OrthoNeuroSpine & Pain Institute
1. What would cause you to suffer neck pain?
The cause of neck pain can be divided into two main groups, those arising from joints, ligaments and muscles of the neck and those involving the cervical nerve roots or spinal cord.
Neck pain may be due to the following:
a) Injury or degeneration affecting muscles or ligaments, soft-tissue strain.
b) Inflammation - rheumatoid arthritis, ankylosing spondylitis.
c) Infection - discitis, epidural abscess, meningitis.
d) Infiltration by tumours.
What risk factors can contribute to the onset of acute neck pain?
a) Occupation and stress at work.
b) The psychosocial nature of the work environment.
c) Involvement in a motor vehicle accident is not a risk factor for developing neck pain, but those who develop neck pain soon after such an accident are at greater risk of developing chronic neck pain.
2. How do you diagnose the cause of neck pain?
Finding the cause of neck pain begins with a detailed history, physical examination and the use of several diagnostic tests. These tests are used to find out the cause of your pain and not to make your pain better. X-rays of the neck are usually a first step and will help determine if more tests are needed. The MRI is commonly used to evaluate the spine because it can show abnormal areas of the soft tissues around the spine. It is done to find tumors, herniated discs, or other soft-tissue disorders.
The CT scan is most useful when a condition that only affects the bones of the spine is suspected. A bone scan is used to help locate the affected area of the spine. Blood tests are done to look for infection or arthritis. Problems originating in areas other than the spine may also cause neck pain. These include cardiac pain, complex regional pain syndrome, entrapment syndromes, herpes zoster, spinal tumors, rotator cuff pathology and thoracic outlet syndrome
3 When should you seek treatment?
a) Continuous and persistent pain.
b) Severe intractable or increasing pain.
c) Radiating pain down the arms.
d) Pain accompanied by headaches, numbness, tingling, or weakness.
e) New symptoms before the age of 20 years or after 55 years.
f) Weakness involving more than one myotome or loss of sensation involving more than one dermatome.
4. What are the treatments for neck pain?
Multimodal treatments (inclusive of cervical passive mobilization /manipulation in combination with either exercise alone or exercise with thermal modalities and education) are more effective than single modality approaches.
a) Control swelling and pain
In an acute injury, lie down on your back with a thin pillow or lie down on your side with a thicker pillow to support the neck. This will relieve the pressure and relax any tight muscles. Ice will help decrease swelling and muscle spasms.
b) Encourage pain-free movement
After an injury, your neck will become stiff. Gentle movements starting as soon as possible will help to regain full range of motion, reduce pain from swelling and muscle spasms, and prevent your muscles from becoming weak.
c) Relaxation and stretching
Stretching exercises can help to relax the neck muscles and restore range of motion.
d) Strengthening and stabilizing
To regain/maintain good posture, your neck needs the support of neck, shoulder, and trunk musculature.
e) Postural care
Maintain proper postural alignment throughout the day in order to decrease any strain created on your neck.
f) Diagnostic and therapeutic injections of local anesthetics and steroids.
g) Surgery to remove pain generator and correct any pathological condition.
5 How do you take care of your neck?
a) Maintain good posture by holding your head up and keeping your shoulders back and down.
b) Use the car or chair arm rests to keep the arms supported.
c) Avoid sitting in the same position for prolonged periods of time. Take periodic five minute breaks from the desk.
d) Avoid looking up or down at a computer monitor; adjust it to eye level.
e) Avoid placing pressure over the upper back with backpacks, over-the-shoulder purses, or children riding on your shoulders.
f) Do not perform overhead work for prolonged periods at a time.
g) Sleep with your neck in a neutral position by sleeping with a small pillow under the nape of your neck (sleeping on your back) or sleeping with enough pillows to keep your neck straight in line with your body (sleeping on your side).
h) Carry heavy objects close to your body rather than with outstretched arms.
i) Relax yourself as stress, tension and worry can tighten muscles and cause more pain.
j) Stay at work or return to work as soon as possible even if the pain hasn’t completely gone.
k) Expect the neck pain to get better by staying positive!