Neck pain, for the most part, isn’t a major problem and can be resolved in a matter of days. On the other hand, it can sometimes signify a serious injury or sickness that necessitates medical attention.
What Causes Neck Pain?
Because the neck is flexible and bears the head’s weight, it is susceptible to injuries and disorders that cause pain and limit movement. The following are some of the reasons for neck pain:
- Muscle strain: Muscle strains are frequently caused due to lying in an awkward position for a long period. Neck muscles can be strained by even simple activities such as reading in bed or grinding the teeth.
- Disc degenerative disease: Like the rest of the body’s joints, the neck joints deteriorate with age. The cushions (cartilage) between the bones (vertebrae) degrade due to osteoarthritis.
- Nerve compression: The nerves in the neck might be compressed by herniated discs or bone spurs in the vertebrae.
- Injuries: Injuries due to jerking the head can put a strain on the neck’s soft tissues.
- Diseases: Neck pain can be caused by rheumatoid arthritis, meningitis, or cancer.
What are the Types of neck pain
There are 3 types of neck pain
- Neuropathic neck Pain –
Arising from the nerves or nerve roots in the cervical spine, neuropathic neck pain could result from conditions such as a herniated disc that compresses a nearby nerve or nerve root .
- Mechanical neck pain –
The spine and its supporting structures (e.g., muscles, ligaments, bones, or cartilage) are the cause of pain . Typically, mechanical pain is caused by poor posture, neck strain caused by work or sporting/physical activities, and even stress.
- Central neuropathic pain –
Most commonly it occurs as a result of a stroke, spinal cord injury, or multiple sclerosis. It may also be a result of injury to the central nervous system, caused by traumatic injury to the brain/spinal cord or infection (e.g., abscess, encephalitis, myelitis) or tumour.
What are the Symptoms of Neck Pain?
The following are some of the symptoms:
- Muscle spasms and stiffness in the back of the head or a “muscle knot” in the neck. This may spread to your shoulders, upper back and arms.
- Limited capacity to move the head
- Moving, twisting, or extending the cervical spine from side to side or up and down might aggravate neck pain.
- Headache , specially complained in the occipital region (back of the scalp) is very common but can also extend up to the top of the head, causing “tension” headaches from muscle tightness.
If the neck pain is caused by nerve compression, it may result in the following symptoms:
- Weakness in the shoulder, arm or hand – one or both the sides
- A feeling of numbness or “pins and needles” in arm, fingers or hand
- Sharp, burning type of pain near the pinched nerve that radiates downwards
Some conditions, like coronary artery disease (angina) or even lung tumors may mimic these conditions.
How is Neck Pain Diagnosed?
The doctor may conduct imaging studies to gain a better clarity of the neck pain.
- X-rays: X-rays can indicate places in the neck where bone spurs or other degenerative changes may be compressing the nerves or spinal cord. X-ray will not provide details about soft tissue like muscles, ligaments or intervertebral discs.
- CT scan
- MRI: MRI creates detailed images of bones , discs and other soft tissues using radio waves and a strong magnetic field.
- Electromyography (EMG) & Nerve Conduction Studies (NCS) are adviced when a particular muscle or nerve is thought to be the culprit of pain.
The most important aspect of treatment is to try to identify the underlying pain generator , as this will guide the treatment.
What is the Treatment for Neck Pain?
If you are having neck pain (2+ weeks), it is important to seek medical attention for further evaluation and treatment. Treatments for neck pain vary, depending on the cause and duration of the neck pain you are experiencing. Many neck pain patients find relief in using one or a combination of these therapies. The most common treatments include
Over-the-counter pain killers can be prescribed during mild to moderate neck pain.
Nonsurgical Interventional pain management procedures
Interventional treatments for neck pain management can be a faster and more effective source of pain relief. These procedures are beneficial when conservative medical care and drugs have failed to relieve severe pain.
Depending on the cause of neck pain, injections such as trigger point injections, epidural steroid injections, and radiofrequency ablations can be performed
- Cervical Epidural Steroid Injection – This procedure is regarded as a highly efficient neck pain treatment. The doctor will insert a small needle into the epidural area and administer a small dose of medicine to relieve the pain under fluoroscopic guidance (real-time x-ray).
- Transforaminal Epidural Steroid Injection — This method is identical to the one described above, but the drug is directed directly onto the nerve fibres that make up the sciatic nerve, resulting in more medication being injected.
- Spinal cord stimulations– When the inflammation in and around the afflicted nerves is too severe for an epidural injection, spinal cord stimulation (SCS) is an excellent and successful therapy option for pain relief without surgery. An electrical pulse is given directly to the spine in SCS, restricting the passage of certain neuron fibres to the brain and, as a result, the brain’s ability to experience the previously perceived pain.
- Radiofrequency Ablation (RFA) – Radio waves are sent through a nerve, stunning it and preventing it from transmitting pain.
Surgery is rarely required for neck pain; however, it may be necessary to relieve nerve root compression if there are any of the following red flags ( warning signs)
- Back pain after injury, such as a fall, road traffic accident
- Sudden worsening or disabling back pain
- progressive neurologic deficits like limb weakness, numbness or both
- Back pain accompanied by fever
- loss of normal bowel and bladder functions
- pain not relieved with the conservative treatments
- back pain associated with unexplained weight loss