Neck pain is one of the most common conditions that we see at Central Performance. It can have many different presentations, from first-episode pain that started recently for no particular reason through to whiplash or chronic pain that comes and goes for years. Often desk-workers describe a history of niggling pain and tightness that has been there intermittently for years, but they have now come in for treatment because it’s gradually getting worse, happening more often and lasting for longer.
Whatever the history, exercise has been proven to be one of the most effective treatment options, especially for chronic or recurrent intermittent pain. So in this post we look at one of the most popular exercise options, clinical Pilates exercise for neck pain, to see how it can help not only relieve current neck pain but help prevent or reduce pain in the future. However, before we dive into Pilates exercise it’s helpful to review what causes neck pain, how we classify it into 3 different types, and how we treat neck pain.
Understanding Neck Pain Causes and Best treatment Options
Neck pain can significantly impact your exercise, sport, work, sleep, leisure and overall activity levels. It may also be associated with headaches which can be especially hard to live with, often making people irritable and moody. Given these widespread impacts of neck pain on people’s lives, managing it effectively is important. Understanding the underlying causes of neck pain is a helpful fist step in choosing the most effective treatment, so let’s review the most common causes of neck pain before exploring how we diagnose it and the role clinical Pilates can play in management.
What Causes Neck Pain?
Neck pain can present in a wide variety of ways with many different types of histories. Some of the more common presentations include;
1. Neck Pain Due To Posture, Muscle Strain and Tension
One of the most common causes of neck pain is muscle strain or tension. This is especially common in desk workers due to sustained sitting postures. It’s important to note that research shows it’s not so much about having “bad posture”, but neck pain more relates to long periods of unbroken sitting. This means we don’t need to focus on having “perfect posture” (just “ok posture” is fine!), but what we do need to focus on is moving regularly because whatever posture we have, if we stay there too long without moving we’re much more likely to get pain.
By the way, sit-stand desks are great for allowing this postural variability throughout the day. It’s not that standing is way better than sitting, it’s just that being able to change between the two breaks up sustained postures and this is good for reducing neck pain.
2. Neck Pain due To Trauma or Injury
Accidents (e.g. a car or bike accident), falls, or sports-related injuries can cause damage to the structures of the neck, including muscles, joints, ligaments, tendons, and cervical vertebrae. Often several structures are involved rather than just one isolated tissue. Good management is important following an injury-related neck pain because fully regaining your strength and mobility means it is much less likely to progress into recurrent or chronic neck pain.
3. Neck Pain Due To Degenerative Conditions
Conditions such as osteoarthritis, degenerative disc disease, or cervical spondylosis can lead to neck pain. However, we need to remember that many of these “degenerative changes” are just part of the normal ageing process and are completely asymptomatic, i.e. they are not necessarily related to your pain.
Many studies show that as we age we all get these age-related degenerative changes yet have no pain or symptoms, or only minimal pain despite having extensive changes shown on imaging. While there is some increase in the rate of neck pain as we age, just because an MRI shows arthritis or disc degeneration it doesn’t mean that your pain will be ongoing – in fact it may not be related to your pain at all!
You’d probably be surprised at the number of clients we see who have pain on one side of their neck, but if they have a scan it shows just as much or more degeneration on the other side of their neck. This is why x-rays and MRI/CTs are not required for the vast majority of neck pain cases.
4. Acute Wry Neck
A wry neck is fairly common and despite it being very painful it is not serious and usually resolves fairly quickly. However, if it happens several times then it needs to be assessed and managed more fully to stop it becoming more frequent or chronic. It’s formal name is “acute spasmodic torticollis”, and it often occurs when people wake up in the morning feeling like they have “slept funny”. The pain is really sharp on one side of their neck, and it’s really painful to move their head or they can’t get their head up straight into a normal position. Sometimes their neck might just be stiff to begin with, then they make a movement like quickly flicking their head back to do their hair and their neck “goes” and becomes acutely painful.
How Do You Diagnose Neck Pain? The Three Types of Neck Pain
In the previous section we talked about the four most common presentations or histories of neck pain that we see as physios. Now lets look at how we categorise or diagnose neck pain, i.e. what is actually going on in the neck structures to cause the pain? To do this we diagnose neck pain into three main categories.
1. Non-specific Neck Pain
Non-specific neck pain is by far the most common type of neck pain. It refers to pain in the neck area and often doesn’t have a clear cause or injury, although it may also come on after a specific incident. It’s called non-specific because it’s often impossible to say it is due to one particular structure like a joint or disc, but this doesn’t matter because it doesn’t change the way we treat it. Imaging like x-rays or MRI/CT are not required to diagnose non-specific neck pain and should be routinely used.
2. Radicular Neck Pain
Radicular neck pain, also known as cervical radiculopathy, occurs when a nerve root in the cervical spine (neck) becomes compressed or irritated, leading to pain, numbness, tingling, or weakness that radiates down the arm. Diagnosis of radicular neck pain involves a comprehensive history, assessment of neck range of motion, palpation to assess muscle and joint mobility, and neurological examination to assess reflexes, strength, and sensation in the affected limb. Imaging is not routinely required for diagnosing radicular neck pain, although if symptoms persist or get worse this may be necessary. Beginning appropriate treatment early is important for this type of neck pain because sustained compression of the nerve can cause more significant pathology and longer-lasting symptoms.
3. Serious Pathology/Red Flags
Neck pain due to serious pathology or red flags is very rare. It includes things like spinal fractures (broken bones), tumors, and some types of infections and inflammatory conditions. There are specific screening questions and tests that physios use to identify possible serious pathology and if they are concerned they will discuss this with you and refer you for further investigation.
What Is The Best Treatment for Neck Pain?
Now that we’ve discussed common presentations for neck pain and how we diagnose it, lets summarise some of the popular treatment options. It should be noted that effective treatment for neck pain often involves a multi-faceted approach that is tailored to the individual needs of each person, meaning that there is no magic recipe or single technique that works for everyone. The best treatment options for managing neck pain often include:
1. Physiotherapy For Neck Pain
Neck pain is one of the most common conditions seen by physios and we are well equipped to manage it, especially acute episodes with significant levels of pain. In most cases manual therapy (hands-on treatment) provides fast relief, and progressive exercise is used to restore movement and strength to minimise the risk of recurrence. Another important part of physio management is providing education on modifying activity (exercise, work and leisure) to resolve this episode and reduce the risk of future neck problems.
2. Exercise for Neck Pain
Research shows that exercise is one of the most important and effective ways to manage most types of neck pain. It is especially important in chronic or recurrent cases, i.e. where the pain has been present for extended periods, or has come-and-gone intermittently for some time. There is no clear research showing that one particular type of exercise is best for neck pain, but rather that a personalised program that is tailored to each person is required. (This is exactly the same principle that applies when using exercise for back pain treatment.)
3. Clinical Pilates Exercise For Neck Pain
Clinical Pilates is a popular option for many people when choosing exercise to treat neck pain. As mentioned above the research shows that exercise is a great for neck pain but there is no single way to exercise that is the best for everyone. The reason many clients choose Clinical Pilates is that it combines the benefits of personalised exercise with a physio’s in-depth knowledge of anatomy, pathology and rehabilitation exercise prescription. This means that the program is safe, effective and targeted at the right muscles and movements that are the most important for each person.
4. Lifestyle Modifications
Some cases of neck pain are at least partly caused by our lifestyle and activities. This is often true when neck pain has been there for some time or keeps recurring, because it suggests there is something that we are doing in our lives that keeps triggering the pain.
The most common example is people working at a desk who regularly spend many hours sitting at a computer without getting up and moving. Often simple strategies can be very effective, for example adopting the “5 and 55 rule” (in every hour you are at work you should spend at least 5 minutes up away from your desk and moving), doing some regular exercise to balance out being sedentary at work, plus getting adequate sleep and managing stress can all help.
5. Medications
If necessary, simple over-the-counter medications can be helpful for temporary relief of pain. Common options to try first are Panadol or Neurofen (or their generic versions like ibuprofen), or if you need something stronger then you could speak to a pharmacist about nonsteroidal anti-inflammatory drugs (NSAIDs) like Voltaren. While medications can be helpful in the short term they should not be used as a long-term solution, so if you find yourself reaching for the Panadol on a regular basis then you should get your neck checked out to see why the pain is persisting or recurring.
How Can Clinical Pilates Treat Neck Pain?
The Role Of Deep Neck Flexor Muscles In Neck Pain
Your deep neck flexors are a very important small group of muscles located deep within your neck that are responsible for stabilising and supporting the cervical spine (the part of your spine in the neck). Their primary role is to produce and control movements of your neck, and which is a difficult task due to the large range of multi-directional movement that is available in this area of your spine.
The deep neck flexors also have an important role in maintaining your head position, which is vital for things like balance and maintaining correct spatial alignment of your body. There has been a great deal of research from the University of Queensland which has shown that in people with recurrent or chronic neck pain, their deep neck flexor muscles lack strength, endurance and control.
- Researchers took a group of people with chronic neck pain, and compared the activity of their deep neck flexor muscles with that of a group of subjects without neck pain. The study found that there was significantly less activity of the deep neck flexor muscles in the group with neck pain compared to the control group. This indicates a strong relationship between deep neck flexor muscle strength and neck pain.
- After discovering the key role that deep neck flexors play in neck pain, further clinical trials were undertaken. These studies showed evidence to support that improving the strength of these deep neck flexor muscles through a low load endurance program can translate into reduced neck pain and headaches.
So How Do We Train This Small Group Of Muscles?
This is where clinical Pilates comes in. Clinical Pilates provides a holistic and effective strategy for managing longer-term neck pain. By focusing on targeted exercises that strengthen the deep neck flexor muscles and improve overall posture and alignment, Clinical Pilates helps address the root causes of neck discomfort to provide lasting relief.
If you experience episodes of neck pain, it is worth first being assessed by your physiotherapist to ensure you do not require additional treatment or manual therapy (i.e. hands-on treatment) before you begin these exercises. Other factors that may contribute to long-standing neck pain include stress, muscle tension and prolonged postures (desk workers), which is why it is important to be guided by a physio initially to address these contributing factors before focusing just on exercise.
Clinical Pilates Exercise For Neck Pain And Deep Neck Flexor Muscle Control
1. Lift Off With Arm Floats
Lie on your back with a towel under your head. Gently tuck your chin to your chest and lift the back of your head slightly off the towel. Alternate lifting your arms over your head while maintaining this position.
2. Bird Dog +/- Band
Begin on your hands and knees, then raise one arm and the opposite leg while maintaining a straight line from head to hips. You can use a resistance band to increase intensity.
3. Arms in Straps with Chest Lift
Lift your head slightly off the surface while raising your legs into a tabletop position. Hold this position as you pull the straps down to your sides and back.
The Benefits of Clinical Pilates
Clinical Pilates offers many benefits beyond just addressing neck pain. Here’s a closer look at how Clinical Pilates can positively impact your overall health and well-being:
1. Improved Posture
Poor posture is often a contributing factor to neck and back pain. Clinical Pilates focuses on strengthening core muscles, including those responsible for maintaining proper posture. By improving alignment and body awareness, Clinical Pilates helps alleviate strain on the neck and spine, reducing the risk of discomfort and injury.
2. Increased Core Strength
The core muscles play a crucial role in providing stability and support to the spine. Clinical Pilates exercises target deep abdominal muscles, pelvic floor muscles, and back muscles, helping to build core strength and stability. A strong core not only reduces the burden on the neck muscles but also improves overall body mechanics and movement efficiency.
3. Increased Flexibility and Range of Motion
Tight and restricted muscles can exacerbate neck pain and limit mobility. Clinical Pilates incorporates dynamic stretching and mobility exercises that promote flexibility and joint mobility throughout the body, including the neck and shoulders. By increasing range of motion, Clinical Pilates helps reduce stiffness and tension, leading to increased range of movement and less pain.
4. Stress Reduction
Chronic neck pain often leads to increased stress and tension, creating a vicious cycle of discomfort. Clinical Pilates is commonly known as a “mind-body” way to exercise that helps with mental relaxation and stress relief as well as physical benefits. Mindful movement, deep breathing techniques, and focused attention on body awareness help promote relaxation, reduce muscle tension, and alleviate stress-related symptoms.
5. Long-Term Prevention
Beyond providing symptomatic relief, Clinical Pilates addresses the underlying factors contributing to neck pain, making it an effective long-term solution. By promoting improved movement control, muscle balance, and postural alignment, Clinical Pilates helps prevent future episodes of neck pain and related issues, allowing you to enjoy a more active and pain-free lifestyle.
Clinical Pilates At Central Performance – Surry Hills
Pilates Physios For Neck Pain
The Clinical Pilates program at Central Performance is delivered by Sonja and Brigitte, who are both physios with advanced training in all areas of Pilates including mat, studio and reformer Pilates. By combining their physiotherapy knowledge with professional Pilates training they are able to provide clients with effective exercise programs that progress through all stages of injury management, from early rehab to end-stage functional training including complex whole-body movements.
The wide variety of Pilates equipment we have available at Central Performance means that our Pilates sessions are very adaptable to meet the needs of each client. It also means that sessions are engaging and challenging due to the wide variety of exercises available. The equipment we use includes the reformer, Cadillac, Wunda chair, barrel and mat work.
Our Pilates program also covers exercise sessions for general health and fitness. Often, once clients progress past the injury management stage of the Pilates program (i.e. the more “clinical” stage of Pilates), they continue on with Pilates sessions to continue improving their strength, stability, flexibility and overall fitness. This can include private (1:1), semi-private (2:1) and small group sessions.
For more information on the Clinical Pilates program at Central Performance click the buttons to read more, make an enquiry or to book online.
Clinical Pilates Exercise For Neck Pain – FAQs
How soon can I expect to see results from Clinical Pilates for neck pain?
Results vary depending on the severity of your condition and your commitment to the exercises. Many patients experience improvements in neck pain and mobility within a few weeks of starting a Clinical Pilates program. However, as with most types of exercise the more consistent the sessions are performed over an increasing period of time the better the results.
Is Clinical Pilates suitable for all ages and fitness levels?
Yes, Clinical Pilates can be adapted to suit individuals of all ages and fitness levels. One of the features of our Clinical Pilates program is that our experienced physios will tailor the exercises to suit your specific needs and abilities, and you will do your own personalised program even when in a small-group class.
How often should I participate in Clinical Pilates sessions for optimal results?
The frequency of Clinical Pilates sessions may vary depending on your individual needs, goals and time available. Your physiotherapist will work with you to develop a customised treatment plan that suits you, but generally sessions at least twice per week are recommended. This may also vary depending on which other types of exercise you do, for example many clients find that doing even one Pilates class a week to break up more intense resistance training is very helpful, whereas other people who don’t do any other exercise may come to 3 sessions per week.
Can Clinical Pilates help prevent future episodes of neck pain?
Yes, Clinical Pilates can play a crucial role in preventing recurrent neck pain by strengthening muscles, improving posture, and promoting overall spinal health. Consistent practice of Pilates exercises, along with good ergonomics and breaking up sustained sitting during the work day, can help reduce the risk of future neck pain episodes.
Are there any side effects associated with Clinical Pilates for neck pain?
When performed correctly, Clinical Pilates is a safe and effective treatment option for neck pain. However, as with almost any exercise, some individuals may experience temporary muscle soreness or fatigue as they adapt to the exercises. These symptoms typically resolve quickly with continued practice and proper guidance.
