“It is difficult to generalise as professional neck massages may be performed in a variety of ways, but people should recognise that passive manipulation of the cervical spine (which occurs when an external party moves your neck) carries an inherent risk of causing spinal injuries,” Dr Chen Haobin said.

“When an individual moves his neck on his own (like when cracking it), the neck movements are kept within his comfort limits without provoking pain or neurological symptoms such as numbness.” Dr Chen explained.

“However, this may not apply to passive manipulation which runs the risk of manipulating the cervical spine beyond the limits of safety, thereby causing or exacerbating underlying injuries. This is particularly a concern for the elderly as well as individuals with underlying osteoporosis,” he added.

“Those with pre-existing neurological symptoms (such as numbness in the limbs) as well as those with certain underlying medical conditions (such as osteoporosis, rheumatoid arthritis and ankylosing spondylitis) should avoid neck massages and external neck manipulation,” advised Dr Chen.

Unfortunately, in Singapore, as there are currently no clear guidelines on this subject implemented to date, it very much remains on the part of the individual to weigh the risks and benefits carefully before proceeding with such procedures. 

“Chiropractic treatments may encompass a wide range of treatment modalities ranging from neck adjustments (passive neck manipulation), advise on exercise or stretching routines, to electrical stimulation,” Dr Chen said.

"These (chiropractic neck adjustments) may provide a degree of relief to neck pain in certain cases. However, I feel that it is important for the individual to be aware of the inherent risks associated with passive neck manipulation (similar to neck massages), before making an informed choice in embarking on such therapies,” he added.

Medical attention is needed for neck pain if you have:

• Persistent neck pain that sees no relief even at rest, particularly if you have an underlying history of malignancy (cancer) or IV (intravenous) drug abuse.
  
  
• A known history of ankylosing spondylitis.
  
  
• Neck pain that occurred following significant trauma (for instance after a fall with head injury, a fall from significant height, or a motor vehicle accident).
  
  
• Neck pain that occurred following trauma (such as a fall from standing height or neck manipulation) particularly in elderly or osteoporotic individuals
  
  
• An explained fever with neck pain.
  
  
• Neck pain that is accompanied by neurological symptoms (these may include pain, numbness or progressive weakness in the limbs, gait or balance disturbances, clumsiness or disturbances to fine motor function of the hands such as buttoning and use of chopsticks, bowel or bladder dysfunction).
  
  
• Unexplained neck pain with no relief beyond six weeks

“Contrary to popular belief, neck flexion (the movement of lowering your chin towards your chest or bending your head forward) while using mobile phones is not strongly linked to neck pain.

Research shows that more or less neck flexion does not increase or reduce neck pain risk," shares Senior Principal Physiotherapist Linus Tan.

On factors that do increase risk of neck pain, he shares the following. They include:

• A sedentary lifestyle,
• Prolonged screen time, and
• Psychological stress

To maintain good neck health, he offered some practical tips:

• Stay active: Incorporate regular movement and exercise into your routine. Avoid prolonged periods of stillness.
  
  
• Take breaks often: If working at a desk or using a mobile device for long periods, take frequent short breaks to move and stretch.
  
  
• Perform strengthening and stretching exercises: Engaging in simple neck and upper back exercises can help improve neck function and reduce stiffness.

To learn about neck pain treatments offered at SKH and for more tips on neck health, check out this Skoop magazine article!

Ref: G25

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