Anatomy

The cervical spine (neck) is comprised of 7 vertebrae (bones) which all glide on each other to produce movement. Fundamentally, each segment bar one is comprised of vertebral foramen which is a central hole which the spinal cord runs through. Either side of this lies transverse foramen through which blood and fight or flight nerve supply runs. Above each cervical spine segment, a nerve root (bundle of fibres sending movement and sensation messages to and from the spinal cord) exits through a neural foramen (hole).

There are three key neck joints; one big joint at the front, and two smaller joints at the back/sides

Biomechanics & planes of movement

Breaking it down, the spine is responsible for moving in four key directions:

• Flexion (looking down)
• Extension (looking up)
• Lateral flexion (tilting sideways)
• Rotation (looking to the side)

However, movement in these planes does not occur equally throughout all the joints. Flexion and extension are initiated by the lower neck segments and are then joined by the upper neck. The lower neck is then again responsible for the very end range of movement.

This is the opposite for rotation; 50% of this movement occurs in the upper neck joints.

Segments 3 to 7 allow anatomical movement in flexion, extension, lateral flexion, and rotation. Segments O to 3 provide flexion/extension and rotation.

Considerations

The orientation of the facet joints begins relatively horizontal at the upper neck, but slopes down to more of a 45 degree angle moving further down

Common pathologies

Common conditions which physiotherapists regularly treat patients for include:

• Cervical facet syndrome (acute wry neck/locked neck)
• Whiplash
• Disc bulge +/- pain radiating into the arm
• Postural pain
• Spinal stenosis (narrowing)

Delving deeper into acute wry neck/locked neck, this is a common condition which results in the temporary locking of a joint at the side of the neck. Many things can trigger it including sleeping position and mattress/pillow, or a quick unguarded movement. It results in the person feeling unable to move their head through their normal range and sometimes severe soreness. They may also experience muscle spasm around the neck which contributes to their symptoms. Whilst uncomfortable and limiting at the time, it is easily treatable by a physiotherapist with simple treatment techniques.

Treatment

There are a variety of treatment options available to treat the neck. These include (but are not limited to):

1. Joint mobilisation (loosening up the joint)
2. Neural stretches (loosening up the nervous system)
3. Soft tissue massage
4. Dry needling
5. Home exercises/strength work

After the symptoms have settled, physiotherapists will address the root cause (work posture, sleeping position, muscle weakness) of the episode to prevent the injury from happening to you again.

None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your injury.

We will include a video soon demonstrating a simple neck exercise to relieve your symptoms.

To know more about neck soreness and to get an assessment, use the link below: