MUSCLE AND SKELETAL PAIN: NECK PAIN

Most people don't usually think much about the space between their head and shoulders until they find themselves with neck pain. After that driving, talking on the phone and many other everyday activities can become a source of great discomfort.

A visit to a physical medicine and rehabilitation (PM&R) physician, also called a physiatrist, can help people get back to active, pain-free lives.

Accurate Diagnosis Leads to Management of Pain

It is important to identify the root cause of your neck pain. PM&R physicians have the specialized, multidisciplinary training that enables them to not only accurately diagnose the cause, but tailor a treatment plan to alleviate the pain as well.

By diagnosing and managing neck pain, PM&R physicians help patients return to their daily activities.

What Kinds of Problems Might Cause Neck Pain?

Neck pain can be triggered by a wide variety of causes including:

· Repetitive Strain Injury. Occurs from a chronically used part of the body, either in a normal or abnormal way. They are often found in people who sit at desks or work at computers for long periods of time.

· Radiculopathy. A pinched nerve, also called sciatica, usually from a herniated, or slipped, disk.

· Myofascial Pain. Generally an aching pain in muscles that can come from poor posture, sitting at a computer or other job-related tasks. Sometimes myofascial pain causes soreness in different parts of the body like the legs.

· Spinal Stenosis. A narrowing of the nerve openings either around the spinal cord or nerve roots that can cause symptoms similar to a pinched nerve.

· Tendon, Ligament and Soft Tissue Pain. Localized pain when an area is stretched or its muscles are overused. This results in tenderness.

· Spinal Instability. Increased motion between vertebra, usually resulting from an injury. The pain typically feels like tingling in the neck or arms.

Sometimes, the pain may come from a combination of factors or something not even related to the neck. Examples would be shoulder and elbow injuries and gall bladder disease.

PM&R Treatment of Neck Pain

Some of the treatments used by PM&R physicians for neck pain include:

· Medically supervised exercise program

· Medication

· Electrical stimulation/electromyography

· Injections

PM&R treatment is nonsurgical. Should a patient require surgery, the PM&R physician will coordinate care both before and after surgery for maximum rehabilitation.

The rehabilitation of neck pain problems occurs in three phases.

1. During the first phase, called the acute phase, physiatrists treat pain and inflammation.

2. Once your pain has been controlled, you move into the recovery phase. Here, flexibility and strength are developed to help get you back to your daily work, sports and leisure activities.

3. The goal of the maintenance phase is to minimize recurrence of the problem and to prevent further injury. Patients learn ways to avoid causing the injury again.

Why PM&R for Neck Pain?

Physical medicine and rehabilitation (PM&R) is a medical specialty dedicated to restoring optimal function for people with injuries or illness. These physicians, also called physiatrists, are specialists in diagnosing and treating problems of the musculoskeletal system. Physiatrists offer a non-surgical approach to pain and injury, which makes them the ideal choice for neck pain.

After completing medical school, a physician becomes a physiatrist after completing an accredited four-year residency program in PM&R. Many physiatrists also go on to become board certified in the specialty by passing a series of exams.

With their advanced, multidisciplinary training, physiatrists are expert in examining all aspects of neck pain — they may determine that there are underlying problems in other parts of your body that are causing your neck pain. Most important, physiatrists have many treatment methods available to reduce or eliminate your problems and to decrease the possibility of a recurrence.

They conduct a thorough exam and collect your medical history to identify the source of your pain, injury or disability, even when standard diagnostic tests don't find specific problems. In addition, physiatrists direct your treatment team if you need any other services, such as those of a physical therapist or athletic trainer. The result is a customized treatment program tailored for you.

By evaluating the impact of a condition on the whole person — medically, socially, emotionally and vocationally — physiatrists help their patients understand and take control of their health.

To locate a PM&R physician in your area or to learn more about physical medicine and rehabilitation, visit www.aapmr.org. Your primary care physician also can refer you to this specialist.