Neck Pain

Introduction

Neck pain is commonly known as “cervical spondylosis or spondylitis” among patients. But spondylitis may not be the cause for all neck pains. Let’s understand common causes and treatment available at Neuron Pain Clinic for neck pains.

Neck pain can manifest as pain only in the neck or can radiate all the way through the arm to forearm and even fingers.

Cervical spine consists of seven bones (vertebrae) and intervertebral disc between bones, muscles, ligaments, spinal cord with spinal nerves. Any abnormality of intervertebral disc, bones, muscle, joint or ligament can lead to pain.

Causes

  1. Aging- With aging, natural wear and tear of cervical spine leading to arthritis of small facet joints, or osteophyte and even nerve compression from slip disc can happen and is a common cause of chronic neck pain.
  2. Physical stress & strain- Overuse of neck muscles during repetitive strenuous and physical activities put stress over muscles, ligaments and spine disc.
  3. Poor posture- Another leading cause of early age neck pain in middle-aged people who use computer and mobile phones for long duration and work in odd sitting posture for prolonged duration. In recent medical literature, a new diagnosis has been coined which is known as “Text Neck Syndrome”where excessive mobile phone use in extremely neck bending position as the cause of neck pain.
  4. Injury- Trauma or injury to neck from accidents, whiplash injury can cause neck pain.
  5. Slipped disc- Disc bulge can compress the spinal cord or the nerves leading to its impingement and this manifests as neck pain as well pain radiation to the hand, in a manner similar to sciatica of lower limb.
  6. Spinal stenosis- In this condition which is commonly seen in old age, the spinal canal can get compressed from disc bulge, age-related wear and tear changes like osteophytes or even displacement of vertebrae.
  7. Myofascial pain- In lot of patients, the actual reason for neck pain is muscles which either are weak or they develop “taut bands” and the condition is also known as “myofascial pain” and in them all the imaging tests might be normal.
  8. Other conditions like cancer, meningitis, or even immunological diseases like rheumatoid arthritis, spondyloarthritis etc can cause neck pain.

Treatment

Most of the time neck pain resolves with exercise, physiotherapy, posture care and medications. However, in chronic and persistent neck pain, following are recommended treatment:

  1. Medication- This can range from anti-inflammatory to muscle relaxant, nerve pain medicines and topical creams. Your Pain Specialist can suggest the best medication suitable for you depending on your conditions.
  2. Physical Therapy goes a long way in stretching and strengthening the neck muscles. It is also important to learn proper ergonomics and posture care.
  • Spine intervention- On occasions, the radiculopathy pain or neck pain may need “spine injection therapy or interventions” which we perform under X-ray or ultrasound guidance in procedure rooms. These include “epidural injections or nerve root blocks” and facet joint injection or ablations and they help tremendously in vast majority of patients.
  1. Dextrose Prolotherapy- For myofascial pain, injection of dextrose helps in muscle deconditioning, healing and regeneration and is found to be very promising.
  2. Surgery- This is the last resort if conservative treatment does not help, mainly in spinal canal stenosis or big disc bulges.

Home remedies

  • Hot fomentation to the neck and paraspinal muscles
  • Topical anti-inflammatory gels for relieving spasm, and muscle inflammation
  • Posture care
  • Physical therapy and neck strengthening exercise
  • Simple analgesics for few days

Prevention

As discussed above, most chronic neck pains are because of poor posture and then age-related wear and tear like disc bulge or arthritis of spine joints.

Here are few tips when incorporated in your daily routine may help.

  • Use proper posture in office or at home.This is most important of all. We see patients in their 30’s with chronic neck pain and most are from desk job with prolonged sitting. Follow proper ergonomics which include standing and sitting in upright position where ones shoulders are in a straight line over your hips and your ears are directly over your shoulders and the computer screen is at eye level. When using cell phones, tablets and other small screens, keep your head up and hold the device straight out rather than bending your neck to look down at the device.
  • Use ergonomic chair by adjust your desk, chair and computerso that the monitor is at eye level. Knees should be slightly lower than hips. Use your chair’s armrests.
  • 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. Taking breaks every 40-50 minutes is recommended.
  • Quit smoking.Smoking has been shown to increase the risk of developing neck pain.
  • Avoid carrying heavy bags with straps over your shoulder.The weight can strain your neck.
  • Sleep in a healthy position.Many people feel that they should not use pillows for spinal pain. This is a wrong concept. 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 kept below your knee, which will relax your spinal muscles.
  • Stay active.Daily exercise by 30-45 minutes of walking or cycling helps lose some weight and remain active.

Consult our Pain Specialist at Neuron Pain Clinic if your symptoms do not resolve or persist for a long time, if pain radiates to hands or if there is associated headache, tingling, weakness or numbness of hands.