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Neck pain is also known as cervicalgia, and it is pain localised around the neck region. Even though the pain is felt at the neck, it can be caused by several conditions in other parts of the body, including spinal problems. Neck pain can be caused by tightness of the muscles around the neck and upper back. Some muscles, like the trapezium, extend from the back and shoulder to the upper neck, and tension in it’s fibers can lead to neck pain.
It may also arise due to nerve related uses. In this case, the nerves involved arise from the cervical part of the spinal cord and pass through the foramina in the cervical vertebrae (the bones of the spine). When neck pain is caused by these nerves, there is usually a pinched nerve, either due to the compartmental syndrome, muscle tightness, spinal arthritis, or a series of other conditions.
The neck is mainly composed of muscles. These muscles are attached to the bones of the back, the scapula (shoulder bone), the clavicle (collar bone), as well as the skull. Besides, muscles, there are also blood vessels that travel through the neck. They are protected by the muscles, and transport blood to and from the structures in the head, including the brain. Pain affecting the muscles in the neck is usually very uncomfortable for several reasons. Besides the obvious discomfort associated with muscular pain, there is also the inconvenience associated with not being able to move the neck.
Even though neck pain is localised to the neck, there is a multitude of types, and these types indicate the causes. Neck pain can be classified based on the source of the pain.
This is usually a result of stress or strain on the muscles of the neck. The origin can range from using a bad pillow or sleeping in a poor posture. In this case, the individual usually wakes up feeling severe pain in the neck, and the pain is aggravated when they move in a certain direction. The pain may also originate from the muscles of the shoulder. Another factor that leads to neck pain of muscular origin is stress (like lifting a backpack that’s heavier than what you’re used to).
Muscular neck pain usually resolves on its own over time, but analgesics and rest can speed up the recovery.
Pain arising from the bones refers to disease conditions that affect the cervical vertebrae. These include several spinal conditions like arthritis, spondylolisthesis, and fractures. The pain could originate specifically from the bones, or the compression of the nerves. For example, in arthritis, the bones impinge on the nerves, and that causes pain.
Nerves are the communication system of the body, and they are responsible for carrying sensory and motor signals to the brain for interpretation and action. Any damage or injury to these communicating structures will lead to pain. The causes of neck pain of nerve origin are numerous, and they can include conditions that affect the nerves themselves like multiple sclerosis and Guillain-Barre syndrome. The neck pain could also be due to indirect causes like nerve compression. Examples include the conditions mentioned under “pain arising from the bones”. Other conditions that can cause nerve compression include disc hernias and spinal stenosis.
If the neck pain is due to compression, relieving the compression usually relieves the pain. In situations where the compression cannot be relieved, or where the damage is irreversible, the focus is always on managing the resulting pain.
This refers to conditions like migraines. Migraines are headache disorders that often reflect on just one side of the head. In some migraines, the pain spreads from the head to the neck, and that can be interpreted as neck pain. However, in neck pain that’s secondary to migraines, the neck pain isn’t the most severe symptom—it’s usually the headaches. As a result, treating the migraines usually relieves the neck pain.
Pain arising from other parts of the body is known as referred pain. This is often caused by injury to some deep organs like the heart and lungs. The pain is usually reflected in other areas of the body like the shoulders as well. Referred pain is difficult to diagnose because examination of the area doesn’t provide any useful information. In this form of neck pain, treatment of the underlying cause also resolves the pain.
Besides the factors listed above, other causes of neck pain include:
Neck pain is very prevalent among all populations and across all ethnic groups. Even in situations where there are no underlying conditions, neck pain can still be caused by factors like bad posture, stress and overuse. As a result, everyone experiences neck pain at some point in their lives.
As of 2010, neck pain was estimated to affect about 330 million people all over the world. That’s about 5 out of every 100 people. It is also more common in women than in men, as it is said to affect about 6 out of every 100 women, and only four out of every 100 men. However, neck pain is still not as prevalent as low back pain, which affects around 4 in every ten people.
Anyone who has any of the conditions listed above has a chance of developing neck pain. Because it is mostly muscular (or localised) and not systemic (widespread), no genetic factors are involved in determines who is at risk of developing neck pain. Some other of the risk factors besides the ones listed above are:
The major symptom of neck pain is pain localised in the neck region. The pain may also spread to the surrounding areas like the base of the skull and the shoulders. The symptoms are usually worsened by activity like turning and stretching the neck and are relieved by rest. Depending on the cause of neck pain, it may also have accompanying symptoms like
Neck pain is diagnosed symptomatically, meaning that the feelings of pain around the neck region are enough to identify the condition. History is usually taken to identify the cause of pain and determine the most suitable treatment available.
If more severe conditions are suspected to be the cause, other tests may be conducted to investigate further. These tests include MRIs, X-rays and blood tests.
As mentioned earlier, in most cases, neck pain is caused by postural and muscular factors, and as a result, it is resolved quite easily. About 50% of neck pain episodes are said to be resolved within one year, and only one in ten cases become chronic.
The treatment of neck pain involves the use of analgesics to reduce the pain and ease the discomfort. Physiotherapy in the treatment of neck pain involves several stretching exercises to relieve the tension in the area. A neck brace may also be recommended to temporarily limit movement around the neck, giving it time to rest and heal.
Other forms of treatment like surgery may be recommended if the underlying cause cannot be addressed by other means.
Deen, Hanifa; Bartleson, J. D. (2009). Spine disorders medical and surgical management. Cambridge, UK: Cambridge University Press. p. 3. ISBN 978-0-521-88941-4.
Amal Mattu; Deepi Goyal; Barrett, Jeffrey W.; Joshua Broder; DeAngelis, Michael; Peter Deblieux; Gus M. Garmel; Richard Harrigan; David Karras; Anita L’Italien; David Manthey (2007). Emergency medicine: avoiding the pitfalls and improving the outcomes. Malden, Mass: Blackwell Pub./BMJ Books. p. 46. ISBN 978-1-4051-4166-6.
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