As a clinician and sometimes researcher, I know what medical evidence says about the management of neck problems.

As an everyday Jo, I know about life with neck ache.

The two are worlds apart.

How does an everyday Jo - or Joe - find out about their neck problem?

It’s a big medical maze, and easy to get lost within it.

As medical problems go, mine is not very exciting. But if I, as a so-called expert, have trouble finding information, how do our patients / employees / claimants fare in trying to get help?

Here’s my tale.

I've had bother with my neck since the age of 12. I wouldn't remember that age, save for the enduring memory of a conversation I had with someone when I was 20, reporting problems for eight years.

The neck ache played up during year 12 so my father made me a book stand that avoided the need for looking down. (There was too much fun and too little study in the years before that to enlist my father's magical hardware skills).

In my second or third year of university I was hit from behind in a reasonably minor car accident. My neck became particularly painful at that point, and was associated with sharp pain going into my upper back and arm. This prompted me to go to the doctor, who decided a neurosurgeon should take a look. At that stage of my life I hadn't heard the word claim; it wasn't part of the process.

Having heard I'd had neck ache for years, and now had pain radiating into my back and arm, the surgeon told me I should have a cervical or neck fusion. Back in those days - or “baaack in mi daay”, as the kids mimic us oldies - CT and MRI scans didn't exist.

So a cervical myelogram was ordered. A myelogram involves injecting dye into the area around the spinal cord, with the injection inserted into the low back. You are then tipped upside down so the dye runs up to the neck. Sure enough, a problem was identified.

As luck would have it, the hole left by the injection kept leaking spinal fluid. It took months to recover from this. The details of this misadventure aren’t key to the story. Suffice it to say, my medical student friends came to my aid when I'd been in hospital six weeks; they engineered the input of an expert who sorted out what was going on.

Whilst languishing flat on my back, as was the way of managing the complication at that time, there was a fortunate conversation with one of my university lecturers.

At the age of 22, you are simply not world wise. I'd been told to have an operation; my naiveté led me to assume that’s what I needed to do.

My wonderful biology lecturer, who was a doctor himself, suggested I didn't need to follow the advice and surgery was an option not an absolute.

By the time the myelogram complications had settled, so had the more severe neck problem. Proceeding with an operation by that stage looked mightily unattractive.

On I went, over the next decade, with a sore neck; bothersome, but just that.

My next recollection of a significant event was at the age of 30. I'd been travelling and working overseas, and in my first year back in Melbourne the neck ache worsened. It was troublesome enough to see a rheumatologist.

He said it was probably stress.

And when I thought about it, it was. I'd come back from amazing medicine, and being thoroughly engaged, to a role where I was rather a waste of space. I was a psychiatry hospital resident. I had little to offer, there was little to do in the job on a day-to-day basis, and there was no role clarity. Being underworked was doing my head in.

The role was temporary, and I moved on after six months. The neck settled back to his usual state.

Over the next decade I did the rounds of treatment, feeling like there should be something available to lessen the problem - to reduce the bothersome level from “3-4/10” to “1-2/10”. Physiotherapy; chiropractic treatment; acupuncture; anti-inflammatory tablets; not much seem to make a difference.

And then I found a physiotherapist who pummeled the daylights out of my neck. It was both incredibly painful and wonderful. Here was something available that helped. I was happy.

More than that, I was gradually learning. I was learning that the ache came from the muscles – when they were tight and tense the soreness increased, and when they were stretched or pummeled, the soreness decreased. The C 5-6 degeneration on XR didn’t seem to correlate to my symptoms.

And I learnt something more. I learnt that I had to work out what made it worse, what made it better, and which treatments were worth spending time and energy on.

Over the years I've learned quite a bit more. I've learnt that looking upwards stirs it up - whether sitting in the front row and looking up at a Powerpoint or kissing my tall husband - even if only do it for a minute or two. I've learnt which stretches can help, I've learnt that massage makes a difference, and I've learned that if I'm in trouble with a certain kind of pain, anti-inflammatory tablets are wonderful.

These days, it gives me minimal bother. I look after it, it looks after me. Over the last ten years it's better than it has been since I was 12.

Perhaps I've grown up and get less tense about things. Perhaps I'm better at identifying and managing tension, but mostly I think I've learnt what to avoid. Or, to know certain things will be leave me sore but there are tricks to settle it down again.

I'd like to use my ordinary, everyday, unexciting ‘dickie neck’ story to highlight a whole bunch of difficulties people with long term musculoskeletal conditions face:

• People go to their doctors, or healthcare practitioners, looking for advice. They tend to get a very medical approach. Referral, medication, scans....
   
• Some musculoskeletal problems, such as a sore neck, are less troublesome in later years. But many people worry if they develop a problem when they are young. They worry about their future as they age.
  
  It’s more common for people to learn to manage their condition over time, with improvement rather than deterioration.
   
• Long term musculoskeletal problems are often thought of as wear and tear. Yet studies of populations show that neck and back complaints typically start in teenage years and continue.
   
• Pain extending into the arm is common in people who have neck problems.
  
  And pain extending into the leg is common for people who have back problems. It occurs in about 25% of cases. That doesn't mean that the person has a significant problem.

In retrospect, the recommendation to have a cervical fusion was ludicrous. There are significant chances of complications with major neck surgery, and the type of pain I had didn't warrant surgery.

What really makes a difference to many people it is learning how to deal with their condition. If they have asthma, they need to learn how they can minimise asthma attacks and how they can manage their asthma if it starts to play up. Ditto for diabetes, back problems and most long term conditions.

I've gone the medical route and it's limited.
 

Footnote: A colleague and I are looking at developing an App for people with back pain. It would provide the best information available from research, but also help people learn to manage their back problem. If you have a tip to share, please let us know.