What are the common causes of neck pain?
There are many common causes of neck pain. Most of the time the pain is
muscular in nature and self-limiting. Trauma can cause strain of the surround
muscular and ligaments (i.e. whiplash). If your neck pain includes arm pain,
weakness or numbness there may be compression of the nerves emanating
from the neck. Headaches may cause upper neck pain and stress can
manifest as neck pain and tightness. Chronic usage of computer and
cell phones may also cause neck pain as the neck is placed under significant
stress when one’s posture is not correct. If pain across the neck persists
beyond six weeks or any other concerning symptoms such as weakness or
numbness is present, medical attention should be pursued.
How do disc injuries cause neck pain?
Discs are the cartilage shock absorbers between the vertebrae. Sometimes, as a result of trauma or natural degeneration, the outer layer of the disc, the annulus fibrosis, may tear. As a result of the tear, a host of inflammatory proteins are released that can irritate nearby nerves and cause neck pain.
What is degenerative disc disease?
Degenerative disc disease is the general term used to describe the “drying out” phenomenon that occurs in all spinal discs beyond the age of 30. The cervical discs are composed of cartilage which, in turn, is composed of approximately 80 percent water by weight. With increasing age, the water content of the intervertebral disc decreases, resulting in loss of disc height which ultimately may cause peripheral disc bulging. This natural phenomenon is referred to as degenerative disc disease. This is very easily identified on MRI scans, which look specifically at water content within the discs. Patients should realize that the existence of disc degeneration on MRI does not necessarily correlate with the existence of neck pain.
How do we treat neck pain?
Initial treatment involves obtaining a thorough history and physical exam. It is key to rule out any other medical cause of
neck pain. Initial imaging with x-rays may help to define the degree of natural degenerative changes as well as the
degree of potential instability or progressive deformity. The acute pain episodes are treated conservatively with rest, ice
or heat, and anti-inflammatory medications. Interventional pain management techniques involving injections to the
joints of the spine may also play a role (facet injections). After the acute phase has been dealt with, treatment will focus
on preventing and reducing the intensity and frequency of subsequent flare-ups. This may be achieved thru participation
in a physical therapy or chiropractic program focusing on posture and core stabilization, strengthening and stretching.
What if I have arm pain, numbness or weakness with neck pain?
Neck pain associated with arm pain, numbness or weakness may reflect compression of the nerves which exit the spinal canal in the neck. These nerves control the strength and sensation of our upper extremities. Nerves may be compressed as the result of an acute disc herniation or progressive arthritis. An MRI may be considered if conservative treatment does not provide relief within six weeks or if there are any other concerning symptoms. These symptoms may include loss of coordination and balance, bowel or bladder incontinence, fevers, neck pain at night, weight loss, or upper extremity weakness or numbness. If you experience any of these concerning symptoms please contact a healthcare professional immediately.
Tips for maintaining a healthy neck:
1) Listen to your Body: If an activity or position is causing pain in
your neck, refrain from doing it. Take a rest from that
specific activity. Pain is an alert system of your body.
Discuss the activity or position with a physician or physical
therapist before proceeding.
2) Weight loss: Excess weight will cause further stress upon the discs and joints of the spine. Losing weight can help
alleviate lower back pain as well as pain in other weight-bearing joints. Speak with a medical professional for
guidance in losing weight.
3) Use proper body mechanics: Ensure that you are sitting properly with adequate back support. Spending long
periods of time staring down at a smartphone/tablet or computer will place a significant amount of strain on
the structures of the neck and lead to pain. In addition, the importance of a good night’s sleep cannot be
overestimated. Choose an appropriate mattress/pillow for your preferred sleeping position so your neck and
back are adequately supported. When lifting objects, use proper mechanics. Use your legs and not your back to
lift a heavy object. Improper technique may further injure an already compromised neck or back.