain with numbness and tingling in the arm
At Square One Active Recovery, I work with my clients to help them find a long-term pain solution. The end goal? To make my own services redundant to them. Hear it from my client himself!
What is neck pain?
Neck pain refers to any unpleasant symptoms a person may be experiencing around their cervical area.
For most cases, the back of the neck region will be affected and the upper trapezius (shoulder region) is also often involved.
In some cases, a person may also experience headache as a result of their neck pain.
Understanding neck and shoulder pain
Before we talk about your neck symptoms, it is important for you to understand that pain is complex. Your neck aches and soreness is likely an interaction of multiple physical and non-physical factors.
To help you understand your pain better, here are quick three facts for you to consider:
1. Pain refers to any unpleasant experience. This means all the soreness, aches, stiffness and tightness you experience fall within pain.
2. Pain is not an indication of damage. Most people think of pain as a sign that something wrong is going on in the body (e.g. my joints are “worn out“). This is not supported by the latest research. Pain and damage are two distinctively separate things.
3. You can have pain without damage and damage without pain. Take for example, stepping on a piece of lego. There is a lot of pain with zero damage.
For more information about how pain works, check out Pain Neuroscience Education.
Your pain works like an “alarm system” for your body. It is a survival mechanism that is designed to warn you of actual or potential threats.
If you bump hard enough into a car, you can trigger its alarm. Does that mean the car is being broken into?
No, it’s a false alarm.
Likewise if you are experiencing neck ache or a sore neck from sitting at the computer, it is likely that you have an oversensitive “alarm”. Your brain interprets the prolonged sitting experience (or stimulus) as a threat and gives you the pain you are currently experience.
To be absolutely clear, poor posture and text neck are likely marketing narratives that are used to push sales. There is no good research to suggest that poor posture is bad for you.
Can neck pain be a sign of something serious?
Most of us believe that neck pain is the result of “something wrong” in the body.
However, neck pain causes can be anything from poor sleep to a burst fracture of the spine.
Many chronic neck pain patients are fixated on trying to find a root cause for our neck aches and soreness. However, research tells us that there are a lot of factors that contribute to a pain experience!
More often than not, trying to find a root cause (e.g. x-rays, MRIs) lead to poorer treatment outcomes.
You may think your neck alignment is off, your poor posture is the culprit, or maybe you think there is wear and tear in your neck joints because of age. The good news is all of these are false! While it is common to read about the harm of “text neck” on social media, research has consistently shown that you don’t need good posture!
“Text neck” is nothing more than broscience and marketing fluff.
Postural strain is not to be confused with “poor posture”
Postural strain refers to being in a position that is taxing for your body for long periods. This is the muscle pain most people experience with sitting.
For example, neck and shoulder soreness from a long flight or a long drive.
It is true that may experience discomfort due to the way you are sitting for prolonged period of time. However, this sensation will subside once you are able to return to your usual posture and way of moving.
Sitting in a “good posture” position that is uncomfortable for you for an extended time will also lead to postural strain!
Does stress cause neck pain?
We know about the biopsychosocial model for health for some time now.
However, not many — if at all — chiropractors or physiotherapists actually address pain in a holistic, whole-person approach.
The status quo is chiropractors trying to adjust or manipulate your joints or physiotherapists trying to breakdown scar tissue or release tension.
Both structural (and problem-based) approaches are considered to be outdated not not congruent with best evidence practice.
With advancement in neuroscience, we know that people your state of mind can change how your brain process pain. Similarly, we also know that you can change your brain — even to a structural extent — with mindfulness practice.
Other research has shown that stress can make a person more susceptible to pain and it is only of the potential reasons why some people experience chronic pain.
A 2018 study looking at 2339 neck pain sufferers and 3290 healthy participants found that anxiety/depression symptoms are associated with neck pain.
A later study in 2019 examining depression and anxiety in lower back pain patients found anxious and depression patients to experience more severe pain.
In short, the neck discomfort you experience is NOT strictly physical.
Take a few minutes to consider your own experience.
Are you able to identify stressful or busy periods when you experience more severe symptoms than usual?
Acute neck pain
Occasionally, we may accidentally strain our neck muscles or sprain the joints in our necks in our day-to-day life.
This is totally normal and part of the human experience.
The sensation is usually very painful at the onset but will subside with time. Such muscle and ligament pain episodes can last for a couple of days to up to six weeks. In such cases, do consider applying some load management principles to avoid aggravating your pain.
A heat pack will also help.
Current clinical guidelines suggestion avoiding bed rest and neck brace, and to keep active as much as possible.
Some of you may have been told that you have a pinched nerve.
It is indeed possible for pinched nerve or bone spurs to contribute to your neck pain experience.
They typically come with numbness and tingling (known also as radiculopathy) down your arms.
As uncomfortable as they may sound, pinched nerve are minor problems that mostly resolve on their own with time.
If you are worried about slipped disc, understand that disc herniation will resorb over time. That is, it will “unslip” itself back into place.
For more information about radiculopathy and the various treatment approaches for that, check out our post on sciatica.
When to worry about your neck pain
Over 90% of neck pain is not serious. While the pain may be intense and feels worrisome, most patients with neck symptoms do not need immediate medical attention.
If you experience one of the following “red flags” signs and symptoms, please seek medical advice as soon as possible:
- Unexplained weight loss or weight gain
- Unexplained fever, chills, or night sweats
- Unable to bend your neck forwards
- Loss of bladder or bowel control
- Numbness or weakness on only one side of your face, arm, or leg
- Difficulty speaking or swallowing
- Visual disturbances – sudden loss of vision, tunnel vision
- Sudden tension headache onset that is unlike those you have had before
If your neck muscles hurt for more than six weeks, you may want to consider seeking professional help from a chiropractor or physiotherapist.
Your chiropractor will be able to help you manage your symptoms.
A good chiropractor will prescribe you with exercises to give you long-term relief. They may also address the lifestyle changes (e.g. better sleep quality, more physical activity, better stress management) to help you manage your symptoms.
It is unlikely that you will need to consult a spine surgeon. In the rare cases where there may be brain and spinal cord involvement (e.g. spinal stenosis), your chiropractor will refer you to an orthopaedic surgeon or neurologist.
What exercises help neck pain?
I know your neck soreness is real and it is a distressing experience. The best thing you can do for yourself at this stage is to relax. If you are having trouble directing your attention away from your cervical spine, you might want to consider mindfulness practice.
Once you are fairly relaxed, there are a few neck pain exercises you may consider trying:
1) Resistance Neck Exercises
2) Range of Motion Exercises
3) Resisted Range of Motion Exercises
(Videos to come.)
The latest clinical practice guideline for neck injury does not support the use of pain killers.
Can chiropractors help neck pain?
The biggest difference between a chiropractor and a massage therapist or stretch therapist is the training they received. Chiropractors are musculoskeletal (i.e. muscle and joints) health experts who had undergone years of chiropractic clinical training to diagnose and treat your symptoms.
On the other hand, masseuse do no have clinical training and by extension cannot diagnose your neck pain. It is common for massage therapist to treat your pain with only manual therapy (soft tissue massage, trigger point therapy, etc).
Chiropractors are trained to provide an array of treatments such as chiropractic adjustments, dry needling, exercise rehabilitation, physical therapy, ultrasound or laser therapy.
To become an accredited doctor of chiropractic in Australia, chiropractors trained for a minimum of five years at a university level.
How can I relieve my “stiff neck”?
If you are thinking of choosing between a chiropractor or a massage for your stiff neck, choose neither.
Believe it or not, the best treatment for neck pain is actually exercise.
While common passive treatments as such chiropractic adjustments, dry needling, IASTM, trigger point therapy are great for providing some short term relief, exercise + education/coaching is the best approach to long term pain free living.
Instead of focusing solely on pain relief, exercise therapy also takes into consideration your capacity for your current lifestyle.
A good massage may help you feel better for a few days but the discomfort almost certainly always comes back.
Forget the “stiff neck remedy”, a good exercise prescription program will address factors that contributes to your pain so you can achieve long term results.
If you spend eight hours at the computer and your neck starts to ache after two hours, a bad chiropractor or physiotherapist will ask you to spend less time at a computer.
On the other hand, good chiropractors will look at why your symptoms start after two hours and increase your capacity to sit to beyond eight hours. This can be achieve through neck strengthening exercises.
The direct result? You get less pain.
Manual therapy tend to focus on relaxing the muscle strain in neck or removing trigger points. None of these approaches are supported by current research. A paper published earlier this year on the 11 best recommendations for musculoskeletal pain advise for hands-on therapy to be used only as an adjunct.
As for what you can do for yourself at home, you may want to gentle stretching for some temporary relief.
If you have a heat pack or heating pad, they tend to help with aches and soreness as well.
I do not recommend that you apply ice because evidence to support icing – even in acute or sport injury cases – is lacking.
Chiropractic treatment for neck pain
Traditional chiropractors believe that chiropractic subluxations are the cause of your neck symptoms. Their approach to your pain consequentially revolve around treatments to remove subluxations. However, no reasonable quality research to date has been able to demonstrate the existence of chiropractic subluxation.
Read more about how subluxation is dogma rather than science.
In addition to that, results with subluxation-based chiropractors tend to be slow and/or short term. It is not uncommon to hear about them selling packages from 12 up to over 40 sessions.
Unfortunately, there are few chiropractic adjustment benefits. Most of which are short-term. This may be why chiropractors who only do adjustments need to sell packages. To learn more, check out our blog post on spinal manipulation.
Chiropractor for stiff neck
Evidence-based chiropractors are completely different from the traditional chiropractors. We take into consideration the latest research on what works the best for your neck pain.
Because we are willing to adapt and embrace the latest research, we offer more than just spinal adjustments. As a result, you get better results with us than traditional chiropractors.
Square One is one of the only practices in Singapore to offer an evidence-based approach to your neck pain. Over 80% of our clients will experience resolution of their symptoms within four to seven visits. This could be you.
In your treatment program, I will take into consideration your current lifestyle (sedentary vs. athletic) and work with your goals.
If your goal is to sit at the computer for eight hours, I am going to help you achieve that.
If you have a tendency to sprain your neck during your weekly tennis games, I will work with you to address the factors that are contributing to your neck sprain.
Square One likely offers the most holistic approach to neck pain treatment and we deliver true long term results.
Take your time to process what it means to be living with neck pain. If we are looking to start chiropractic treatment for neck pain with Square One, you can book an appointment with us via the form below. We are located at Bukit Pasoh Road, just two minutes away from Outram Park MRT (purple line, Dorsett Hotel exit).