Physiotherapy in Mechanical Neck Pain

Neck pain (NP) is most commonly defined as pain between the superior nuchal line, an imaginary transverse line through the tip of the first thoracic spinous process, and laterally by sagittal planes peripheral to the lateral borders of the neck. Pain in the neck may be local and/or referred into the head, and/or one or both upper limbs.  Apart from its anatomical definition, NP can also be defined based on its duration (acute, subacute, chronic) or reason for onset.Individuals with NP may lack an identifiable pathoanatomic source for their symptoms; this patient group is classified as having mechanical or non-specific NP because a direct pathoanatomic cause is rarely identifiable. Although the cause of NP may be associated with degenerative processes or pathology identified during diagnostic imaging, the tissue that is causing a patient’s NP is usually unknown. The most common cause of cervical radiculopathy in 70 to 75 percent of cases is foraminal encroachment of the spinal nerve due to combination of factors, including decreased disc height and degenerative changes of the intervertebral joints anteriorly and zygapophyseal joints posteriorly. It is generally agreed that involvement of the C6 and C7 nerve roots secondary to lesion of the C5/C6 and C6/C7 vertebrae are the most common. Cervical disc herniation and cervical spondylosis have been attributed as the main causes of cervical radiculopathy.