Neck Pain
Neck Anatomy
The cervical spine is formed by seven square shaped bones
called cervical vertebrae. The vertebrae are named beginning at the top with
C1, C2, C3, down to C7. Together with the supporting ligaments and the
overlying neck muscles, the cervical vertebrae form a spinal canal that surrounds
and protects the spinal cord. The vertebrae have gelatin-like cushions between
them called intervertebral discs which function as shock absorbers.
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Neck pain causes:
- Cervical strain is due to spasm of
cervical and upper back muscles. It may result from injury or due to physical
stress of everyday life, including poor posture, muscle tension from anxiety
and high stress level or from poor sleeping habits.
- Cervical spondylosis is due to
wear and tear of the cervical spine that occurs with aging. It results in the
gradual narrowing of the disc space and growth at the edges of the bone (bone
spurs). These spurs can put pressure on the surrounding tissue and pinch the nerves
in the neck.
- Cervical discogenic pain is the
most common cause of the neck pain. It is caused by the changes in the
structure of the intervertebral discs.
Symptoms
- Pain, stiffness and tightness in
the neck, upper back and shoulder muscles
- Limited ability to move the neck
due to pain and stiffness
- Pain may refer to the arm and/or
shoulder
- Headaches (known as cervicogenic
headache)
- Numbness or abnormal sensation of
the arm or shoulders
- Pain is often worsened by holding
the neck in prolonged position such as occurs with driving, reading or working
at a computer
Neck Pain Tests:
- Your health care provider will
usually perform the following physical exam:
- Evaluation of the range of motion
(the ability to move the head in every direction)
- Testing for neck and arm strength
- Feeling for muscle tightness
In some cases, further testing,
such as X-ray, CT scan, MRI or electrodiagnostic testing (EMG) may be
recommended. The need for these tests depends on person’s symptoms, medical
history and examination.
Treatment
- Pain control with over-the-counter
medications, such as Tylenol or NSAIDS (ibuprofen, naproxen, etc.) is helpful
for mild to moderate neck pain. Prescription pain medicine may be necessary for
severe pain.
- A prescription muscle relaxant
such as Flexeril, Robaxin or Soma
- Cold therapy
- Heat therapy
- Massage
- Range of motion and stretching
exercises
- Transcutaneous electrical nerve
stimulation (TENS) uses a mild electric current to decrease pain and increase
mobility and strength.
- Cervical traction involves the use
of weights to realign or pull the spinal column back into alignment.
- Ultrasound to provide deep heat to
muscles and ligaments
- Trigger point injections of a
local anesthetic medicine into the area of the muscle that is tight and tender
(“trigger
point”)
Prognosis
Approximately ten percent of adults have neck
pain at any one time. The majority of patients, regardless of the cause of
pain, recover with conservative therapy. Surgery is very rarely needed
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