What Causes Neck Pain?
Neck pain is a common complaint, affecting two thirds of people at some point in their lives1, and up to 15% of the population at any one time. Studies suggest that, much like low back pain, patients with neck pain are likely to experience improvement and flareups2.
Neck or cervical pain can take many forms, ranging from a dull ache to severe pain producing radiation of pain or numbness into the arms or fingers. Neck conditions can also produce headache, depending on the structures of the neck involved.
Neck pain has many causes, including:
- Disc Herniation
- Disc Decompression
- Degenerative Disc Disease
- Cervical Spine Kyphosis (Upper Crossed Syndrome)
*Côté P, Cassidy D, Carroll L. The Saskatchewan health and back pain survey: the prevalence of neck pain and related disability in Saskatchewan adults. Spine 1998;23:1689–1698.
*Côté P, Cassidy D, Carroll L, Kristman V. The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain 2004: 112:267-273.
More properly known as acceleration/deceleration injury, hyperextension injury or even sprain/strain, whiplash results from a force applied to the neck which exceeds the normal range of motion, causing injury to the muscles, ligaments and joints, or even the disc structures or nerves of the neck. Whiplash can result from numerous causes, including sports injuries, but is most commonly associated with automobile accidents. Whiplash from auto accidents often occurs because when a car is struck from behind, the body is thrown forward in the seat as the car moves forward. However, the occupant’s head moves a fraction of a second more slowly than the body, causing the head to extend, hyperextending the neck. Patients can sustain injury to their neck even when there is little or no damage to the vehicles involved.
Symptoms can range from mild discomfort to excruciating pain, and the onset of symptoms can be delayed. Symptoms can include:
- Neck pain, aching or stiffness
- Pain between the shoulder blades or in the shoulder
- Mid and Low back pain
- Pain or numbness in the arm and/or hand
- Ringing in the ears or blurred vision
- Difficulty concentrating or remembering
- Irritability, fatigue, sleep difficulties
- Anxiety, sensitivity to noise
- Jaw pain (TMJ)
Proper treatment begins with a careful examination, and may include imaging studies such as xray or MRI. Treatment can include a variety of modalities, including braces, physiotherapy such as electrical stimulation or low level laser, manipulation, stretching, ice or heat packs, nutritional supports and other approaches. As symptoms improve, your doctor may progress you through a rehabilitation program. Other forms of treatment can include massage, acupuncture, medication.
Discs separate the bones (vertebrae) of the spine and provide a cushioning effect. The disc is comprised of a soft inner center (the nucleus pulposus) , surrounded by a tough outer shell of fibrous tissue (the annulus), much like a jelly donut. Many factors can contribute to a sudden or gradual breakdown of the disc, resulting in bulging or even herniation of the disc. Disc herniation can produce both localized and referred pain, and can affect the nerves of the arms or legs. Symptoms can include numbness in the extremity and even weakness if the disc is irritating the nerve.
DISC DEPRESSION (NECK)
Lumbar (and cervical) Decompression Therapy (LDT) is one of the fastest growing and effective therapies available today for the non-surgical treatment of herniated/bulging discs, arthritis, and non-responsive mechanical low back pain.
DEGENERATIVE DISC DISEASE
Degeneration of the cervical (neck) vertebrae is less common than degeneration of the low back discs, since the neck is subject to less load and torque. The degeneration refers to the gradual breakdown of the disc due to alterations in nutrient supply to the disc. Since discs do not have a blood supply of their own, they rely on normal movement of the spine to diffuse fluids and nutrients, sort of like a sponge. As the disc deteriorates over time, the structures can become inflamed and irritated, causing pain, numbness, and even weakness. Degenerative disc disease usually results from trauma or prolonged stress on the spinal structures.
Evaluation by your chiropractic physician will include a review of your symptoms, range of motion testing and various physical examination tests. Xrays are used to confirm the diagnosis, and additional imaging studies , such a MRI may be warranted.
CERVICAL SPINE KYPHOSIS
The normal neck has a “C” shaped curve, allowing the weight of the head to be distributed over the joints of the neck. When the head is held in a forward posture, the load on the neck joints and muscles changes, and can lead to neck pain, headaches and other problems. Common causes include poor ergonomics, poor posture habits, and too much reading, computer use, cell phone texting and more.
The upper crossed syndrome produces:
- Forward translation of the head
- Overuse of the trapezius (upper shoulder) and suboccipital (below the skull) muscles
- Rounding of the shoulders
- Shortening of the chest muscles
- Weakness of the upper back muscles
These postural changes result in chronic neck pain and headaches. Correcting cervical spine kyphosis involves a number of approaches, include postural exercises, manipulation to restore joint function and therapy to reduce pain and muscle spasm, among other approaches.