Neck & Upper Back Pain

Sensation, Perception for Skilled Performance

How does your brain respond to pain? 

Pain is an unpleasant sensory and emotional experience associated with actual

or potential tissue damage. Some people are distracted by pain, taking them

longer to do a task and perform it less well, while others use tasks to distract

themselves from pain, these people actually do the task better when they are in pain.

This ability to divide their attention when in pain affects their engagement in

occupations, and results in either a decrease or increase in the performance of that

occupation.

To better understand how your body responds to pain, it is first important to

understand the systems that contribute to this sensation. Your central nervous

system is made up of the brain and spinal cord, while the peripheral nervous

system involves both the sensory and motor nerves. Sensory nerves send out

messages about what is happening in your environment to the central nervous

system, which then sends information back to the motor nerves that contribute to 

the actions your body decides to perform.

More specifically, special pain receptors called nociceptors activate when there has been damage such as an injury or even potential injury. This damage then causes the nociceptors to fire a response through the nerve, into the spinal cord and ending in the brain. The brain responds by activating motor pathways that work to alleviate the painful stimuli, such as removing your hand away from the hot stove. In addition, the brain produces endorphins in response to such injury to help regulate and reduce the painful sensation.

These systems work as one to create the painful experience, prevent further damage, and help the individual cope with pain. Although the system acts similarly in everyone, the level of sensitivity and efficacy of these circuits determine your unique ability to cope and handle pain, which is why different people may have a greater tolerance for pain compared to someone else. Much like other aspects of our lives, people have variability in their ability to respond to stimuli.

This variability in pain can impact which treatment may be best for the individual. For mild pain sensation, non-prescription medications can target the cells where the pain sensation begins. Stronger pain medications and anesthetics act by reducing the pain sensing circuits or boosting our ability to cope with the pain itself. On the other hand, some people may choose to use non-medical approaches that involve distraction, relaxation, meditation, or cognitive behavioural therapy.

Overall, pain is a major issue affecting the lives of countless individuals. Some people’s lives are often defined by pain every single day. Therefore, it is essential to understand how the brain responds to pain to be able to truly understand what treatment may be the most effective for the individual client.

More specifically, Stephanie who is experiencing neck and shoulder pain onset by prolonged sitting at various work stations would benefit from treatment options that work to prevent and alleviate soreness before it becomes more severe. Therefore, it would be beneficial to refer to several of the resources provided on this website regarding exercises, ergonomic recommendations and further suggestions regarding stretching and body positioning to gain a better understanding of what treatment may be most appropriate for the specific pain experience. 

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Neck pain sensation

Neck pain can result from stress to the spine, as well as injury, disease, or poor body mechanics. Due to our busy and demanding lifestyles, neck pain can be a common disorder as our spine is often prone to overuse and injury. Acute pain can manifest through intense and abrupt sensations that radiates to the head, shoulders, arms, and hands. Pain sensations that may be a sign of a problem are:

• Stiffness

• Tightness

• Aching sensation

• Burning

• Stabbing

• Shooting pain

• Pressure

• Tingling

• Soreness

• Tension

You may also experience muscle spasms, which is a sign of your muscles contracting in response to harmful stimuli as discussed above. As a result of these previously mentioned sensations, the individual may experience a restriction in their range of motion. For example, the patient may have difficulty turning their head from one side to the other. Nerve involvement can also be a sign to look out for- such as nerve compression, which can cause severe pain and have a devastating effect on other regions of the body such as the arms or legs. It is also important to be aware of what sensations your body may be experiencing in relation to the neck pain, for example, headaches, fever, nausea, loss of coordination and strength are all significant problems that need to be addressed by a medical professional immediately.

Many treatments are available for the client who is experience pain sensation in the neck or upper back region:

For instance, taking care of yourself is a major component to having a fast and effective recovery. Neck pain often resolves with rest, ice or heat, massage, pain relievers, and gentle stretches.

• An individual can reduce muscle inflammation and pain by using an ice pack for 20 minutes several times a day during the first 48 to 72 hours of the onset of pain. Using a heating pad or a warm shower can be used in addition to help relax the muscles.

• Bed rest can be used for a short period of time, but this should be limited to no more than a couple of days.

• Self-care routines can be an excellent addition to a treatment regimen for neck or upper back pain, however, if pain persists for more than a couple of days, see your doctor.

Medications such as anti-inflammatory drugs like aspirin, ibuprofen and naproxen are excellent over the counter ways to relieve pain sensation from prolonged sitting that has caused neck and upper back pain.

Acute neck pain responds well to treatment, however, prevention is key to avoiding the same pain from reoccurring. Ways to prevent neck pain include; ensuring good posture when sitting at a desk or workstation, using ergonomic adjustments and devices, regular exercise, stretching and strengthening. As well, relaxation and stress management help to alleviate tension and sore muscles. 

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 For more information on Pain Perception please refer to the article below:

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References: 

Andersen, L. L., Andersen, C. H., Sundstrup, E., Jakobsen, M. D., Mortensen, O. S., & Zebis, M. K. (2012). Central adaptation of pain perception in response to rehabilitation of musculoskeletal pain: randomized controlled trial. Pain Physician, 15(5), 385-394.

Ryan, B. (2013, March). Acute neck pain. Retrieved April, 2016, from http://www.mayfieldclinic.com/PE-NeckPain.htm 

TED-ed. (2014, June 2) How does your brain respond to pain?-Karen D. Davis [Video file]. Retrieved from https://www.youtube.com/watch?v=I7wfDenj6CQ