The Ins and Outs of Neck Pain
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The Ins and Outs of Neck Pain
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Neck pain may result from problems lurking in muscles, ligaments, nerves, bones and joints of the spine. The most common causes are soft-tissue abnormalities because of injury, wear and tear; rarely, tumors or infections can cause this type of pain. In addition, neck problems may be the source of pain in the upper back, shoulders, or arms.
The neck (cervical spine) consists of vertebrae beginning in the upper torso and ending at the base of the skull. The bony vertebrae along with the ligaments provide stability to the spine.
The muscles allow for support and motion. The neck has a significant amount of motion and supports the weight of the head.
The neck can be vulnerable to abnormalities that produce pain and restrict motion. For many people, neck pain is a temporary condition; those suffering from prolonged bouts of pain may be in need of medical attention. Causes of neck pain include rheumatoid arthritis, which destroys joints in the neck and causes pain in the upper neck area; cervical disk degeneration (which typically occurs in people over 40), in which the gelatin-like center of the disk degenerates and the space between the vertebrae narrows; added stress is applied to the joints of the spine.
In addition, the cervical disk also may protrude and put pressure on the spinal cord or nerve roots when the rim of the disk weakens. This is known as a herniated cervical disk; injury caused by motor vehicle or diving accidents, contact sports, and falls. For example; a “rear end” automobile collision may result in hyperextension, a backward motion of the neck beyond normal limits, or hyperflexion, a forward motion of the neck beyond customary limits.
The most common neck injuries involve the soft tissues: the muscles and ligaments. Severe neck injuries with a fracture or dislocation of the neck may damage the spinal cord and cause paralysis.
The use of seat belts is an important tool in combating this type of neck injury; tumors, infections, or congenital abnormalities of the vertebrae are less common causes of neck pain.
A patient who feels severe neck pain following an injury (motor vehicle accident, diving accident, or fall), or pain that spreads from the neck down the arms and legs, should seek medical attention immediately.
When no injury has occurred, a person who suffers from continuous, persistent, severe neck pain, and/or neck pain accompanied by pain that radiates down the arms or legs and is accompanied by headaches, numbness, tingling, or weakness should also see a doctor.
Orthopaedists are trained physicians who diagnose, treat, and help prevent problems involving the muscles, bones, joints, ligaments, and tendons.
Most treat a wide variety of diseases, injuries, and other conditions. Your orthopaedist will take a complete history of your neck pain, ask about illnesses or injuries, and will perform a physical examination and possibly X-rays.
Patients who require further evaluation may undergo a MRI (magnetic resonance imaging), an evaluation of the spinal cord and nerve roots; a CT (computed tomography), which allows evaluation of the bone and spinal canal, a Myelography (injection of a dye or contrast material into the spinal canal), which permits evaluation of the spinal canal and nerve roots; an EMG (electromyography), which evaluates nerve and muscle function, blood tests, etc.
Most neck pain is treated with rest, medication, immobilization, physical therapy, exercise, activity modifications, or a combination of these methods. Surgery is sometimes needed.
For example, if pain is caused by inflammation as a result of stretching muscles and ligaments beyond their limits, your orthopaedist may prescribe rest and a neck collar for a specified period of time, as well as medication to reduce inflammation.
If medication is prescribed to reduce pain, it should be used only as directed and should not be taken for extended periods of time. In addition, if your orthopaedist prescribes rest, it is vital that you follow these instructions carefully.
When neck pain persists or is chronic, your orthopaedist may recommend a rehabilitation program that includes an exercise program and various types of physical therapy to help you relieve your pain and prevent it from coming back.
Very few patients require surgery to relieve neck pain. For most patients, a combination of rest, medication, and physical therapy will relieve neck pain.
Surgery may be necessary to reduce pressure on the spinal cord or a nerve root when pain is caused by a herniated disk or bony narrowing of the spinal canal. Surgery may also be required in extreme cases.
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