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Head & Neck Pain

Did you know that more than two thirds of americans will experience neck pain at some point in their lives? Similar to the low back, neck problems are typically progressive.  This means that in the younger population (15-30 years of age), most issues tend to be related to strains or sprains of the cervical spine.  As one ages, however, continued stresses on the neck can result in more serious chronic neck/shoulder/arm pain, headaches, numbness, and weakness due to herniated, discs, degenerative disc disease (osteoarthritis of the spine) causing irritation and possibly damage to nerves exiting the spinal cord.  At ELEVATE, our physical therapists are experts in treating neck pain.  At our facillity, you will first receive a thorough spine exam by a board certified orthopedic physical therapy specialist with a doctoral degree in physical therapy. Once the exact cause of your neck pain has been determined, our therapists will establish a comprehensive treatment program for you utilizing the most effective and revolutionary treatments available to treat your neck pain and "get you back into life!"   

The most common causes of neck pain are discussed below.  If you have any questions about how we can help you, don't hesitate to contact our office.  


Neck Strain or Sprain 

The neck and back are complex structures of bone and muscle, supported by cartilage, tendons, and ligaments, and fed by a network of blood vessels and nerves (see below). 

Muscles of neck and backThe neck—especially the lower cervical spine,—bears much of the head's weight during walking, running, and lifting.  In addition, relatively static activities such as working in front of a computer all day or prolonged standing in one position can be very strenuous to the cervical spine.  As a result, injuries to the neck—such as strains and sprains—are common.

A strain is an injury to either a muscle or tendon. Tendons are the tough, fibrous bands of tissue that connect muscle to bone. With a neck strain, the muscles and tendons that support the cervical spine are twisted, pulled, or torn.  A sprain is the stretching or tearing of a ligament. Ligaments are the fibrous bands of tissue that connect two or more bones at a joint and prevent excessive movement of the joint.  

Symptoms of a strain or sprain include:  

  • Pain that worsens with movement
  • Muscle cramping or spasms (sudden uncontrollable muscle contractions)
  • Decreased function and/or range of motion of the neck (difficulty looking over your shoulder, bending your head forward or sideways, or standing straight)

A neck strain can be caused by:

  • Extreme physical exertion
  • Falling
  • Bending your head forward repeatedly
  • Lifting heavy objects if you are not in shape

It can also be caused by emotional stress, improper posture, being overweight, out of shape, or sitting in the same position for long periods of time.  Even a severe cough can result in a neck strain.  Keep in mind that neck strains are most common between the ages of 15-30 years old.  If lifestyle changes don't occur, the persistent stresses on the cervical spine will result in more serious neck problems such as herniated discs, pinched nerves/arm pain, and osteoarthritis/degenerative disc disease.

At ELEVATE, our therapists are experts in evaluating and treating patients with neck strains or sprains.  We utilize the most revolutionary and effective treatments available to eliminate the debilitating pain that can come with neck strains and sprains.  Don't let your neck pain keep you down.  Call our office today!  



X-ray of neck in hyperextension  


Whiplash is a common type of neck sprain or neck strain (see above) caused by an abrupt jerking motion of the head, either backward or forward, and often occurs as a result of a car accident or a fall.   Whiplash is characterized by a collection of symptoms that occur following injury to the neck.  In whiplash, the intervertebral joints (located between vertebrae), discs, and ligaments, cervical muscles, and nerve roots may become damaged.

Symptoms of whiplash may be delayed for 24 hours or more after the initial trauma. However, people who experience whiplash may develop one or more of the following symptoms, usually within the first few days after the injury.

  • Neck pain and stiffness
  • Headaches
  • Pain in the shoulder or between the shoulder blades
  • Low back pain
  • Pain or numbness in the arm and/or hand
  • Irritability, sleep disturbances, fatigue

At ELEVATE, we utilize the most advanced and revolutionary treatments available to eliminate the pain and disability associated with whiplash injuries.  If you or someone you know is suffering from a whiplash injury, call our office today!


Disc Herniation

All of the bones (vertebrae) that form the spine in your back are separated by rounded, flattend discs that actually resemble a jelly donut (image below).  These discs normally have a firm outer ring (the annulus fibrosus) with a jelly-like substance (nucleus propulsus) forming the center.  When the discs are healthy, they act as shock absorbers for the spine, and they keep the spine flexible.  If the discs become damaged, however, the back of the disc commonly becomes weakened and allows the jelly to migrate out of the center to form a disc bulge.  Without the appropriate treatment, this process may continue and cause the disc to break open (rupture) resulting in what is called a herniated or slipped disc.  If the disk bulges far enough backward (see below), it will press on the nerves that are leaving the spinal cord producing pain, numbness, and/or weakness down one or both arms or upper back.  This is commonly referred to as cervical radiculopathy; which is the equivalent of sciatica in the legs.                                             

Disc herniation

A herniated disc with the nucleus pulposus ("jelly") migrating through the annulus pressing on the spinal nerve.


At ELEVATE, our therapist have extensive experience in the conservative treatment of patients with cervical disc herniation. With the appropriate treatment program, most people suffering from cervical herniation see symptom resolution quickly and are ableto return to their normal active lifestyle.  If you have any questions about how we can assist you, call our office today.


Neck Arthritis (Osteoarthritis/Degenerative Disc Disease)

Types of spine problems

Neck arthritis or osteoarthritis of the cervical spine is also known as degenerative joint disease (DDD). It is a wear-and-tear process in which the discs that cushion the vertebrae degenerate, or wear down. As we age, the water content in discs decreases, and as a result, the discs in the spine lose their pliability or flexibility.  

This decreased pliability causes the discs to be less capable of performing their primary job as a shock absorber of the spine.  Beginning around the age of 40, the normal stresses placed on neck can become a burden to the discs resulting in the gradual wearing away of the discs especially in the areas of the neck that experience the most stresses-the lower cervical.  This process can cause pain and swelling; and, it may also result in the development of osteophytes, or bone spurs that can press on the nerves exiting the spine causing pain, numbness, and/or weakness into the neck, arms, or shoulder blades/upperback.  (See side image). 


The symptoms associated with neck arthritis can be very disabling resulting in difficulty performing the most basic daily activities.  At ELEVATE, we utilize the most advanced and revolutionary treatment available to quickly and effectively decrease and eliminate arthritis related pain.  In addition, we work to normalize the impairments associated with neck arthritis allowing patients to return to a normal, active lifestyle.  Let us help "get you back into life!" 

Cervical Radiculopathy 

Cervical radiculopathy is the equivalent to sciatica in the legs.  It occurs when one or more of the nerves that exit the spine to supply the arms, neck or upper back is irritated.  This most commonly occurs at the areas in the low cervical spine where the nerves exit the spine-C5-6, C6-7, and C7-8 (See image below).  The most common cause of cervical radiculopathy is a disc herniation, or bone spurs (osteophytes) that have developed as apart of degenerative disc disease (DDD/osteoarthitis of the spine).

Cervial radiculopathy may include one or several types of symptoms depending on where and how badly the nerve is being pinched in the spine.  And, because the nerves of the cervical spine supply the muscles and sensory fibers from the neck, shoulders and down both arms and hands, symptoms of pain, cramping, numbness/tingling/shocking, and weakness may occur from the neck down the length of the nerves path into the hands.  The severity of symptoms varies from person to person.  Typically, the farther down the arm the symptoms are felt, the more serious the case of radiculopathy; and, if conservative treatment isn't sought promptly, symptoms may worsen, and they can become very debilitating requiring surgery.

At ELEVATE, our therapist have extensive experience in the conservative treatment of patients with cervical radiculopathy. With the appropriate treatment program, most people suffering from cervical radiculopathy see symptom resolution quickly and are able to return to their normal active lifestyle.  If you have any questions about how we can assist you, call our office today.


Post-Surgical Neck Rehabilitation



Neck surgery is a major undertaking.  Most people who elect neck surgery do so due to the debilitation brought on by the pain or weakness that neck problems can produce.  Many times, spine surgery is very effective in eliminating these severe symptoms; in some cases, however, it may not eliminate all symtoms or disability completely.  Rehabilitation is an important part of helping patients get the most possible benefit from their neck surgery. Essentially, rehabilitation can help patients recover from spine surgery as quickly and completely as possible.

Physical therapy or post-surgical neck spine rehablitation can be thought of as alignment and balance for your body. If you buy new tires for your car, they won’t last as long if they are not aligned and balanced and the new tires will be a waste of money. Surgery is like new tires, and a physical therapist’s role is to do the alignment, balance, and engine tuning to make sure that the effects of the surgery are as positive as possible.

At ELEVATE, our physical therapists have extensive experience in post surgical spine rehablitation. There are several ways that we will assist you in getting back into good physical condition and heal from your neck surgery.

1. Pain Control after Spine Surgery     

Controlling pain is an important first step in allowing you to regain your strength, as it is very difficult to complete a rehabilitation program if one is in a great deal of pain.  While a certain amount of pain is common in the recovery process, there are several means that we use at ELEVATE to help minimize and eliminate pain, such as:       

  • 830 Cold Laser
  • Moist heat and ice application
  • Ultrasound and electrical stimulation
  • Certain types of movements
  • Electrical devices (e.g. TENS units)
  • Education in postures/positioning to decrease the strease on the spine

Many of the techniques for neck pain relief are simple and easy to learn and can be done at home or at work throughout the day. 

2. One-on-One Training after Spine Surgery

At ELEVATE our therapists will develop a training program tailored for you, taking into account the your specific surgery, body type and tissue conditions.  We will focus on muscle fascilitation in areas where the muscles may need special retraining to gain strength and provide stability following the neck surgery. This type of exercise therapy will focus on:

  • Muscles in the incision area
  • Muscles that may have been weakened by nerve problems before the surgery
  • Small muscles that work around each vertebra and help stabilize the spine. Most people (even those without spine problems) do not use these muscles very often. However, if these small muscles are trained properly, they can provide excellent stabilization to the muscles that can protect the spine and protect the newly operated area to prevent future problems.

Individualized physical therapy will also help with areas where your mobility and flexibility have been limited by spine surgery. We can help the joints and the muscles involved regain the movement in relation to your individual body type and allow you to return to the activities you enjoy! 

3. Exercise for Recovery after Spine Surgery

Exercise is vital to getting better after neck surgery.  It is the key to eliminating fatigue, getting you back to activity safely, and avoiding re-injury. Ultimately, exercise is critical both in helping the body heal from the original injury and in preventing (or minimizing) future episodes of neck pain.

At ELEVATE, our physical therapists will develop an individually tailored exercise program based on knowledge of the exact type of spine surgery, and the forces that are most beneficial for the your spine under different conditions. There are many choices of exercise available for you and we will work with you to esablish a comprehensive exercise program that you will enjoy and continue to do on your own at home to maximize your function after neck surgery.

4. Education about Exercise following Spine Surgery

Because most neck problems result from the culmination of a lifetime of poor posture and lifting mechanics that have gradually injured the spine, patient education is an important part of the post surgical rehabilitation program.  During your time at ELEVATE, you will receive extensive education in safe postures/positioning, lifting mechanics, and activities to avoid which are not safe for your spine.  Also, during your treatment sessions, you will have plenty of opportunity to ask questions of your therapist. Your therapists can explain exactly what changes have occurred as a result of your specific surgery, and what can be done to maximize the benefits from that surgery.

Your success in recovery from neck surgery depends on your willingness to work hard at home as well as with your therapist. Ideally, the surgery will take you a great deal of the way on the road to recovery, and then the patient and therapist team can work together to make the recovery the best possible.  Let us help "get you back into life!"



Within a given year, 90% of men and 95% of women have at least one headache, and recent studies show that more than 45 million americans suffer from chronic recurring headaches. Additionally, more than 20% of all young people in the United States experience chronic headaches. 

Headaches have many different causes. They are generally classified as either a primary headache or a secondary headache.  A primary headache is caused by dysfunction or overactivity of pain-sensitive features in your head. A primary headache isn't a symptom of an underlying disease such as cancer.

Primary headaches are the result of chemical activity in your brain, chemical activity in the nerves or blood vessels of your head outside your skull, or chemical or mechanincal activity in the muscles of your head and neck — or some combination of these factors. 

A secondary headache is a symptom of a disease that can activate the pain-sensitive nerves of the head. Any number of conditions — varying greatly in severity — may cause secondary headaches. 

Tension headaches are by far the most common type of headache.  It is estimated that about 30%-80% of the adult U.S. population suffers from occasional tension headaches; and, approximately 3% suffer from chronic daily tension headaches. Women are twice as likely to suffer from tension-type headaches as men, and most people with episodic tension headaches have them no more than once or twice a month, but the headaches can occur more frequently.  
Chronic tension headaches tend to be more common in females, and many people with chronic tension headaches usually have had the headaches for more than 60-90 days.   
A tension headache is named not only for the role that stress may play in triggering the pain, but also for the contraction of the neck, face, and scalp muscles brought on by stressful events. Tension headaches are a severe (but temporary) form of a muscle-contraction headache. The pain can range from mild to moderate, and it feels like pressure is being applied to the base of the head or neck.

What Causes Tension Headaches?

There is no single cause for tension headaches. This type of headache is not an inherited trait that runs in families. In some people, tension headaches are caused by tightened muscles in the back of the neck and scalp. This muscle tension may be caused by:

  • Degenerative disc disease
  • Herniated disc
  • Inadequate rest
  • Poor posture
  • Emotional or mental stress, including depression
  • Anxiety
  • Fatigue
  • Overexertion

Tension headaches tend to occur at increased frequency when there is also an underlying neck problem such as:  history of neck strains, disc herniation, or degenerative disc disease.  Over time, these neck problems can result in stiffness of the joints that make up the cervical spine and weakness in the muscles that support the neck.  These range of motion and strength impairments can put the neck muscles at a disadvantage in supporting the head and neck.  

The average head weighs up to 12 pounds.  Needless to say, weakened neck muscles can become unable to efficiently hold up the head during normal activities.  With the fatigue of these muscles, muscle tension increases and neck pain occurs.  The pain typically begins at the base of the skull where the large muscles (upper trapezius muscles) attach.  The head pain will increase in intensity and radiate around the head as this process progresses-producing a tension headache.  Usually, these tension headaches begin mid-day and worsen throughout the afternoon and evening if rest from activity doesn't occur. 

At ELEVATE, our therapists have extensive experience in treating these types of tension headaches.  We will assist you in normalizing the postural, range of motion, and strength impairments required to provide long-term headache relief and prevention.  In addition, we utilize the most effective and revolutionary treatments available to provide quick, lasting pain relief to help you manage your headaches and return to a normal, active lifestyle.  Don't let the debilitating effects of tension headaches keep you down.  Call our office today! 




Bell’s Palsy

Bells palsy may cause pain behind the ear and affected side of the face.

Bell's palsy is a paralysis or weakness of the muscles on one side of your face. Irritation or damage to the facial nerve that controls muscles on one side of the face causes that side of your face to droop. The nerve damage may also affect your sense of taste and how you make tears and saliva. This condition typically comes on suddenly, often overnight.

Bell's palsy is not the result of a stroke or a transient ischemic attack (TIA).  While stroke and TIA can cause facial paralysis, there is no link between Bell's palsy and either of these conditions. But sudden weakness that occurs on one side of your face should be checked by a doctor right away to rule out these more serious causes.

The cause of Bell's palsy is not clear. Most cases are thought to be caused by the herpes virus that causes cold sores.  It's thought that, the virus somehow effects the facial nerve causing inflammation and swelling of the nerve.  The facial nerves exit the skull behind each ear.  Each nerve travels to the face to supply the muscles on half the face, but the nerves have no no sensation component; that's why people with Bell's palsy experience paralysis on one side of the face but no sensation loss.  Also, because of the swelling and inflammation, it's not uncommon for people with bells palsy to experience mild to moderate pain behind the ear, and the affected side of the face.  

Many health problems can cause weakness or paralysis of the face. If a specific reason cannot be found for the weakness, the condition is called Bell's palsy.

Symptoms of Bell's palsy include:

  • Sudden weakness or paralysis on one side of your face that causes it to droop. This is the main symptom. It may make it hard for you to close your eye on that side of your face.
  • Drooling.
  • Eye problems, such as excessive tearing or a dry eye.
  • Loss of ability to taste.
  • Pain in or behind your ear.
  • Numbness in the affected side of your face.
  • Increased sensitivity to sound.

Most people who have Bell's palsy may have symptoms of pain and facial paralysis or weakness for weeks to months, and a small number of people may have permanent muscle weakness or other problems on the affected side of the face.  

At ELEVATE, our physical therapists have extensive experience in assisting patients with Bell's palsy.  We utilize the most revolutionary and effective treatments available to minimize the pain and muscle atrophy associated with Bell's palsy.  If you or someone you know are suffering from this disorder, call our office today to see how we can help!