Management of neck osteoarthritis
Physiotherapy uses a variety of modalities in the management of neck osteoarthritis based on particular aims directed to:
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• Reduce pain or discomfort in the neck
• Improve active movement in the neck
• Strengthen the neck muscles
Using heat is an effective means of pain relief and when the pain decreases to a limit which allows you to begin exercise, then you may do so gradually.
Reducing pain is a primary goal as some individuals present with tense neck muscles and hence the need to help relax the muscles and reduce any swelling present.
Neck bending exercises
These involve bending exercises of the neck to enhance mobility in instances of stiffness in the neck.
Stand or sit in a comfortable chair and gently bend your neck by moving your chin toward your chest. Hold the position for 15 seconds then bring your head back gently to look at the ceiling.
You may also bring your right ear near your right shoulder as far as you can tolerate and repeat to the left side. Repeat throughout the day.
Neck rotation exercises
This exercise involves the turning of the head. Stand or sit against a wall while you gently turn your head to the right.
Hold for 15 seconds, and then return your head to the midline/middle so that you are looking straight ahead. Then gently turn to the other side and hold for 15 seconds.
Repeat throughout the day.
Chest stretch
Stand against a wall with your arms by your side, elbows relaxed and palms facing out pull or draw your shoulder blades together.
Hold that for 15 seconds and repeat throughout the day.
Posture education
Physiotherapy also assists individuals to learn to correct their poor posture and bring to a halt bad habits which may have developed and eventually make the symptoms worse.
It’s practical to maintain a good posture - straight neck with chin tucked in and with a straight back at all times - for example if you remain seated for prolonged number of hours (more than two hours) then it’s essential to have a desk that prevents excessive bending of the neck and a chair which offers support of the head, neck and shoulders.
A small pillow or lumbar roll could also be used and this is placed between the waist line and the chair, both arms should also be placed on the armrest to provide pain relief to the arms while working.
It’s important to sit upright and not slouch in the seat and stand or walk around briefly every two hours.
It would also be useful to either sleep on a firm mattress to keep the whole spine (including your neck bones) in its alignment. There is the need to use a flat pillow or avoid using a pillow altogether especially when the individual experiences tingling sensation or ‘pins and needles’ in one arm or both.
Large pillows only aggravate pain in the neck and arms. It’s safer to sleep on either side or on the back.
Neck brace
Using a brace for the neck muscles may assist in relieving a lot of pain. Immobilising the neck usually restricts excessive or wrong movements of the neck, thereby reducing any nerve irritation present. The individual's tolerance and compliance are considerations when braces are used.
A firm/hard neck collar may be recommended for some individuals and should be worn during the entire day as its very efficient especially during daily activities or travel.
The individual also needs to wear the soft neck collar whenever he goes to bed to enhance comfort and reduce pain.
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The writer is a senior physiotherapist at the 37 Military Hospital ([email protected])