Ins and Outs of Physical Therapy

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By Kim Cohee - Physical Therapist
University of Utah

My doctor has recommended physical therapy for my neck pain. How can physical therapy make the pain in my neck less?

A physical therapist can do many things to help relieve your discomfort. If the pain is severe, the therapist may try a variety of modalities like heat, ice, ultrasound, and electrical stimulation. These can all help reduce the pain but will unlikely address the source of the problem. It is very important that your physical therapist do a thorough evaluation to determine what may be contributing to your pain. Tightness, weakness, posture or instability are a few examples of sources of neck pain. Proper stretching, strengthening and posture re-education to take unnecessary strain off your neck. These are just some of the ways the physical therapist can help eliminate the cause of you symptoms and possibly prevent recurring problems.

Are there situations where physical therapy is dangerous? Could it make my neck worse?

It is possible physical therapy can make your neck worse if you have not been thoroughly screened by the physical therapist before treatment begins. Your history is very important and a record of any trauma to the head and neck is a good indicator you may need diagnostic tests such as an MRI or X-ray before beginning therapy. Your therapist can also do many tests to rule out serious pathologies that may make therapy not appropriate for you.

Besides exercises, what else can a physical therapist do to help make the pain in my neck better?

Modalities such as heat, ice, ultrasound, and electrical stimulation can be useful for addressing severe acute pain. In addition, joint mobilization or manipulation can be useful in relieving restrictions in your neck that are limiting movement. Workstation evaluations to determine sources of poor body mechanics can be very useful in reducing neck pain also. Finally, people who suffer from chronic pain often get relief from use of Transcutaneous Electrical Nerve Stimulators (TENS units.) These can be worn throughout the day and are about the size of a pager.

Are there exercises that I can do at home that can make my neck feel better?

Absolutely, but you have to do them regularly and correctly. Also, the exercises need to be the right exercises for you. Also, if you stop doing your exercises, the neck pain can return. It is like brushing your teeth. If you stop doing that, your teeth can get quite diseased. It is possible if you stop taking care of your neck, the problem can return if it is your body's "weak link".

Is physical therapy painful? How do I know if the pain that I feel during or after physical therapy is dangerous or not?

Physical therapy usually makes you feel better. The initial evaluation and treatments can irritate your symptoms at first. This is very normal. Severe or acute pain during therapy is not typically normal and your therapist will modify or stop treatment and possibly contact your doctor in such situations.

If my doctor recommends physical therapy, how long should it take before I feel better? How will I know if it is not working?

The answer to this is often related to how long you have had your symptoms and how often you have therapy. Typically, you should notice a gradual improvement in your symptoms after the first week or two of starting therapy. However, if you have had pain for several years, you may want to try at least 3 weeks of therapy before giving up. During the remaining course of your therapy, it is normal to have good and bad days. However, if the general trend is one of improvement over time, you should continue treatment as your therapist recommends in order to attain optimum results.

The materials on this Web site are for your general educational information only. Information you read on this Web site cannot replace the relationship that you have with your health care professional. We do not practice medicine or provide medical services or advice as a part of this Web site. You should always talk to your health care professional for diagnosis and treatment.