Neck pain is a common complaint and tends to occur with increasing frequency after the age of 30. Most episodes of neck pain are short-lived and tend to respond to non-operative management.
Your neck is made of seven bones called cervical vertebre. Between the vertebre are discs, which provide a cushion. Also, between each vertebra a nerve exits from your spinal cord.These nerves extend into your arms giving you sensations like hot, cold, and pain as well as allowing you to move your arm muscles.
Muscle tightness can occur from poor posture and stress.
Injuries to the neck can create radiating pain which is felt in the head, shoulders, arms and hands.
Disc degeneration is when the discs lose water and become shorter, causing the vertebre to be closer together.
Bony spurs can develop, causing pain and irritation to the nerve.
Arthritis is when the bone surfaces become rough, which can cause irritation to the disc and nerve as well.
Herniated disc is when disc material ruptures and presses on a nerve, increasing pressure on the nerve.
Sports and industrial accidents account for a large number of injuries.
Whiplash is caused by a quick forward or backward motion of the head resulting in the ligaments, tendons,
or muscles stretching beyond their normal limits. This movement is typical in car accidents.
Signs and Symptoms
Reduced range of motion
Laboratory studies should include routine blood workup; a complete blood count with differential, an erythrocyte
sedimentation rate (ESR) and C-reactive protein(CRP).
An electromyogram (EMG) may be helpful in defining a specific anatomic level
when nerve compression is present.
A plain X-ray series should include an anterior/posterior view, a lateral view, and oblique views. Degeneration can
often be noted within the disc spaces and the facet joints. There are often osteophytes noted along the area of the
disc space, and foraminal narrowing can be noted on oblique views.
Myelography can be used to help evaluate nerve root compression as well as compression of the spinal cord.
In cases of severe compression, there will be complete obstruction of flow of the myelogram dye.
MRI perhaps the primary imaging modality overall for cervical spine disorders. It provides excellent visualization
of the spinal cord and soft tissues.
Typical activities to modify include athletic activities, sitting at a desk with neck flexion (e.g. reading and typing)
for extended periods of time and driving. The use of two or three pillows at night, in order to decrease reflux
symptoms or breathing problems, exacerbate cervical spine problems and should be avoided.
Use of medications including anti-inflammatory medications help decrease the amount of inflammation
and provide pain relief. In cases of severe pain, mild narcotics may be useful. Muscle relaxants may also help
decrease the amount of spasm and allow or more comfortable periods of rest. Short courses of steroids
are sometimes needed to control the inflammatory process.
Physical therapy is often useful in the treatment of neck and radicular arm pain, once the phase of severe pain
and radicular problems resolve. Active ROM exercises along with some isometric exercises can help
regain the strength of the neck.