Enhancing Neck Mobility and Comfort: by Dr Andrew Welsh, PhD

Experiencing neck pain and stiffness can significantly impact daily activities, from working at a desk to participating in sports. Dr Andrew Welsh (PhD), an Osteopath with 24 years of clinical practice and a recent addition to the team at Eclipse Health and Osteopathy, aims to assist individuals in improving neck mobility and decreasing discomfort. Andrew has dedicated recent years to post-graduate study and research in Europe, culminating in a PhD focused on spinal quantitative assessment and exercise prescription.

Understanding Neck Range of Motion (ROM)

The cervical spine’s range of motion is crucial for functional movements and overall quality of life. Quantitative assessment of neck ROM provides valuable insights into mobility limitations and guides tailored interventions.

• Normal Neck ROM Values: According to Norkin and White (2016), typical cervical spine movements in healthy adults are approximately:
  • Flexion (forward bending): 60 degrees
  • Extension (backward bending): 75 degrees
  • Lateral flexion (side bending): 45 degrees
  • Rotation: 80 degrees
• Age-Related and Pain-Related Changes:
  • Age-Related Changes: Cervical spine mobility tends to decline with advancing age. A study by Yukawa et al. (2012) found that cervical ROM decreases significantly with age, particularly in the lower cervical spine (C2–C7). Kuhlman (1993) also observed similar findings. The elderly group had approximately 12% less flexion, 32% less extension, 22% less lateral flexion, and 25% less rotation. The elderly group also had a wider variation of cervical range of motion values than the younger group, highlighting the importance of understanding age-related ROM changes and their potential impact on daily activities like driving or looking upward. Studies suggest that targeted interventions, such as stretching and mobilisation exercises, can help mitigate these age-related declines (Gross et al., 2015).
  • Pain-Related Changes: Research indicates that neck pain is associated with reduced ROM. A systematic review by Thoomes-De Graaf et al. (2020) found that total active ROM significantly decreases in individuals with neck pain compared to healthy controls, particularly in flexion and rotation. A systematic review by Reid et al. (2014) highlighted that manual therapy can significantly improve cervical ROM and pain in patients. Additionally, a systematic review by Miller et al. (2010) demonstrated that manual therapy combined with exercise provides greater improvements in pain, ROM, and quality of life in individuals with chronic neck pain compared to either intervention alone.

Impact of Modern Technology and Workplace Ergonomics

Prolonged use of electronic devices and suboptimal workplace ergonomics can contribute to neck discomfort.

• “Tech Neck”: The term “Tech Neck” describes neck pain associated with extended periods of looking down at screens. This posture can lead to muscle strain and joint discomfort.
• Office Ergonomics: Improper workstation setups are linked to increased neck pain among office workers. Adjusting monitor height, chair support, and keyboard placement can alleviate strain.

Benefits of Exercise and Manual Therapy

Combining exercise with manual therapy may offer benefits for individuals experiencing neck pain.

• Exercise Programmes: Regular exercises focusing on neck flexibility and strength aim to enhance range of motion and reduce discomfort. A systematic review by Gross et al. (2015) suggests that specific exercises can be beneficial for mechanical neck disorders.
• Manual Therapy: Techniques such as mobilisation and manipulation, when combined with exercise, may provide improvements in pain and function. A randomised controlled trial by Reid et al. (2014) demonstrated that manual therapy techniques significantly improved cervical ROM and pain, highlighting its potential to enhance mobility and alleviate discomfort. Additionally, Miller et al. (2010) emphasised that combining manual therapy with exercise leads to greater outcomes in terms of pain reduction, functional improvement, and overall patient satisfaction.

Dr Andrew Welsh’s Approach

At Eclipse Health and Osteopathy, Dr Andrew Welsh employs precise measurement tools, including Swiss and German-made goniometers, to assess cervical spine mobility. This quantitative assessment informs personalised treatment plans that may include:

1. Comprehensive Evaluation:
   • Utilising precise measurement devices to identify specific limitations in neck movement.
   • Assessing factors contributing to discomfort, such as posture and ergonomic habits.
2. Individualised Interventions:
   • Developing exercise programmes tailored to improve flexibility and strength.
   • Incorporating manual therapy techniques aimed at enhancing mobility and reducing pain.
3. Ergonomic Guidance:
   • Providing advice on optimising workplace setups to minimise strain.
   • Educating on posture correction strategies to prevent “Tech Neck.”

Take the Next Step

If neck pain or stiffness is affecting your daily life, you may benefit from a consultation with Dr Andrew Welsh. By providing a thorough assessment and tailoring care to your individual needs, he seeks to assist patients in addressing neck discomfort and improving overall function. Further research continues to advance our understanding of neck mobility and treatment options, and personalised approaches remain a cornerstone of effective care.

References

• Gross, A., et al. (2015). Exercises for mechanical neck disorders. Cochrane Database of Systematic Reviews, (1).
• Kuhlman, K. A. (1993). Cervical range of motion in the elderly. Archives of Physical Medicine and Rehabilitation, 74(10), 1071–1079. https://doi.org/10.1016/0003-9993(93)90064-h
• Miller, J., et al. (2010). Manual therapy and exercise for neck pain: A systematic review. Manual Therapy, 15(4), 334–354.
• Norkin, C. C., & White, D. J. (2016). Measurement of Joint Motion: A Guide to Goniometry (5th ed.). Philadelphia, PA: F.A. Davis Company.