Pain located in the neck is a common medical condition. Neck pain is also referred to as cervical pain. The neck is made up of vertebrae that extend from the skull to the upper torso. Cervical discs absorb shock between the bones. The bones, ligaments, and muscles of the neck support the head and allow for motion. Any abnormalities, inflammation, or injury can cause neck pain or stiffness.
Many people experience neck pain or stiffness occasionally. In many cases, it’s due to poor posture or overuse. Sometimes, neck pain is caused by injury from a fall, contact sports, or whiplash.
Most of the time, neck pain isn’t a serious condition and can be relieved within a few days. But in some cases, neck pain can indicate serious injury or illness and require a doctor’s care. If the pain continues for more than a week, is severe, or is accompanied by other symptoms, seek medical attention immediately.
Common Symptoms Of Neck Pain:
- Stiff neck. Soreness and difficulty moving the neck, especially when trying to turn the head from side to side.
- General soreness. The pain is mostly in one spot or area on the neck, and it’s described as tender or achy, not sharp.
- Sharp pain. This symptom can be pain localized to one spot and might feel like it’s stabbing or stinging. Often, this type of pain occurs in the lower levels of the neck.
- Radiating pain. The pain can radiate along a nerve from the neck into the shoulders and arms. The intensity can vary and this nerve pain might feel like it’s burning or searing.
- Tingling, numbness, or weakness. These sensations can go beyond the neck and radiate into the shoulder, arm or finger. There could be a “pins-and-needles” sensation. Typically, pain that radiates down the arm is felt in only one arm, not both.
- Trouble with gripping or lifting objects. This can happen if tingling, numbness, or weakness in the fingers is present.
- Headaches. Sometimes an irritation in the neck can also affect muscles and nerves connected to the head.
Common Causes Of Neck Pain
In order to effectively treat neck pain, it’s important to understand the underlying medical condition that’s causing the pain. This is especially true if the pain has lasted 4 or more weeks. Neck pain causes include:
- Muscle strains. Overuse, such as too many hours hunched over computer or smartphone, often triggers muscle strains. Even minor things, such as reading in bed or gritting teeth, can strain neck muscles.
- Worn joints. Just like the other joints in the body, neck joints tend to wear down with age. Osteoarthritis causes the cushions (cartilage) between the bones (vertebrae) to deteriorate. Bone spurs are then formed that affects joint motion and cause pain.
- Nerve compression. Herniated disks or bone spurs in the vertebrae of the neck can press on the nerves branching out from the spinal cord.
- Rear-end auto collisions often result in whiplash injury, which occurs when the head is jerked backward and then forward, straining the soft tissues of the neck.
- Certain diseases, such as rheumatoid arthritis, meningitis or cancer, can cause neck pain.
Diagnosing Neck Pain:
As a first step to diagnosing the specific cause of neck pain, the doctor will take a thorough history of the patient in order to better understand the nature of the patient’s pain, such as if the pain is worse at certain times of day or exacerbated by certain activities. Physical examination will also be conducted to assess the neck movements.
Certain imaging tests are advised to get a better picture of the cause of the neck pain which includes:
- X-rays.X-rays can reveal areas in your neck where your nerves or spinal cord might be pinched by bone spurs or other degenerative changes.
- CT scan.CT scans combine X-ray images taken from many different directions to produce detailed cross-sectional views of the internal structures of your neck.
- MRI uses radio waves and a strong magnetic field to create detailed images of bones and soft tissues, including the spinal cord and the nerves coming from the spinal cord.
It’s possible to have X-ray or MRI evidence of structural problems in the neck without having symptoms. Imaging studies are best used as an adjunct to a careful history and physical exam to determine the cause of pain.
The most common types of mild to moderate neck pain usually respond well to self-care within two or three weeks. If neck pain persists, other treatments might be recommended.
Medications: Many over-the-counter pain relievers are available to either reduce inflammation or hinder pain signals from reaching the brain. However, these drugs must be used with caution. Read the pain reliever’s entire label for directions and warnings, and be careful not to overdose. Consult a doctor who might prescribe stronger pain medicine than what you can get over-the-counter, as well as muscle relaxants and tricyclic antidepressants for pain relief.
- Physical therapy.Correct posture, alignment and neck-strengthening exercises, use of heat, ice, electrical stimulation and other measures can help ease the pain and prevent a recurrence.
- Transcutaneous electrical nerve stimulation (TENS).Electrodes placed on the skin near the painful areas deliver tiny electrical impulses that may relieve pain.
- Traction uses weights, pulleys or an air bladder to gently stretch the neck. This therapy, under supervision of a medical professional and physical therapist, may provide relief of some neck pain, especially pain related to nerve root irritation.
- Short-term immobilization.A soft collar that supports the neck may help relieve pain by taking pressure off the structures in the neck. However, if used for more than three hours at a time or for more than one to two weeks, a collar might do more harm than good.
Surgical and other procedures
- Steroid injections.Your doctor might inject corticosteroid medications near the nerve roots, into the small facet joints in the bones of the cervical spine or into the muscles in the neck to help with pain. Numbing medications, such as lidocaine, also can be injected to relieve neck pain.
- There are three common reasons to have surgery for a problem in the neck:
- To remove the damaged disc and/or other structures irritating a nerve root
- To stabilize the cervical spine
- To decompress the spinal cord
Common Types of Surgery for Neck Pain
- Anterior cervical discectomy and fusion (ACDF): The most common surgery for neck pain symptoms involves a discectomy, which is the removal of a problematic disc in the cervical spine. Typically, the surgery is done through the front of the neck, called anterior cervical discectomy; this procedure is done in conjunction with a cervical spinal fusion to maintain spinal stability where the disc was removed, so the entire surgery is called an anterior cervical discectomy and fusion, or ACDF for short.
- Posterior cervical decompression (Microdiscectomy) surgery: Another way to do a discectomy is through the back of the neck, where only part of the disc is removed and no spinal fusion is needed.
- Cervical artificial disc replacement: somewhat newer option is discectomy with artificial disc replacement. This surgical procedure involves removal of the damaged disc and replacement with an artificial disc. This surgery is an alternative to ACDF. A potential benefit of this surgery is that it retains more neck flexibility.
- Spinal decompression: There are a few different surgical options available to relieve symptoms of myelopathy and increase space in the spinal canal for the spinal cord:
- Anterior cervical corpectomy. This surgery is similar to anterior cervical discectomy, except that it involves the removal of at least one vertebral body (the cylindrical bone at the front of a vertebra) along with the adjacent discs above and below that vertebra. After the removal, a bone graft and/or cage will be placed to fill the space and set up a favorable environment for the bones to fuse together into one solid segment of bone. This surgery may be done for someone who has spinal stenosis at more than one vertebra.
- Posterior cervical laminectomy. This surgery is done through the back of the neck and involves the removal of a lamina, which is the back part of a vertebra. A potential advantage to this surgery is that more flexibility in the neck can be retained if a spinal fusion can be avoided. However, sometimes a spinal fusion is still done in conjunction with laminectomy.
- Posterior cervical laminoplasty. This surgery is similar to the laminectomy, except the lamina isn’t completely removed. Rather the lamina is cut and restructured to make more space in the spinal canal.
- Posterior cervical foraminotomy. This surgical procedure goes through the back of the neck and a small part of the foramen is removed. If a nerve is irritated by a herniated disc, then the surgeon might remove part of the disc. If a nerve is irritated by a bone spur, then the surgeon will chisel away that bone spur. No spinal fusion is needed.