Neck pain is a common condition that is more frequently seen in women than men. Most people will experience neck pain at some point in time of their life.
Pain in the neck can be due to issues such as an injury, a mechanical or muscular issue, an impinged nerve caused by a intervertebral disc bulge or from arthritis of the spine.
The neck is made up of structures such as cervical ligaments which provide stability and muscles which allow for support and motion. The neck joint has a significant range of motion and supports the head. Unlike the rest of the spine, it is less protected and is vulnerable to injury.
Common Causes of Neck Pain
Prolapsed Intervertebral Disc – This occurs when a degenerated or injured disc protrudes out
Cervical nerve compression – When nerves are compressed by a disc or degenerated bones
Facet Joint Syndrome – An arthritis-like condition of the spine that is due to degenerative changes to the joints between spine bones
Muscle and Ligamental Pain Syndrome – Fibromyalgia
Non-specific Neck Pain – This is the most common type of neck pain with no obvious cause. It may happen due to exposure to cold wind or even a minor twist. The underlying cause is not well understood and Xrays may look normal. It usually disappears after a few days.
“Whiplash” – Commonly due to a sudden acceleration/deceleration injuries from motor vehicle accidents
Tension – Constant strain to your anti-gravity muscles which have to work all the time to keep your body upright may cuase muscles at the back of your neck to be in spasm
Wry Neck – A condition when you wake up in the morning with a stiff neck which gets worse when you turn your head. Usually due to tense neck muscles during disturbed sleep.
Symptoms of Neck Pain
Neck pain may present a range from mild discomfort to severe debilitating pain. It may also present as stiffness and you may find it difficult to move your neck. This could be due to muscle spasm or even cervical spondylosis where you lose range of movement due to degeneration of the bones and discs. Degenerated bones may also lead to noisy joints which may sound like clicking or grating (crepitus) as you move your head. Cracking of the neck is the sound of gas released from the facet joints when you “crack the neck”, much like cracking your knuckles. Dizziness and blackouts are much rarer symptoms when your vertebral artery is pinched by a degenerated spine. Lastly, depression may ensue when you have chronic neck pain especially so if your sleep is disturbed which will lead to excessive tiredness and low mood.
Diagnosis and Treatment of Neck Pain
Determining where the pain originates is the key to the treatment of neck pain. During your visit, your physician will take a complete history and examine you thoroughly. Some other important pieces of information will include any other medical conditions or injuries/illnesses that you may have had before or if you have already received any treatment or procedures to your spine.
Radiological investigations may also be done to allow a better look at the structures in your neck.
Cervical Spine Xray
CT (computed tomography)
MRI (magnetic resonance imaging)
Myelogram (injection of a dye or contrast material into the spinal canal)
EMG (nerve conduction and electromyogram)
Treatment is then tailored specifically to what is the source of your pain. A range of treatment modalities include rest, medication, immobilization, physiotherapy, exercise, activity modifications and non-surgical methods which include minimally invasive pain procedures.
When should you seek medical care?
You should consider seeing a doctor when the pain is persistent and affecting your lifestyle, severe, when it is radiating down your arms or legs, when it is accompanied by headaches, numbness, tingling or weakness or if it is associated with a recent traumatic episode.