Neck Pain: Causes and Treatment

The neck is composed of seven bones, called vertebrae that

Begin in the upper torso and end at the base of the skull

(Figure 2).

With the help of muscles and ligaments, the neck provides stability to the spine and allows motion.

 The neck has two other very important responsibilities:

supporting the head, which can weigh 15 pounds, and allowing

the spinal cord to pass through, connecting the  brain to nerves of the body.

There are three basic movements for the neck’s range of motion:

 First, the neck’s ability to move side-to-side is called rotation.

Second, the ability to move forward and backward is called

flexion and extension. Third, the neck’s ability to move head to

shoulder is called lateral bending.

As stated earlier, the neck is susceptible to injury because of

its range of motion and lack of protection compared to other

parts of the body. Common causes of neck pain include muscle

strain, inflammatory disease, cervical disk degeneration, disk

herniation (Figure 3) and injury.

Good posture is essential in safeguarding yourself from neck pain. When you have good posture, your neck, spine and head are in alignment. Activities that require you to lean over however, such as sitting at a desk, can cause the neck to become fatigued. When the neck becomes fatigued, it eventually becomes strained (Figure 4).

Inflammatory disease, such as rheumatoid arthritis, also leads to

neck pain. When the neck is overused, joints become swollen and

stiff, reducing the neck’s range of motion. Arthritis harms the

joints in the neck and leads to severe pain as a result of stiffness.

Cervical disk degeneration is also responsible for causing neck pain.

Here, the gelatin-like center of the disk degenerates and the space

 between the vertebrae narrows. The disks, which should act as shock absorbers between the bones, are unable to cope with the additional applied stress causing further degeneration.

This narrowing of the spinal canal is known as spinal stenosis.

The additional stress may also cause the disks to protrude and

put pressure on the spinal cord. This condition is known as a

herniated cervical disk (Figure 3).

Injuries may also cause neck pain. Most often, neck pain arising

from an injury is the result of a motor vehicle accident, fall or

contact sport. Often these injuries cause pain because the neck is extended beyond its normal limits. Here, pain is either the result of hyperextension (backward motion beyond normal limits) or hyperflexion (forward motion beyond normal limits). With hyperextension or hyperflexion, the soft tissue around the neck is stretched past its normal limits.Patients should seek medical attention if pain is persistent and continuous; radiates down the arms and legs; occurs following an automobile accident or other injury; or is accompanied by numbness, headaches, weakness or tingling.

To identify the cause of neck pain, orthopaedic surgeons may utilize several different tests such as family history and physical examination; MRI evaluation of the spinal cord and nerve roots; CT scan to evaluate the bone and spinal cord; X-ray (Figure 5); or an EMG, where needles are placed in the arm and muscles with wires attached to measure the electrical activity of nerves, to evaluate nerve and muscle function.While most neck pain can be treated with rest, medication, immobilization, exercise, activity modification, physical therapy or a combination of these, surgical intervention is sometimes needed.

For more educational videos, Check Dr. Ebraheim's educational youtube channel, and access the Neck playlist through this link for more valuable information:

Author

Nabil Ebraheim, MD