Physical Therapy for Neck Pain Infographic

Neck pain is the leading cause of worldwide disability and one of the most common reasons for entering into the healthcare system for relief. Neck pain affects 30-50% of adults, the majority of whom experience a reoccurrence of neck pain within 1-5 years after the initial episode of neck pain.  The neck is particularly vulnerable to injury as it is a complex structure comprised of bones, nerves, muscles, ligaments, and tendons that house and protect the spinal cord while remaining strong, flexible, and mobile.

Neck pain can result from an injury during sports, a fall, a car accident, or diseases such as rheumatoid arthritis or meningitis. Neck pain can also be caused by osteoarthritis, herniated discs, or mechanical issues due to poor posture, overuse, or repetitive movements. With neck pain, it is common to experience pain throughout the neck, upper back, shoulders, and arms; numbness or tingling in these areas; muscles spasms in the neck; weakness in the arm or shoulder muscles; or stiffness when trying to move or feeling stuck in a certain position.

Physical therapy is one of the most effective treatments for neck pain rather than surgery or pain medications. Physical therapy reduces and eliminates neck pain and stiffness, restores range of motion in the neck, and strengthens the postural flexibility of the neck. Physical therapy treatment may include pain management using heat and ice therapy, manual therapy soft tissue and joint mobilizations of the neck, cervical traction to gently stretch the neck to relieve pressure, and targeted strengthening exercises of the neck and spine.

A 2019 study showed that physical therapy treatment that combines manual therapy and targeted strengthening exercises benefits neck pain patients and helps them to regain function. Evidence supports strength training of the upper quadrant (neck, scapula region, and upper limbs), upper quadrant endurance training, and neck and shoulder muscle girdle control and stabilization exercises.

Another study assessed the effectiveness of an individualized physical therapy intervention in treating neck pain. In this study, 30 patients completed physical therapy treatment while the control group of 27 did not receive treatment: all 57 participants in the study experienced neck pain. After four weeks, both groups were evaluated. The patients who received physical therapy demonstrated statistically significant increases in cervical range of motion, decreases in pain, increases in physical performance measures, and decreases in the level of disability. The control group showed no differences in these outcomes.

A 2016 study revealed that when patients received early physical therapist management they were twice as likely to experience a meaningful change in disability and were 1.8 times as likely to achieve a meaningful reduction in pain in comparison if they waited longer than 4 weeks to receive care.

The study evaluated healthcare utilization over 1 year among 308 patients with neck pain, who were divided into three groups: the early group that consulted a physical therapist within 14 days of the onset of neck pain, the delayed group who received a physical therapy consult between 15 to 90 days after the initial healthcare provider consult, and the late group who waited between 91-364 days to consult with a physical therapist.

The results from the study showed that early physical therapy care for neck pain not only leads to decreased pain and improved function and range of motion in the neck but also a more efficient use of the healthcare system by the patient:

  • Compared to the early physical therapy group, the delayed group was 5.34 times more likely to receive a spinal injection to manage pain than the early group.

  • The late group was estimated to be 2.79 times more likely to receive an opioid prescription than the early group.

  • The delayed and late groups were 4 times more likely to receive an MRI and nearly 3 times as likely to receive an x-ray compared with the early group.

  • At the end of 1 year, the average adjusted total health care cost for the early group was $1,853—about $1,000 less than the cost for the delayed group ($2,917) and less than half the cost associated with the late group, which averaged $4,026.

Physical therapy is an effective, safe, low-cost treatment option to address neck pain, improve function and mobility in the neck, and return patients to daily life, work, and sports in a timely manner.

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Managing Rotator Cuff Tendinitis and Tears with Physical Therapy