Instead of passive treatment of the painful tissue (joints, muscles, connective tissue), the path should be one of active strengthening, mobilization and coordination training of the muscles, as well as improvement of general physical fitness. In cases of severe pain and fear of movement, it is advisable to enable the patient to take up activity through passive physiotherapeutic treatment and medication, and to gradually balance it out as the disease progresses. Before active physiotherapy is started in the group, it should be clarified by differential diagnosis that it really is a chronic neck pain without additional pain causes that can be treated in any other way.
In practice, however, it unfortunately appears that many patients with neck pain are sent to group treatment from the outset without specific diagnosis and treatment for cost reasons. Often acute functional or structural causes of pain are not treated, which reduce the success of the treatment or even lead to an increase in pain during activity, to which those affected react with increased fear of movement. These could be:
- Acute functional disorders of the cervical vertebral joints
- Acute functional disorders of the thoracic spine or shoulder joints
- “High tension” in the neck and shoulder muscles
- Condition after whiplash injury
- Disc protrusion or herniated disc (nucleus pulposus prolapse)
- Arthrotic changes of the cervical spine (osteochondrosis)
- Constrictions in the spinal canal (spinal stenosis of the cervical spine) or at the nerve exit holes
- Inflammatory changes in the small vertebral joints (facet syndrome)
The effectiveness of physiotherapeutic treatment measures for chronic neck pain has been verified in studies.
For this purpose, the passive treatment of chronic neck pain with massage, manual therapy and physiotherapy in individual therapy was compared with the consistent implementation of a fixed exercise program in a closed group of 6-8 participants over a certain period of time. The participants were asked about their perception of their pain, the frequency of absences from work due to their complaints, and their satisfaction with the treatment after completion of the respective treatment. The result was astonishing.
The active group therapy, especially the strength training muscle building was more successful and lasting than the individual treatment. Physiotherapy practices offer so-called neck schools under professional guidance, in which the special problems of chronic neck and headaches are addressed. A closed group concept with 6-10 participants over a period of approx.
10 weeks makes sense. If a corresponding group offer is not available, information and practice mediation can also take place in an individual therapy (more expensive). The group has the advantage that you can exchange information with other patients and see that you are not alone with your pain.
In addition, the “fun and motivation factor” that cannot be ignored is certainly higher in the group. Fun and joy in movement support the healing process and the “overcoming of the pig dog” in the continuation of the program at home. It is also recommended to participate in a neck school in the group as a preventive measure if there are no or only latent complaints.
Most health insurance companies cover about 80% of the costs within the scope of their preventive offers. Another possibility is to participate in 50 units of rehabilitation sports, which can be prescribed by a doctor.
