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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.


  • 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.


  • 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”)


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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