Neck Pain

FAQs on Neck Pain

 

Neck pain is the most reported musculoskeletal pain after headache and back pain. Almost two-thirds suffer from the disorder at any point of life. The neck pain prevalence rate is 9 in 100 for men and 12 in 100 for women. Stiff neck problem is common in at least 45% working people.

What is neck pain?

Neck pain or cervical pain occurs in the neck structures that connects head with the rest of the body. Seven vertebral segments extending from the skull to the upper back constitute the neck, which also has many muscles, nerves, ligaments, and bones that hold the head above the torso. The cervical spine or the uppermost part of the spinal cord, which carries signals to and from the brain, runs through these structures.

The structure of the neck is strong and delicate yet flexible enough to permit movement in all directions. But due to its intricate and interconnected structures, neck is prone to stress and trauma causing painful conditions, including cervical stiffness, osteoarthritis, stenosis, herniated disc, and degenerative disc diseases.

What are the symptoms of neck pain?

  • Pain in the neck
  • Neck pain may be acute or chronic
  • Neck stiffness
  • Restricted neck movement
  • Pain radiating to skull, shoulders, and back
  • Pain, weakness, or sensory disorders in upper extremities
  • Spinal nerve irritation causing “pins and needles” in the arm

What are the structures involved in neck pain?

The neck has “muscles, arteries, veins, lymph glands, thyroid gland, parathyroid glands, esophagus, larynx, trachea, and bones.” Any disorder impacting these structures results in neck pain.

The bony cervical spine column that extends from the skull end to the upper back of the shoulders has seven vertebral segments fastened with facet joints. Discs separate these vertebral segments from each other and cushion them. When these discs herniate, degenerate, or collapse backward, cervical spinal nerves feel the pinch due to compression and irritated. This leads to neck pain.

Similarly, the neck has many spinal ligaments and muscles providing support and flexibility to the cervical spine. Nerves emanating from the spine connect these structures. When these muscles and ligaments are strained, stressed, injured, or subject to wear and tear, this causes irritation in spinal nerves that emit pain signals.

What are the causes of neck pain?

  • Muscle strains caused by overuse and body posture
  • Worn or degenerated neck joints traced wear and tear or osteoarthritis
  • Nerve impingement
  • Herniated vertebrae discs
  • Neck injuries, such as whiplash injuries
  • Neck is affected by conditions, such as rheumatoid arthritis, cancer, carotid artery tears, infections causing abscess in the neck area, congenital cervical rib, thyroid trauma
  • Spondylosis
  • Stress and traumatic injuries
  • Soft tissue abnormalities
  • Spinal stenosis or narrowing down of the spinal canal
  • Radiating upper back pain
  • Pinched spinal nerve syndrome
  • Neck jerking during activities and workouts

Who are at the risk of neck pain?

Those drive long distances frequently or have head and neck injuries, thyroid trauma, and tracheal trauma are at increased risk of the pain. Sleeping in incorrect postures, bending on the work station for hours, or watching TV or monitoring computer also enhances the risk.

When to see a doctor?

Visit a doctor if you have continuous and persistent severe neck pain. It may radiate to the shoulders and back and lead to debilitating headaches.

How is neck pain diagnosed?

The doctor may examine the pain area for tenderness, swelling, or any injury. The focus remains on the spine. Bone scam, MRI, or x-ray may be employed to assess if there is any injury to the cervical spine or nerve areas around it.

What are the treatment methods available for neck pain?

  • Medication: Anti-inflammatory painkillers, steroid painkillers, or muscle relaxants are prescribed to reduce tension and pain in the neck.
  • Self-care: Apply ice, heating pad, rest, activity changes, neck exercises, posture changes, shoulder stretching, neck massage, enhanced nutritional intake, and use of special pillow for sleeping.
  • Physical Therapy: Use exercises, endorphin release through acupuncture, chiropractic manipulations, and massage help overcome chronic neck pain and reduce functional limitations.
  • Epidural Steroid Injection: Corticosteroid and local anesthetic injected to the root of the irritated spinal nerve subdues irritation an inflammation and provides semi-permanent pain relief. Studies indicate 72% effectiveness of such treatment in reducing neck pain. These injections are also administered to “Trigger Point,” to subdue neck pain linked to muscle spasm. Since 2005, Botox injections are also used to treat neck pain associated with cervical dystonia.
  • Medial Branch Block: The procedure involves denervation of the medial branch nerve that transmits pain sensation to the brain using epidural injections or radio-frequency ablation.
  • Racz Procedure: Scar tissues formed in the epidural area are removed ensuring no compression of spinal nerves.
  • Cervical Spinal Cord Stimulation: Electrodes are inserted into the epidural place adjacent to the spinal cord and electrical current is administered to interfere with pain signal transmission.
  • Prolotherapy: Platelet rich plasma or stem cells are injected to promote the bodies healing of damaged muscles. This is effective for neck pain traced to ligament or tendon degenerations.
  • Surgery: The option of surgery for neck pain patients is limited to relieve the pinched nerves or spinal compression.

References

Rubin DI. Epidemiology and risk factors for spine pain Neurol Clin. 2007 May;25(2):353-71

Manchikanti L, et al. Therapeutic cervical medial branch blocks in managing chronic neck pain: a preliminary report of a randomized, double-blind, controlled trial. Pain Physician. 2006 Oct;9(4):333-46

Trinh K, et al. Acupuncture for neck disorders. Spine. 2007 Jan 15;32(2):236-43.

Vallejo R, et al. Neuromodulation of the cervical spinal cord in the treatment of chronic intractable neck and upper extremity pain: a case series and review of the literature. Pain Physician. 2007 Mar;10(2):305-11

Binder AI. “Cervical spondylosis and neck pain”. BMJ 2007, 334 (7592): 527–31

Croft PR, Lewis M, Papageorgiou AC, et al. Risk factors for neck pain: a longitudinal study in the general population. Pain. Sep 2001;93(3):317-25.

Anderson AV. Cervicogenic processes: results of injury to the cervical spine. Pain Practitioner. 2001;11:9-11.

Mercer S, Bogduk N. The ligaments and annulus fibrosus of human adult cervical intervertebral discs. Spine. Apr 1 1999;24(7):619-26; discussion 627-8.

Chen TY. The clinical presentation of uppermost cervical disc protrusion. Spine. Feb 15 2000;25(4):439-42.

Sampath P, Bendebba M, Davis JD, et al. Outcome in patients with cervical radiculopathy. Prospective, multicenter study with independent clinical review. Spine. Mar 15 1999;24(6):591-7.

Freund BJ, Schwartz M. Treatment of chronic cervical-associated headache with botulinum toxin A: a pilot study. Headache. Mar 2000;40(3):231-6.

JOIN OUR E-MAIL LIST!