Living the past is a dull and lonely business; looking back strains the neck muscles, causing you to bump into people not going your way.
American novelist Edna Ferber
This chapter considers acute and chronic soft tissue conditions that cause neck pain. Severe neck injuries are considered in Chapter 47.
The surface anatomy of the neck is shown in Figure 20.1. Structures of the neck that are likely to cause pain are the zygapophyseal joints, cervical disks, the ligaments and muscles of the neck, and neural structures.
Anatomy of the neck
(a) Surface anatomy of the neck from in front
(b) Anatomy of the anterior neck—superficial
(c) Anatomy of the anterior neck—deep cervical musculature
(d) Surface anatomy of the neck from behind
(e) Anatomy of the posterior neck and scapulothoracic region
(f) Anatomy of the posterior neck—deep cervical musculature
(g) Dermatomal distribution for the cervical spine
Neck pain is considered within a biopsychosocial model where, collectively, account is taken of biological factors, any psychological reactions (e.g. anxiety, fear), and social factors (e.g. home or family situation, access to healthcare, occupational factors) that may contribute to the disorder and potentially influence recovery (Fig 20.2).1, 2 This model fits well within the framework of the World Health Organization’s Interational Classification of Functioning, Disability and Health (ICF) domains where impairments, activity, and participation limitations are considered within the context of a person’s overall health and quality of life.3 The biopsychosocial approach to healthcare, within the framework of the ICF, is a very relevant model for the individual with a neck pain disorder.4
The biopsychosocial model as applied to neck pain. When considering neck pain, take account of biological factors, psychological reactions (e.g. anxiety, fear), and social factors (e.g. home or family situation, access to healthcare, occupational factors) that may contribute to the disorder and potentially influence recovery.1, 2
Many people suffer from chronic or recurrent bouts of neck pain5 and impairments may persist, even after symptoms have resolved.6 This underscores the importance of ...