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Physiotherapy in Neck Pain

The neck is the spinal structure that supports the head. It is the least protected structure compared to the rest of the spine. Due to its anatomical structure, the neck is highly vulnerable to injury and from conditions that produce pain and restriction of motion. Physiotherapy is a therapeutic management designed to restore the neck’s flexibility and maintain its normal range of motion. It comprises treatment options that are designed for the patient’s specific condition.

Causes of Neck Pain

  • Neck pain is a common medical condition. It may be due to biomechanical causes and injury arising from traumatic accidents or a standing medical condition. Common causes of neck pain may be due to muscle strain, disc herniation or degeneration, and worn-out cervical joints. A whiplash injury is another common neck injury that occurs due to a mobile accident with resulting extreme pain and injury to the neck.


  • Physiotherapy provides several benefits in relieving neck pain. It can help maintain the strength of the neck muscles when under threat to be weakened by certain conditions such as spasm and pain. It also helps improve the flexibility of the neck muscles through the help of therapeutic neck exercises. Moreover, it adapts other forms of treatment such as manipulation, treatment modalities and massage that help improve the circulation and range of motion of the neck, which are vital to help relieve neck pain.

Types of Physiotherapy

  • Physiotherapy involves a variety of therapeutic approaches in managing neck pain. Common among the treatment options for neck physiotherapy are massage, manipulation, application of modalities such as hot or cold compresses, electrical stimulation and neck exercises. The aims of these types of therapeutic approaches to neck pain are to relieve inflammation, relax the cervical muscles, relieve neck pain, reduce compression to the cervical discs, strengthen the neck muscles and promote its muscular tensile strength, flexibility and mobility.

Physical Therapy Exercises

  • Because neck pain most frequently occurs due to muscular strain and injury, strengthening the neck muscles is vital in order to withstand cervical immobility and stiffness in the presence of neck pain. Stretching exercises improve the flexibility of the neck, which may become immobilized by pain. Basic range-of-motion exercises such as flexion, extension, side bending and rotation of the neck are done in gradual ranges that are tolerable to the patient. Neck exercises are integral in maintaining range of motion and warding off stiffness and pain.


  • While the main goal of physiotherapy treatment is to help restore the normal function of the neck, there are still potential risks. It is important to be aware of any symptoms such as tingling or a numbing sensation during therapy as it may indicate neurological involvement such as nerve compression. Modalities such as electrical stimulation, traction, and hot and cold packs must also be used appropriately.


Traction (Physiotherapy)

In orthopedic medicine, traction refers to the set of mechanisms for straightening broken bones or relieving pressure on the spine and skeletal system. There are two types of traction: skin traction and skeletal traction.

It is largely replaced now by more modern techniques, but certain approaches are still used today:

  • Bryant’s traction
  • Buck’s traction – hip fractures
  • Dunlop’s traction – humeral fractures in children
  • Russell’s traction
  • Milwaukee brace

Skeletal Traction:

Although the use of traction has decreased over the years, an increasing number of orthopaedic practitioners are using traction in conjunction with bracing.

Bryant’s Traction:

Bryant’s traction is mainly used in young children who have fractures of the femur or congenital abnormalities of the hip. Both the patient’s limbs are suspended in the air vertically at a ninety degree angle from the hips and knees slightly flexed. Over a period of days, the hips are gradually moved outward from the body using a pulley system. The patient’s body provides the countertraction

The purpose of traction is to:

  • To regain normal length and alignment of involved bone.
  • To reduce and immobilize a fractured bone.
  • To lessen or eliminate muscle spasms.
  • To relieve pressure on nerves, especially spinal.
  • To prevent or reduce skeletal deformities or muscle contractures.

In most cases traction is only one part of the treatment plan of a patient needing such therapy. The physician’s order will contain:

  • Type of traction
  • Amount of weight to be applied
  • Frequency of neurovascular checks if more frequent than every four (4) hours.
  • Site care of inserted pins, wires, or tongs
  • The site and care of straps, harnesses and halters
  • The inclusion of any other physical restraints / straps or appliances (eg. mouth guard)
  • the discontinuation of traction

The physician is typically responsible for initial application of traction and weights while the adjustment or removal (to perform ablution functions / physiotherapy) of skeletal traction weights will be based on the doctors charted plan.

In most cases cervical traction may be adjusted or temporarily removed, per physician order, by an orthopedic nurse who has documented competency to do so.

The alignment and moving of the patient will only be changed on physician’s directive and the affected extremity will need to be maintained in proper alignment at all times with the ropes and traction straps – making sure the mentioned is unobstructed and weights hanging freely.

If it is necessary to move the patient while skeletal traction is in place, the patient should be moved in the bed with weights hanging freely.

In most cases traction will be applied for a number of weeks to months and Neurovascular checks will need to be performed by a nurse as ordered by the physician or as dictated per traction unit policy.

Traction is an appropriate treatment for a number of medical problems including spinal deformities such as scoliosis.

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