Neck Pain

The cervical spine is made of seven vertebrae, C1-C7, that are separated by spinal discs which absorb shock and cushion the vertebrae, neck muscles, tendons, and ligaments.

The pain may be acute and leave within a week or two but can return if the cause such as poor posture reoccurs. When pain lasts longer than three months it is called chronic neck pain. Chronic neck pain increases with age.

Types of neck pain:

• Axial pain is pain in the cervical spine that spreads to the shoulders
• Radicular pain is shooting pain that radiates from the neck up the back of the head or down into an arm. It is caused by nerve irritation due to a herniated disc compressing the nerve or a narrowing of the canal. This pain may also affect your reflexes and muscle strength.

Most neck pain is not a symptom of a serious disorder unless it is the result of trauma like an auto accident or neck pain that is accompanied by headache, fever, nausea and vomiting, or signs of nerve problems like numbness and tingling in the arm and fingers.

• Whiplash
• Weak and overworked neck muscles
• Degeneration of the cervical spine due to aging and overuse, including bone spurs and osteoarthritis, herniated discs, and thickened spinal ligaments
• Narrowing of the spinal canal called cervical spinal stenosis that compresses the spinal cord. It causes radiating pain that shoots into the shoulder or arm, an unsteady gait when walking, muscle spasms, loss of coordination in arms, hands and fingers, loss of muscle tone, and clumsiness dropping or holding items.
• Inflammatory conditions of the spine
• Jaw problems
• Severe headaches
• Stress and poor sleep

Your orthopedic specialist will review your medical history and ask about your symptoms and what causes them, how long you have been suffering with neck pain and whether physical or mental stress is involved. They will conduct a physical exam to test reflexes and muscle strength in the arms and shoulders, and test function and range of motion.

Based on your history, symptoms and results of the physical exam, imaging studies including x-rays, MRI or CT scans may be ordered to determine the cause for your chronic neck pain such as arthritis or degeneration.

Initial treatment is nonsurgical. It involves brief rest, pain and anti-inflammatory medication, heat, and cold therapy, stretching, strengthening, massage and chiropractic. Muscle relaxers, prescription pain medications, and steroid injections can help reduce pain and inflammation. Even cervical disc herniation can improve with conservative measures.

Surgery is only considered when a clear cause has been identified and conservative measures have not relieved pain. The goal of surgery is to decompress the spine and nerves, improve spinal stability and maintain or correct spinal alignment.