Neck Pain

Muscle strain is the most common and can occur due to poor posture or improper positioning while working, using the computer, reading, watching TV, or even sleeping.

Many adults are affected by neck pain at some time in their lives, and it can involve just the neck and shoulders, or radiate down an arm.

The pain can be dull or feel like an electric shock into your arm. It can range in intensity from a dull, constant ache to a sudden, sharp sensation that leaves the person incapacitated. Pain can begin abruptly due to an accident, or it can develop over time due to age-related changes in the spine or repetitious behaviors.

Certain other signs and symptoms, such as numbness or muscle weakness in an arm, can help pinpoint the cause of your pain.

ABOUT THE SPINE:

The first step to understanding neck and back pain is understanding how the spine and muscles relate. First, there are three distinct regions of the spine:

• Cervical or neck
• Thoracic or mid-level
• Lumbar or lower back

The lumbar and cervical regions are most susceptible to injury and pain because of their weight-bearing function and involvement in moving, twisting and bending. The thoracic spine (mid-back) region is much more rigid than the other two areas.

The neck or cervical region is part of the spinal column or backbone, which extends through most of the body. The cervical spine (neck region) consists of seven bones (C1-C7 vertebrae), which are separated from one another by intervertebral discs which act as a shock absorber and allow the spine to move freely.

Attached to the back of each vertebral body is the spinal canal, an area through which the spinal cord and nerve bundles pass. The spinal cord is bathed in spinal fluid and surrounded by three protective layers, which are further supported by strong muscles and ligaments that are attached to the vertebrae.

Signs and symptoms include:

• Pain that's often worsened by holding your head in one place for long periods, such as when driving or working at a computer
• Muscle tightness and spasms
• Decreased ability to move your head, lack of complete motion
• Headache

Usually, episodes of neck pain cause stiffness or soreness and may resolve on their own after a couple of days or weeks.

To help relieve discomfort, try these self-care tips:

• Ice or heat: Apply an ice pack or bag of frozen peas to your neck for 15 minutes three or more times a day. Taking a hot shower or bath can also help relax strained muscles.
• Stretching: Stretch your neck muscles by turning your neck gently from side-to-side and up and down.
• Massage: Rubbing the sore places in your neck can help relieve muscle spasms.
• Good posture: Practice good posture, especially if you sit at a computer all day. Keep your back supported, and make sure that your computer monitor is at eye level.

However, the following symptoms are potential “red flags” that might lead a patient to see one of the neurologists at Semmes Murphey Clinic:

• Pain accompanied by numbness, tingling or weakness in the hand or arm
• Pain that gets worse during the night
• Pain accompanied by difficulty breathing or swallowing
• Pain and loss of control over bladder or bowel function
• Pain caused by a fall, injury, or other trauma
• Pain persists or worsens after days or weeks of self-care

Seek immediate care if severe neck pain results from an injury, such as a motor vehicle accident, diving accident or fall, or if it is accompanied by a high fever.

Your neck is flexible and supports the weight of your head, so it can be vulnerable to injuries and conditions that cause pain and restrict motion.

The vast majority of cervical (neck) pain is mechanical in nature or due to the general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older.

Causes of neck pain include:

• Muscle strains: Overuse, such as too many hours hunched over your computer or smartphone, often triggers muscle strains. Even minor things, such as reading in bed or gritting your teeth, can strain neck muscles.
• Worn joints: Just like the other joints in your body, your neck joints tend to wear down with age. Osteoarthritis causes the cushions (cartilage) between your bones (vertebrae) to deteriorate. Your body then forms bone spurs that affect joint motion and cause pain.
• Nerve compression: Herniated disks or bone spurs in the vertebrae of your neck can press on the nerves branching out from the spinal cord.
• Injuries: Rear-end auto collisions often result in a whiplash injury, which occurs when the head is jerked backward and then forward, straining the soft tissues of the neck.
• Diseases: Certain diseases, such as rheumatoid arthritis, meningitis or cancer, can cause neck pain.
• Poor posture or positioning: Many things we do every day could slowly be damaging neck alignment, such as carrying a heavy backpack or purse on one shoulder or slumping over a computer.

Because many instances of neck pain are associated with poor posture combined with age-related wear and tear, there are many helpful things that can be done to hopefully prevent or alleviate future neck pain issues:

• Use good posture: When standing and sitting, be sure your shoulders are in a straight line over your hips and your ears are directly over your shoulders.
• Take frequent breaks: If you travel long distances or work long hours at your computer, get up, move around and stretch your neck and shoulders.
• Adjust your desk, chair, and computer so that the monitor is at eye level: Knees should be slightly lower than hips. Use your chair's armrests.
• Avoid tucking the phone between your ear and shoulder when you talk:. Use a headset or speakerphone instead.
• Smoking can put you at a higher risk of developing neck pain.
• Avoid carrying heavy bags with straps over your shoulder: The weight can strain your neck.
• Sleep in a good position: Your head and neck should be aligned with your body. Use a small pillow under your neck. Try sleeping on your back with your thighs elevated on pillows, which will flatten your spinal muscles.
• Warm-up properly: Whether you’re beginning your day, about to run a 5K, or join your friends for softball, it’s important to stretch your muscles and warm them up. You’ll often notice that the first thing a dog or cat does when they wake up is a long, full stretch. We all should do the same. If possible, include arm and shoulder rolls, rotating the neck, stretching up, and stretching down and to the sides.
• Lose weight: The extra strain on your back from extra pounds all over your body, but especially in the stomach, can cause neck and back pain.

Your Semmes Murphey team can assist or guide you in selecting some key exercises or health goals to match your needs.

The physicians and pain management team at Semmes Murphey Clinic are dedicated to finding solutions for patients with neck pain. Because of the many and varied causes, the Semmes Murphey team conducts complete diagnostic testing and interviews to narrow the causes and devise a successful treatment plan.

Diagnosis is made by a physician based on history, symptom review, a physical examination and, if necessary, the results of diagnostic tests.

• During the exam, he or she will ask about the onset, location, and severity of the pain, duration of symptoms and any limitations in movement, as well as any previous episodes or health conditions that might be related to the pain.
• Some patients may be treated conservatively and then undergo imaging studies if medication and physical therapy are ineffective. These tests may include:
• Computed Tomography Scan (CT or CAT scan)
• Discography
• Electromyography (EMG)
• Nerve Conduction Studies (NCS)
• Magnetic Resonance Imaging (MRI)
• Myelogram
• Selective Nerve Root Block
• X-rays

If neck or cervical pain occurs after a recent injury — such as a car accident, a fall or sports injury — see a physician immediately.

Determining a treatment strategy depends mainly on a complete diagnostic review and identifying the location and cause of the irritated nerve root. Although neck pain can be quite debilitating and painful, nonsurgical management can alleviate many symptoms.

The most common types of mild to moderate neck pain usually responds well to self-care within two or three weeks. If neck pain persists, your doctor might recommend other treatments.

The doctor may prescribe medications to reduce the pain or inflammation and muscle relaxants to allow time for healing to occur. Trigger point injection, including corticosteroids, often can temporarily relieve pain. Occasionally, epidural steroids may be recommended.

There are different types of therapy that may be used, either alone or in conjunction with other options, to help relieve neck pain.

• Physical therapy: A physical therapist can teach you correct posture, alignment, and neck-strengthening exercises, and can use heat, ice, electrical stimulation and other measures to help ease your pain and prevent a recurrence. During regular appointments, physical therapists can also guide patients through specific movements or exercises to help them get stronger and rehabilitate issues that are causing their neck pain.
• Transcutaneous electrical nerve stimulation (TENS): Electrodes placed on your skin near the painful areas deliver tiny electrical impulses that may relieve pain.
• Traction: Traction uses weights, pulleys or an air bladder to gently stretch your neck. This therapy, under the supervision of a medical professional and physical therapist, may provide relief of some neck pain, especially pain related to nerve root irritation.
• Short-term immobilization: A soft collar that supports your neck may help relieve pain by taking pressure off the structures in your neck. However, if used for more than three hours at a time or for more than one to two weeks, a collar might do more harm than good.

SURGICAL OPTIONS:

The benefits of surgery should always be weighed carefully against its risks. Although a large percentage of neck pain patients report significant pain relief after surgery, there is no guarantee that surgery will help every individual.

In general, surgery is recommended only if there is evidence of worsening nerve damage and when diagnostic tests indicate structural changes for which corrective surgical procedures have been developed.

Many of today’s modern surgical techniques were invented by physicians at Semmes Murphey Clinic. They were researched, implemented and perfected at SMC and are now taught in U.S. medical schools and around the world. They have revolutionized spine surgery and treatments and brought relief to thousands of patients. SMC patients can rest assured that they are being treated by nationally and internationally recognized leaders in this field.

There are a variety of surgical options to help people suffering from back pain “get their normal back.” These specialized procedures are designed to:

• Repair compression fractures of the vertebrae caused by osteoporosis,
• Remove a disc in cases where it has herniated and presses on a nerve root or the spinal cord and relieve pressure and pain,
• Repair discs that are cracked or bulging as a result of degenerative disc disease,
• Block or interrupt nerve conduction (including the conduction of pain signals), and
• Replace damaged discs with an artificial disc that helps restore height and movement between the vertebrae.

This information was provided by the specialists at Semmes Murphey Clinic. Readers are encouraged to research trustworthy organizations for information. Please talk with your physician for websites and sources that will enhance your knowledge and understanding of this issue and its treatments.