Conditions & Injuries: Head, Neck & Back


People normally complain of pain either at the base of their skull, at the side of the head – particularly around the eyes – or across their forehead. You may feel a throbbing pain or a painful tightness around those areas.

Common causes

Headaches are often caused by stiffness in the vertebrae of your neck (facet joint stiffness). This restricts the moments of your neck and pain is referred to different areas of the head. Stress and poor sleep are two other common causes. They cause the muscles in your head, neck and shoulders to tense up, causing pain. These are often referred to as ‘stress’ or ‘tension headaches’.

How we treat headaches

Treatment would normally include mobilising your facet joints, soft tissue release, and an exercise programme to improve the flexibility of your neck and reduce muscle tension. We also provided strengthening exercises for muscles that attach around the neck to ensure that they can cope with the load placed upon them.

Average recovery time

If your headache is caused by facet joint stiffness it can usually be alleviated quite rapidly. If the root cause is stress and/or poor sleep, then this will longer as you’ll need to improve your sleep and reduce your stress levels to deal with the problem long term.

Facial surgery

Facial rejuvenation or facial corrective surgeries include rhinoplasty (nose) blepharoplasty (eyes) otoplasty or pinnaplasty (ears), genioplasty (chin) and a number of ‘face and necklift’ surgeries.

How we help with recovery post facial surgery

Physiotherapy can help to speed up your recovery from facial surgery and reduce swelling and tension around your face and neck. We use gentle massage techniques, including lymphatic drainage and soft tissue release to improve healing times and mobility in your facial muscles.

You can see a physiotherapist 2 weeks after your surgery, once your wounds are dry and closed.

Average recovery time

Your recovery time will vary depending on the procedure, your age and your overall health. It will take at least 2 to 4 weeks, but full recovery may take 3 to 6 months depending on the type of facial surgery you have.

Neck pain

You may experience neck pain either at the sides or the back of the neck. If the shoulder muscles are involved, you could get pain radiating down your neck and into your shoulder. You might experience stiffness, reduced movement and an ache even when you’re not moving, or only get pain when you move your head. The pain can come on suddenly or gradually.

Common causes

There are many things that can cause neck pain. Poor posture, shoulder malalignment, stress and poor sleep can all cause neck pain, as can maintaining a position for a long period or experiencing a traumatic impact. This last one results in whiplash.

How we treat neck pain

We’ll treat the muscle tightness and any stiffness in the joints using manual therapies and soft tissue massage. This should improve your mobility and reduce the pain. We’ll also give you an exercise programme to help with flexibility and strengthening the muscles around the neck and shoulder to correct your posture if that’s part of the issue. We may also talk to you about ways to help manage your stress or improve your sleep if we think this is causing your symptoms. If your neck pain is influenced by sitting for long periods of time at a desk, we can assess your workstation and advise you on how to improve the layout and positioning of your chair, screen, keyboard and mouse.

Average recovery time

With treatment, your neck pain will usually subside within a week or two. However, if there’s a weakness in your neck or shoulder, strengthening those muscle could take a couple of months.

Read our article in Sebra News W2 on dealing with neck pain.


Whiplash is a spasm of the neck and shoulder muscles which can make it very painful to move your head. It also restricts your range of movement. The spasm could be in muscles at the back or the side of your neck.

Common causes

Whiplash is most often caused by the sudden impact of a car accident, but it can happen while doing sports, for example when there is unexpected contact between players.In fact, whiplash can result from any situation where your head is forcefully moved forward or sideways at speed and your neck muscles must suddenly contract to pull your head back.

How we treat whiplash

You may be advised to wear a neck brace and take pain medication. However, wearing a brace can slow down your recovery. The pain and restriction is normally due to muscle spasm and so we recommend applying heat to the tight muscles and will use soft tissue massage to relax the muscles.

Your physiotherapist will also advise you to keep moving, slowly moving into your restricted range to gradually improve your range of movement. We’ll also check for any abnormal symptoms that may require you to see another health professional. We may also recommend some strengthening exercises, especially if you’ve waited some time before getting treatment and the muscles have weakened.

Average recovery time

Most of our patients return to all activities within a few weeks, once they have regained full range of movement in their neck.

Lower back pain

As you might imagine, lower back pain is usually felt across the lower back, but it can radiate up your spine to the middle of your back, or down into your legs.

Common causes

Lower back pain has a variety of causes. It’s commonly caused by the muscles in your lower back going into spasm because they are overworked, they’ve received a direct trauma, or they are trying to protect your spine. Tired, overworked lower back muscles could be caused by poor posture, repetitive moments, or weak or tired muscles in other parts of your body.

How we treat lower back pain

For back pain that’s come on suddenly we’ll usually use techniques to release muscle tension and give you an exercise programme. This will be designed to improve your range of movement and strengthen any muscle weaknesses that may be contributing to the spasm.

With long-term back pain there could be other factors to consider. We’ll discuss these with you during your initial assessment. If you’ve had the pain a long time, you’re likely to have changed the way you move to try and minimise it. We’ll assess these movement patterns and the activities that aggravate your pain to advise on how to make sure you’re not overworking the muscles around your spine. If you experience the pain again, we’ll give you techniques for managing it, and preventing it from becoming debilitating in the future. With long-term back pain, treatment is very insectionidualised as everyone has a different trigger for their pain.

Average recovery time

If the back pain has come on suddenly and it’s treated quickly and effectively, your symptoms should resolve within a week or so. However, it does depend on the underlying cause. With long-term back pain it will take longer. Without assessing you, it’s impossible for us to say how long.

Read our article in Sebra News W2 on myths in back pain.

Facet joint injections

For back pain caused by inflammation of the facet joints or a disc of your spine, your consultant may recommend facet joint injections. These are steroid or botox injection into the spine or surrounding muscles. It will usually be a spinal surgeon, specialist pain consultant or a specialist radiologist who gives them. The injections are typically given either under ultrasound or X-Ray to ensure that the consultant injects into the exact area where you need treatment, and you’ll usually be in hospital for a day.

How we support rehabilitation after facet joint injections

We’ll usually start physio treatment 24 hours after you’ve received your facet joint injection. We’ll design a tailored programme to gradually improve your mobility, taking advantage of the pain- and inflammation-reducing effect of the injection to do this work. Treatment may also include addressing compensatory movement patterns that you’ve adopted to avoid pain and an exercise programme to strengthen muscles that may have become weak through lack of activity.

Average recovery time

Depending on why you needed the injections, your symptoms could improve within 3 to 6 months. You may also require more injections.

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