In this blog I’d like to talk about a very common condition seen in clinic – neck pain.
Neck pain has to be one of the most common complaints seen in clinic. Whether its a crick in the neck or ongoing severe pain which has lasted for number of years, one thing is for sure, neck pain will be having a detrimental effect on peoples daily lives. From avoiding certain movements for fear of triggering an acute episode to holding themselves in all manner of positions to simply avoid the pain, it’s immediately apparent the moment a client with neck pain walks through clinic door the impact it’s having on their daily lives.
Fortunately, there are many therapies available which can help clients out of pain and back on the road to recovery.
Despite this, there are many others who have difficulty in finding any long term relief from their pain, despite keeping up with their exercises and stretching.
For these clients, the frustration and annoyance at having to live with ongoing discomfort can leave them feeling drained.
So, with this in mind, I’d like to talk about a little known therapy called Myofascial Release which I’ve found to produce positive results for clients suffering from chronic pain pain. Hopefully this will give a little hope to those going through the ongoing daily grind with neck pain.
I’ve tried to keep things as simple as possible, and it’s a difficult topic to explain fully in a short blog, but hopefully things will be a little clearer by the end!
Neck Pain and Myofascial Release
Neck pain is a very common complaint among clients seeking manual therapy. Symptoms vary, from those experiencing a constant neck stiffness to others who may be suffering from complete immobility and unrelenting pain.
Many chronic neck pain clients may have received a diagnosis of osteoarthritis, degenerative disc disease or disc bulges — and are convinced these abnormalities are responsible for their pain. Although these medical terms do sound scary, they are, in fact, part of the normal ageing process of the human spine and, depending on how the brain perceives the threat, may or may not be actual pain generators.
It’s quite common for clients diagnosed with a degenerating spine to automatically assume the pathology is responsible for their pain, but this kind of mental connection often causes much unneeded worry and stress.
The point is that many of these diagnosed pathologies may not actually be responsible for the clients pain. Whether there’s a disc bulge, degenerative changes or a nerve entrapment, the pain being experienced may be due to how the body reacts to these changes rather than the actual pathology itself.
The human body is equipped with a nervous system which is responsible for monitoring and regulating changes within the body and informing the brain how to react to these changes.
When ongoing dysfunction is present such as in a degenerative spine, the nervous system will detect these changes and inform the brain. If the brain interprets this information as potentially causing harm, then it will attempt to protect the area in some way – possibly by layering the area with protective muscle spasm or sending pain signals to prevent certain movements it feels may cause further harm.
Although this reaction sounds perfectly sensible – the body is simply trying to protect us from further harm, after all – there are occasions when the brain can be overstimulated by the nervous and ‘over react’ by producing pain, stiffness and immobility.
Quite often, the key to reducing chronic neck pain is to try and encourage the nervous system to accept the changes which are taking place within the spine and therefore prevent the brain from receiving constant messages warning of potential danger and further injury. By doing this, we are trying to encourage the body to learn to live within it’s new environment and accept what are naturally occurring changes within the spine.
But how do we do this and how is myofascial release perfectly placed to help…well read on and I’ll (try) to explain!
How Can Myofascial Release Help With This?
Often when approaching chronic neck pain cases it’s important to understand the role the nervous system may be contributing to the clients pain. Too much pressure applied during treatment may excite the nervous system further, resulting in protective muscle guarding and increased pain as the nervous system attempts to protect prevent further injury to what it feels is an already weakened area.
The key is to find an effective way of releasing the tension without overstimulating the already heightened nervous system. This is where myofascial release is perfectly placed to help.
During a myofascial release session the therapist will gently engage the tissues by applying a slow sustained stretch to the area where the client is feeling their pain. Quite often this will create a reproduction of the clients presenting symptoms but just enough so as not to over stimulate the already heightened nervous system. The therapist will then simply wait until a release is felt within the tissues and/ or the client reports a reduction in their symptoms.
This stretching and low level reproduction of the clients symptoms, allows the body to become aware of the potential threat without having to react and warn the brain of potential further injury. By engaging the tissues in this way, the nervous system can be helped to recognize the area of dysfunction is not a threat and therefore begin to let go of any muscle guarding and reduce pain.
Often in chronic neck pain cases this is often a successful approach in providing safe, effective and long term relief for the client. Once the area has settled, various other treatments such as corrective exercises and movement can be applied.
As previously mentioned, neck pain is a very common complaint seen in clinic and there are many effective therapies out there to help clients resolve their issues. Despite this, there are a number of others who have had little success in finding relief from their pain.
Often, previous diagnosed pathologies may have given them the thought that their condition is beyond help.
When working with these clients, it is important not to dramatize, catastrophize, or blame their pain on the pathology or previous diagnosis. We as therapists must try to avoid language that may trigger fear and stress in the client and possibly induce the nocebo effect. The nocebo effect being the opposite of the placebo effect; the nocebo effect occurs when negative beliefs and expectations influence a situation in a negative way.
This, along with working with the clients body in a way in which it can begin to accept the changes within the spine and learn to live in it’s new environment, can be key components when working with chronic neck conditions.
Body in Balance Therapies are based in West Kirby on The Wirral. For more information please call on 0151 374 2418.