Neck complaints
Neck complaints can be very troublesome and can have a wide range of causes.
Poor posture, stress or a whiplash injury are examples of common causes. What these causes have in common is that they're all forms of overload. This can take the form of structural overload (stress or poor posture), or acute overload (such as suddenly making an awkward movement, or a whiplash injury).
What often happens is that certain muscles tighten up. This leads to restricted movement and can cause pain. The pain may be felt in the neck itself, or it may manifest as pain radiating from the neck into peripheral body parts such as the shoulder, arm, hand, etc. This is explained by several theories, the two most important of which are outlined below.
Referred Pain Principle & Myofascial Trigger Points (Dry Needling)
This evidence-based principle explains how, for example, headache, dizziness and pain in the shoulder or arm can arise from muscle tension in the neck.
A muscle is controlled from the brain via nerve pathways that exit the cervical spine at a particular level. At that same spinal level, the brain also receives and sends information to and from other muscles and areas of skin. This incoming and outgoing information can interfere with each other, meaning that, for example, a tense muscle in the neck —> produces pain in the shoulder.
This principle is also where the concept of myofascial trigger points comes from, on which the widely praised and successful Dry Needling method is based. A trigger point is a tender, localised contraction of a small part of the muscle, and feels like a “knot.” Pressure on a trigger point can produce a recognisable pattern of pain radiating to another part of the body. Every muscle has a unique, characteristic referral pattern typical of that particular muscle. These are specific points in the muscle that, anatomically, hold the most tension, and releasing them can allow the entire muscle to relax. Read more about this under DRY NEEDLING.
Secondly, radiating pain can be explained by nerve entrapment. This can occur in the neck itself or further along the course of the nerve. If the entrapment occurs in the neck, the resulting pattern of complaints follows the dermatomes; if the nerve is entrapped further along its course, the pattern of complaints is different – which allows a therapist to distinguish between the two and trace the cause of the complaint.
If the nerve is entrapped along its course, this can be because certain muscles are tense and therefore thickened, pressing against a nerve, which then causes pain or tingling in a particular area.
