 What is it?
The cervical spine (bones in the neck) allows more motion
than other parts of the spine, thus the neck is an extremely
flexible part. The problem with the neck's being so flexible
is that because it moves so easily and is less protected than
the rest of the spine, it is more prone to injury. For most
people neck pain is something that disappears with time, but
for some it requires medical diagnosis and treatment.
Causes
Neck pain can come from a variety of abnormalities including
the soft tissues, the muscles, the ligaments, and the nerves.
Neck pain also can come from the ones and joints of the spine.
Prolonged wear and tear causes damage to the soft tissues,
and this is the most common reason for neck pain. In some people
neck pain can come from problems in the back or shoulders.
Rarely people will get pain from infections or tumors.
Degenerative diseases that cause neck pain include osteoarthritis
and rheumatoid arthritis, osteoarthritis usually occurs in
the elderly as a result of wear and tear of the joints between
the bones in the neck. Rheumatoid arthritis causes destruction
to the neck joints. Both are known to cause stiffness and pain.
Cervical disk degeneration can also cause neck pain, because
the disk acts like a shock absorber between the bones in the
neck. People usually develop this after the age of 40. The
disk degenerates and the space between the vertebrae narrows.
Also what could happen is the cervical disk could protrude
and cause pressure on the spinal cord or nerve roots when the
disk weakens (herniated cervical disk).
Because the neck is so flexible and it supports the head,
it's very susceptible to injury. Injury occurs often in motor
vehicle accidents, with contact sports, diving accidents, and
falls. Sometimes in car accidents people hyperextend their
neck, which is when the neck moves backwards further then the
normal limit. People can do the opposite, which is known as
hyperflexion, a forward motion beyond the normal limits. Fractures
or dislocations of the neck can damage the spinal cord and
cause paralysis.
Seek Treatment When...
One should seek medical care for neck pain if it occurs after
an automobile accident, or following any sort of trauma to
the head or neck. Immediate medical care should be sought if
the injury causes pain down the arms and legs. Also if the
pain isn't to bad in the neck, but causes radiating pain down
the arms and legs with numbness the emergency care should be
taken. If there hasn't been any injury then medical care should
be obtained when neck pain is: continuous and persistent, severe,
accompanied by pain down the arms and/or legs, and when pain
is accompanied by headaches, numbness, and weakness.
Diagnosis
Often times orthopedic care is used for proper care of neck
pain. They are trained in the workings of the musculoskeletal
system, including the muscles, bones, joints, ligaments, and
tendons. The first thing to do in order to treat the pain is
to determine the source of the pain, which can be tougher than
it may seem. The doctor will first take a complete history
of the problem concerning the neck pain, also the doctor will
ask about other medical problems, and if there was any previous
treatment for the neck. Second, the doctor will perform a physical
examination, which will include evaluation of some neck movements,
neck tenderness, and nerve and muscle functions. Also, a lot
of time x-rays are used to be sure there isn't anything happening
with the bones. If after these test are performed the doctor
needs more help, one or more of the following tests will be
prescribed:
- MRI (Magnetic Resonance Imaging), which
allows evaluation of the spinal cord and nerve roots; it
is non x-ray
- Myelogram (injection of a dye or contrast
material into the spinal canal), this x-ray allows for very
specific evaluation of the nerve roots and spinal canal.
- CT (computed tomography), this specialized
x-ray allows evaluation of the bone and spinal canal.
- EMG (electromyogram), this
test is used to evaluation nerve and muscle function.
Treatment
Treatment obviously depends on the diagnosis made by the doctor,
but most of the time patients are successfully treated with
rest, medication, immobilization, physical therapy, exercise,
and activity modifications.
Rest is good simply because sometimes people have a tendency
to do to much and wind up overusing their muscles which can
cause pain. Medication is often given in the form of anti-inflammatories
because people may get swelling from overuse or irritation
of the muscles. Immobilization is again to allow for the body
to calm back down and rest before getting back into stressful
situations.
Physical therapy can be good to teach various stretches as
well as to help people strengthen their muscles, to alleviate
pain from overuse.
Surgery is sometimes used to treat neck pain, if the pain
persists after all of the other treatments has been applied.
Sometimes surgery is needed to reduce the pressure on the spinal
cord or a nerve root, when the pain is caused by a herniated
disk or narrowing of the spinal canal. Surgery is also needed
sometimes following an injury, to stabilize the neck and minimize
the possibility of paralysis, for example when a fracture results
in instability of the neck.
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