|
What
causes neck pain?
Neck pain may
result from abnormalities in the soft tissues - the muscles, ligaments,
and
nerves - as well as in bones and joints of the spine. The most
common causes of neck pain
are soft tissue abnormalities due to injury
or prolonged wear and tear. In rare cases, infection
or tumors may cause
neck pain. In some people, neck problems may be the source of pain
in
the upper back, shoulders, or arms.
Degenerative
and inflammatory diseases - Degenerative diseases that cause neck pain
include
osteoarthritis and rheumatoid arthritis. Osteoarthritis usually
occurs in older people as a result
of wear of the joints between the
bones in the neck. Rheumatoid arthritis can cause
destruction of the
joints of the neck. Both of these major types of arthritis can cause
stiffness and pain.
Cervical disk degeneration also can cause neck pain. The disk acts as a
shock absorber
between the bones in the neck. In cervical disk
degeneration (typically age 40 onwards),
the normal gelatin-like center
of the disk degenerates and the space between the vertebrae
narrows. As
the disk space narrows, added stress is applied to the joints of the
spine causing
further wear and degenerative disease. The cervical disk
may also protrude and cause
pressure on the spinal cord or nerve roots
when the rim of the disk weakens. This is known
as a herniated cervical
disk.
Injury - Because the neck is so flexible and because it supports the
head, it is extremely
vulnerable to injury. Motor vehicle or diving
accidents, contact sports, and falls may result
in neck injury. The
regular use of seat belts can help to prevent or minimize injury. A
"rear
end" automobile collision may result in hyperextension,
a backward motion of the neck
beyond normal limits, or hyperflexion, a
forward motion of the neck beyond normal limits.
Most common injuries
are to the soft tissues, i.e., muscles and ligaments. Severe injury with
fracture or dislocation of the neck may damage the spinal cord and cause
paralysis
(quadriplegia).
Much less
common causes of neck pain include tumors, infections, or congenital
abnormalities of the vertebrae.
When should you seek medical care?
If severe neck
pain occurs following an injury (motor vehicle accident, diving
accident, fall),
a trained professional, such as a paramedic, should
immobilize the patient to avoid the risk of
further injury and possible
paralysis. Medical care should be sought immediately. Immediate
medical
care should also be sought when an injury causes pain in the neck that
radiates down
the arms and legs. Radiating pain or numbness in your arms
or legs causing weakness in the
arms or legs without significant neck
pain should also be evaluated.
If there has not been an injury,
you should seek medical care when neck pain is:
-
continuous and
persistent
-
severe
-
accompanied by pain
that radiates down the arms or legs
-
accompanied by
headaches, numbness, tingling, or weakness
Diagnosing
neck pain
Patients who
require further evaluation may undergo one or more of the following
examinations:
-
MRI (magnetic
resonance imaging).
This
non X-ray study allows an evaluation of the spinal cord and nerve
roots.
-
CT (computed
tomography).
This
specialized X-ray study allows careful evaluation of the bone and spinal
canal.
-
Myelogram (injection
of a dye or contrast material into the spinal canal).
This
specific X-ray study also allows careful evaluation of the spinal canal
and nerve roots.
-
EMG (electromyogram).
This test
evaluates nerve and muscle function. Your orthopaedist may supplement
your evaluation with blood tests, and, if necessary, will consult with
other medical specialists.
Treatment
How neck pain
is treated depends on what the diagnosis reveals. However, most patients
are treated successfully with rest, medication, immobilization, physical
therapy, exercise,
activity modifications, nerve blocks, or a
combination of these methods.
For example, if pain is caused by inflammation as a result of stretching
muscles and ligaments
beyond their limits, Lynne Carr Columbus, D.O. may prescribe
rest and a neck collar for a
specified period of time, as well as
medication to reduce inflammation. If medication is
prescribed to reduce
pain, it should be used only as directed and should not be taken for
extended periods of time.
When neck pain
persists or is chronic, Lynne Carr Columbus, D.O. may recommend a
rehabilitation
program that includes an exercise program and various types of physical
therapy
to help you relieve your pain and prevent it from coming back. Cervoid Epidural steroid
injections may be very helpful in relieving
pain due to a herniated disc, spinal stenosis, or
degenerative disc
disease. Epidural steroid injections are helpful in conjunction with
physical
therapy. These injections decrease inflammation and pain, so
you can gain more benefit from
the physical therapy.
Very few
patients require surgery to relieve neck pain. For the vast majority of
patients, a
combination of rest, medication, physical therapy, and nerve
blocks will relieve neck pain.
Surgery may be necessary to reduce
pressure on the spinal cord or a nerve root when pain is
caused by a
herniated disk or bony narrowing of the spinal canal. Surgery may also
be
required following an injury, to stabilize the neck and minimize the
possibility of paralysis
such as when a fracture results in instability
of the neck.
|