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The neck (cervical
spine) is composed of 7 vertebrae which begin at the
base of the skull and end in the upper torso . The bony
vertebrae along with the ligaments and muscles 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, in the adult weigh
between 14-16 pounds. However, because it is less
protected than the rest of the spine, the neck can be
vulnerable to injury and disorders that produce pain and
restrict motion. For many people, neck pain is a
temporary condition that disappears with time. Others
need medical diagnosis and treatment to relieve their
symptoms.
This information helps explain
some of the causes of and treatment for neck pain.
However, does not replace an examination or the advice
of a physician. |
What causes
neck pain?
Neck pain may result from abnormalities in
the soft tissues - the muscles, ligaments, and nerves - as well
as in bones and joints of the spine. The most common causes of
neck pain are inflammation of the joints and soft tissue
abnormalities due to injury or prolonged wear and tear. In some
people, neck problems may be the source of pain in the upper
back, shoulders or arms since the nerves that supply the
shoulders arms and hands originate in the neck.
Degenerative and inflammatory diseases
- Degenerative diseases that cause neck pain include
osteoarthritis and rheumatoid arthritis. Osteoarthritis usually
occurs in older people as a result of wear of the joints between
the bones in the neck. Rheumatoid arthritis can cause
destruction of the joints of the neck. Both of these major types
of arthritis can cause stiffness and pain. When the spine is
injured and any of these conditions exist, the pain can be more
intense than if these conditions were not present.
Cervical disk degeneration also can cause
neck pain. The disk acts as a shock absorber between the bones
in the neck. In cervical disk degeneration (typically age 40
onwards), the normal gelatin-like center of the disk degenerates
and the space between the vertebrae narrows. As the disk space
narrows, added stress is applied to the joints of the spine
causing further wear and degenerative disease. The cervical disk
may also protrude and cause pressure on the spinal cord or nerve
roots when the rim of the disk weakens. This is known as a
bulged, herniated or ruptured cervical disk.
Injury - Because the neck is so
flexible and because it supports the head, it is extremely
vulnerable to injury. Motor vehicle or diving accidents, contact
sports, and falls may result in neck injury. The regular use of
safety belts in motor vehicles can help to add to injury of the
neck since it fixes the upper and lower body in place and as a
result more force occurs in the neck. However, it prevents or
minimizes more severe head or chest injuries. 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 normal limits, this is
commonly called whiplash. Most common injuries are to the soft
tissues, i.e., muscles. ligaments and discs. Severe injury with
fracture or dislocation of the neck may damage the spinal cord
and cause paralysis (quadriplegia).
Much less common causes of neck pain
include tumors, infections, or congenital abnormalities of the
vertebrae.
When should
you seek medical care?
If severe neck pain occurs following an
injury (motor vehicle accident, diving accident, fall), a
trained professional, such as a paramedic, should immobilize the
patient to avoid the risk of further injury and possible
paralysis. Medical care should be sought immediately. Immediate
medical care should also be sought when an injury causes pain in
the neck that radiates down the arms and legs. Radiating pain or
numbness in your arms or legs causing weakness in the arms or
legs without significant neck pain should also be evaluated.
If there has not
been an injury, you should seek medical care when neck pain is:
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continuous and persistent
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severe
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accompanied by pain that
radiates down the arms or legs
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accompanied by headaches,
numbness, tingling, fever or weakness
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What should you do
when you have a neck injury or pain?
The Back Pain Institute specializes in the
care for neck and back pain. We have on staff medical doctors,
chiropractors and physical therapists because they are
specifically trained in the musculoskeletal system, including
the diagnosis, treatment, and prevention of problems involving
the muscles, bones, joints, ligaments and tendons.
Diagnosing
neck pain
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Determining the
source of the pain is essential to recommend the right
method of treatment and rehabilitation. Therefore a
comprehensive examination is required to determine the
cause of neck pain.
We will take a complete history
of the difficulties you are having with your neck and
ask you about other illnesses, any injury that occurred
to your neck and any complaints you have associated with
neck pain. Previous treatment for your neck condition
will also be noted.
Next, we will perform a physical
examination. This examination may include evaluation of
neck motion, neck tenderness, and the function of the
nerves and muscles in your arms and legs.
X-ray studies often will be done
to allow us to look closely at the bones in your neck.
These simple diagnostic techniques often help to
determine the cause of neck pain and to prescribe
effective treatment. |
Patients
who require further evaluation may undergo one or more of the
following examinations:
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MRI
(magnetic resonance imaging). This non X-ray study
allows an evaluation of the spinal cord, nerve roots
and disc as well as other soft tissue.
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CT
(computed tomography). This specialized X-ray study
allows careful evaluation of the bone and spinal
canal.
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EMG
(electromyogram). This test
evaluates nerve and muscle function.
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Treatment
How neck pain is treated depends on what
the diagnosis reveals. However, most patients are treated
successfully with rest, medication, immobilization,
chiropractic, physical therapy, exercise, activity modifications
or a combination of these methods.
For example, if pain is caused by
inflammation as a result of stretching muscles and ligaments
beyond their limits, you may be prescribed 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, remember
that if you are prescribed rest, it is vital that you follow
instructions carefully.
When neck pain persists or is chronic, you
may be recommend a rehabilitation program that includes an
exercise program and various types of physical therapy and/or
chiropractic manipulation to help you relieve your pain restore
function and prevent it from coming back.
Very few patients require surgery to
relieve neck pain. For the vast majority of patients, a
combination of rest, medication chiropractic and physical
therapy will relieve neck pain. Although very rare, 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 following an
injury, to stabilize the neck and minimize the possibility of
paralysis such as when a fracture results in instability of the
neck.
Our physicians have extensive training in
the diagnosis and treatment of the musculoskeletal system,
including bones, joints, ligaments, tendons, muscles and nerves.
If you are injured it is always best to
have an examination as soon as possible to detect any indication
of significant or hidden injury. It is not uncommon for the
effects of an injury to show up days, weeks, months or even
years after an injury. |
