Neck pain

Neck pain can result from a number of injuries, disorders, and diseases in your neck. Arthritis, degenerative disc disease, neck strain, whiplash, a herniated disc and a pinched nerve are some of the many conditions that can result in neck pain and problems. 

Causes

Neck pain causes can include:

  • Poor spinal alignment – This can result from poor posture or improper sleeping techniques that can twist your spine out of its normal alignment and make you more vulnerable to neck injuries.
  • Herniated or ruptured disc – The gel-like substance inside the discs that cushion the vertebrae in your spine can become squeezed and compressed so much that the discs bulge out beyond their normal position in the spinal column. When the bulging disc comes in contact with a spinal nerve, it can cause neck pain, inflammation, numbness and swelling.
  • Pinched nerve – A compressed spinal nerve can cause tremendous pain in your neck as well as other areas of the body. There are many different reasons for a nerve to become pinched, ranging from injury to cervical spinal stenosis and lumbar spinal stenosis.
  • Injury or trauma – Injuries of significant force such as whiplash or sports injuries can cause neck pain. Fractures such as vertebral compression fractures can result from these injuries. If there is a tear in the ligament or muscle in the neck area, this can lead to cervical herniated discs or lumbar herniated discs.
  • Meningitis – Bacterial infection of the membranes covering the brain and spinal cord. The main symptoms are severe neck pain and stiffness.
  • Osteoarthritis – Bone spurs can form in discs as they naturally wear out over time. The affected discs will dry out and shrink while slowly destroying the structure of the spine. Spinal stenosis and herniated (ruptured) discs are the most common results of osteoarthritis.
  • Spinal stenosis – Narrowing of the spinal and nerve root canals result from herniated (ruptured) discs, enlarged and inflamed facet joints and stiff ligaments. As the spinal canal narrows, it compresses the entire spinal cord as well as the nerves. This can lead to other spinal problems, all of which can cause neck pain and other symptoms.
  • Spondylosis – A stress fracture develops in one of the bony bridges that connect the upper and lower facet joints of the spine.
  • Spondylolisthesis – The vertebrae of the spine can slip out of their normal position due to weakness in the surrounding muscles and ligaments.

Symptoms

Signs and symptoms of neck pain and problems can include:

  • Dull aching
  • Pain that increases with movement
  • Stiffness or tightness
  • Decreased range of movement
  • Burning or stabbing pains
  • Headaches
  • Pressure
  • Muscle spasms
  • Tingling
  • Pain and stiffness can spread to the face, shoulders, arms and even hands
  • Fever
  • Nausea
  • Loss of strength
  • Loss of bladder control
  • Numbness, tingling or pain in the legs

If you have more severe symptoms such as fever, nausea, loss of bladder control and numbness, tingling or pain in your legs in addition to your neck pain, you may have a more serious condition. Always consult your physician if you are suffering from any of the above symptoms, but consider the more severe symptoms as a medical emergency.

Diagnosis

After your physician gathers your complete medical history and provides a physical exam, one or more of the following diagnostic tests for neck pain will be performed:

  • Blood tests
  • X-ray – Uses invisible electromagnetic energy beams to produce images of internal organs, tissues, and bones.
  • MRI (magnetic resonance imaging) – A diagnostic imaging procedure that creates more detailed images of internal structures than an X-ray does. MRI scans use a combination of large magnets, radio frequencies, and a computer to obtain these images. This procedure can determine the extent of disease and damage in a ligament or muscle.
  • Computed tomography scan (CT or CAT scan) – This diagnostic procedure uses a combination of computer technology and X-rays to produce images of the body. It can show very detailed images of any area of the body including organs, muscles, fat and bones.
  • Myelogram – Dye is injected into the spinal cord to allow the images to be seen clearly on an X-ray.
  • Electromyogram (EMG) – This test records the electrical activity of nerves and muscles. Abnormal readings can suggest different diseases and conditions.

Treatment

Treatments for neck pain and problems depend upon the severity of the condition and can range from nonsurgical treatments and physical therapy to surgical procedures.

Medication

Your physician may prescribe pain medicine, such as muscle relaxants and tricyclic antidepressants, to relieve your neck pain.

Nonsurgical treatments

  • Immobilization – To take pressure off the structures in your neck, a soft collar may be prescribed for a short amount of time.
  • Physical therapy – A physical therapist can help you with neck-strengthening exercises and by applying ice, heat and electrical stimulation to help reduce pain and promote healing.
  • Traction – This form of therapy uses weights and pulleys to gently stretch your neck and relieve pain.
  • Transcutaneous electrical nerve stimulation (TENS) – Electrical impulses are delivered through electrodes near painful areas to relieve pain.
  • Steroid injections – Corticosteroid injections near nerve roots, into small facet joints of the cervical spine or into muscles can help relieve swelling and pain in some patients.

Surgery

Surgery is rarely recommended unless the source of the problem is a herniated disc, a spinal compression or another condition that results in more severe symptoms.

The multidisciplinary team of spine experts at Northwell Health Orthopaedic Institute treats neck pain and problems as well as a broad range of spine conditions that can occur at any stage of life.

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