Neck pain is a fairly common complaint with many possible causes.
What is going on in the body?
Many people have had mild neck pain from time to time that goes away in a day or two. In some cases, however, neck pain can persist or be more severe. The causes of neck pain range from mild to life threatening.
What are the causes and risks of the condition?
Neck pain has many possible causes, including : -
arthritis, or bony inflammation in the part of the spine located in the neck, usually due to osteoarthritis. Rheumatoid arthritis can also cause neck pain.
bone infections, known as osteomyelitis.
Paget's disease, which causes bone deformities.
a bulging or ruptured disk in the spine located in the neck, sometimes called cervical disk disease.
muscle strain, such as occurs during whiplash or from lifting heavy objects.
a broken or dislocated bone in the neck, such as in the spine.
a pinched nerve in the neck, which may occur after sleeping in the wrong position or with overuse or misuse of the neck muscles.
cancer or a tumor, such as from cancer in the thyroid gland, breast cancer, or lung cancer that spreads into the neck.
referred pain, which is pain that comes from another part of the body. For instance, neck pain can occur with a heart attack or heartburn, also called gastroesophageal reflux disease.
infections in the neck, such as a group A streptococcal infection of the throat. Ear infections, such as acute otitis media, and a viral infection of the thyroid gland, called subacute thyroiditis, are other causes.
psychological causes, such as anxiety, depression, or psychosis.
Other causes are also possible. Sometimes no cause can be found.
Symptoms & Signs of Cervical Pain
What are the signs and symptoms of the condition?
When someone complains of neck pain, the healthcare provider will need more information.
Questions may be asked related to : -
when the pain started.
the exact location of the pain, such as whether it is on one or both sides of the neck, or whether the pain goes anywhere else outside the neck.
whether there has been any injury or trauma to the neck area.
whether there is any family history of neck pain.
whether the neck pain is constant or comes and goes.
what medications, herbs, or illegal drugs a person takes, if any.
what other medical conditions a person has, if any.
if anything makes the neck pain worse or better, such as turning the head to one side or aspirin.
any other symptoms, such as arthritis, fever, weight loss, or weakness in the arms.
Diagnosis & Tests of Cervical Pain
How is the condition diagnosed?
The first step in figuring out the cause is a history and physical exam. This may be all that is needed to make the diagnosis. In other cases, further tests may be needed.
Different tests may be ordered, depending upon the suspected cause of the neck pain. For instance, blood tests can be used to help diagnose some infections in the thyroid gland. Neck x-rays are commonly used, and can detect arthritis in the neck or broken and dislocated bones in the neck. Special x-ray tests, such as a CT scan, may be needed in certain cases. For instance, a CT scan can help detect bulging disks or tumors in the neck.
Prevention & Expectations
What can be done to prevent the condition?
Prevention is related to the cause. For instance, avoiding overuse or injury of the neck muscles can prevent these causes of neck pain. Many cases cannot be prevented.
What are the long-term effects of the condition?
Any pain, when severe, can disrupt a person's life. Sleep, work, and other activities may be difficult. Other long-term effects are related to the cause. For instance, cancer can result in death. A bulging disk or severe arthritis may cause muscle weakness, numbness, or even paralysis in the arms or hands. A broken or dislocated bone in the spine of the neck may cause permanent paralysis and numbness of the body below the head.
Treatment
Most cases of neck pain originate from strain and can be treated non-surgically. Helping the patient through the acute phase addresses breaking the pain cycle. This involves relieving neck pressure and muscle spasm.
Cervical collars limit movement and support the head taking the load off the neck. Lying down has a similar affect. Limiting neck movement and reducing pressure (weight) gives muscles needed rest while healing.
Cervical traction may be prescribed for home use. This form of traction gently pulls the head, stretching neck muscles while increasing the size of the neural passageways (foramen).
Depending on the cause of the neck pain, non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and/or short-term use of narcotics may be prescribed. In some cases trigger point injections are beneficial.
Often Physical Therapy (PT) is incorporated into the treatment plan. Passive forms of PT such as heat/cold, ultrasound, and massage may help alleviate pain and stiffness. Therapeutic exercise can help build strength and increase range of motion. Therapists also educate the patient about their condition and teach posture correction and relaxation techniques.
Surgery
Seldom does neck pain require surgical intervention. Indications for surgery include, but are not limited to spinal cord dysfunction, excruciating pain unrelieved by conservative measures, and prolonged pain and/or weakness.
For example, a vertebral fracture or herniated disc may cause spinal cord compression resulting in serious neurologic deficit. Spinal stenosis, a narrowing of the foramen or neural passageways, may entrap nerve roots that may cause unrelenting pain.
The type of surgical procedure is dependent on the patient's needs. The surgeon considers the patient's medical history, age, general physical condition, occupation, and other factors. Cervical spinal surgery is delicate and requires a skilled surgeon.
Recovery
Following doctor's/physical therapist's orders along with time are often all that is needed to overcome neck pain. Whether neck pain is treated with or without surgery, eating properly, regular exercise, and weight maintenance help healing and benefit spinal health.
For patients who undergo a surgical procedure the road to recovery may be a bit longer. However, that is not reason to become discouraged. It is normal to feel tired and emotionally down following surgery. During stress such as surgery, the body cranks out extra hormones - after surgery the level drops, which may result in a 'down' period.
Prevention can be a key to avoiding neck pain in the future. Remember the neck - although very mobile, it has limitations. Avoid activities that cause the neck to hyperflex or hyperextend, maintain good posture, and take frequent stretch breaks from desk/computer work. Incorporate neck safety into your activities of work and play.
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