Many people suffer from neck pain and/or headaches at some point in their lives. For those that experience neck pain more frequently however, it can interfere with their participation and enjoyment of activities of daily living.
Neck pain does not have to derive from a trauma, such as a fall or motor vehicle accident, but can also occur due to prolonged adverse loading secondary to sustained poor postures and muscle imbalances.
There are many muscles that attach from our trunk, ribs and shoulder blades to our neck. If these muscles are continually overworking, they can develop painful trigger points, reduce in length, restrict joint motion and increase compressive loading at neck joints. This can contribute towards the aching and tightness experienced in people’s necks. A small percentage of headaches derive solely from the upper neck segments and can occur in combination with tension-type headaches and migraines.
Manual therapy such as joint mobilisations and massage can help improve people’s symptoms, however contributing factors such as poor postures, general activity levels, muscle imbalances and muscle strength and length issues, need to be addressed for improved longer term outcomes.
Following a competent assessment, your physio can help get you back to doing the things you love.
What a pain in the ass...
Pain occurring in the side of the hip, +/- down the leg, can be referred from your lower back or be the result of gluteal muscle dysfunction, particularly the gluteus medius muscle. The gluteus medius and minimus tendons attach onto the greater trochanter of your hip bone. One of their functions is to provide stability to your hip joint when standing on one leg. You know, like when you have to walk :)
For various reasons, the gluteal tendons can develop an inappropriate response to compressive load at their attachment site. Painful activities can include walking, running, stairs, sit-to-stand and lying on your side. This condition is often called “bursitis” of the hip however advanced imaging and surgical procedures have revealed a primary pathology (tendinopathy) of the gluteus medius and minimus tendons.
One treatment option for gluteus medius tendinopathy is a corticosteroid injection, which can result in a significant reduction in symptoms for approximately 70-75% of people one month post-injection. Unfortunately, these effects can be short-lived, with symptoms often recurring 3-4 months later. Underlying causative factors, such as tendon remodelling, need to be addressed for long term resolution of symptoms.
Your physiotherapist will perform a thorough assessment to determine the source of your symptoms (lower back or gluteal tendon) and establish which exercises, taping techniques and manual therapy are appropriate for you and the stage of your gluteal tendinopathy.
Close monitoring, adjustment and progression of your exercise programme is required throughout the rehabilitation process.