What is it?
Postural neck pain occurs from having sustained poor posture and with prolonged activity with incorrect posture. Typically occurs when the neck, shoulders, and upper back are not in correct alignment and uneven strain is placed on certain structures in the neck, such as muscles, ligaments, vertebral joints and discs.
It is often characterised by a pronounced forward head posture, rounded shoulders and upper back, scapular winging, and an increased curve of the neck (lordosis).
Muscles at the front of the shoulder complex become tight and short, whilst muscles in the back become lengthened and weak. In the neck the opposite occurs, with the front neck muscles become weak, and the posterior neck extensor muscles becoming short and tight. This constant pulling and shortening in prolonged positions can strain the posterior back muscles and pull on their attachment points at the spine. Spinal joints and discs can become irritated due to chronic postural adaptions, usually due to the increase compression as the neck is pulled back into extension (increased lordosis) and altered force distributions around the neck during arm and neck movements.
Postural related pain is common in jobs requiring prolonged periods of looking or leaning forewords to look at computer screens, working at bench tops and driving.
Pain and/or tightness is often described as being muscular in nature, and felt across the top of the shoulders, down the scapular, and at the back of the neck. Pain can also be in the form of headaches, or from the cervical spine itself and referring across the shoulders and the upper back. Movement, or change of position often alleviates these symptoms. People often describe the pain as a diffuse ache or soreness and tender when the muscles are palpated.
Treatment has been shown to be most effective when a combined clinical approach is taken. This includes a combination of manual therapy and rehabilitation exercises including; Spinal mobilisation is done to reduce pain, inflammation and associated stiffness of vertebral joints. Neck mobility exercises and stretches will be prescribed to regain normal range of motion of the neck and reduced stiffness. Muscles relaxation techniques, such myofascial release, trigger point therapy, dry needling and neuromuscular techniques to relax tight overactive muscles and repair strained muscles. Postural control and strengthening exercises, focusing on the deep neck muscle endurance and activation and back retractor and scapular stabiliser muscles endurance. Functional training can be completed to correct activation and timing of postural muscles into every day and work related tasks.
Also increased tension or stress can often cause bad posture and overactivity of some muscles around the neck, which is why relaxation techniques can be implemented to help with this. Use and postural cues and ergonomic aids, such as a supportive chair, elevated computer monitor, visual markers, and reminder notifications also have been show to help with postural neck pain.
If you suffer from postural neck or upper back pain book an appointment with one of our Physiotherapists to help alleviate your symptoms and devise an individualised rehabilitation program.