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Overview:

Neck Pain

Each year, over 30% of adults in the United States experience some type of neck pain.

It is usually due to poor posture, sudden jerky movements, the strain caused by exercise, an increase in activity or sport, an injury, or even using the wrong pillow. In most cases, the pain experienced in the neck region can abate with no treatment at all, or with some self-care remedies such as a light massage, neck exercises, or over-the-counter pain relief medication.

Sometimes, though, the pain may persist, and no amount of self-care remedies or over-the-counter pain relievers will help relieve it.

What are the causes of neck pain?

The neck holds up and supports the weight of the head, provides its movement and protects the nerves that act as the vessels of sensory and motor information from the brain to all parts of the body for them to function properly. The neck also has the important task of housing the arteries that supply blood from the heart to the brain for the latter to function normally. The neck includes vertebrae that start from the skull and extend all the way down to the upper part of the torso and contains crucial structures such as the jugular veins, larynx, and vocal cords.

There are various causes of neck pain that manifest as pain, soreness, or stiffness. They include:

  • Muscle strain and tension – This could be caused by poor posture, sitting with the shoulders hunched for prolonged periods of time, lifting heavy objects, bad posture during exercise, etc.
  • Injury – Any minor injury such as a fall or a strain where the ligaments and muscles in the neck move unnaturally, or out of their natural range of motion, can cause neck pain. Pain caused by sudden and jerky movements of the neck (a fall, contact sports or car wreck) can also have a whiplash effect.

In some cases, neck pain can be more chronic in nature and occur due to reasons such as:

  • Osteoporosis
  • Rheumatoid Arthritis
  • Spondylosis
  • Fibromyalgia
  • Herniated Cervical Disc
  • Spinal Stenosis
What are the symptoms of neck pain?

Though predominantly characterized by stiffness, soreness, tenderness, inability to move the neck normally, or radiating pain in other regions, some other symptoms accompany these sensations. They include:

  • Headaches
  • Pain along with weakness in the arms caused by nerve compression or muscle fatigue
  • Feeling of fatigue
  • Loss of neck mobility
  • Paraesthesias, a numbness or tingling sensation in the arms
  • Sharp, burning pain

Depending on the region of the pain and the reasons causing it, neck pain can be experienced in different ways:

  • Central neuropathic pain is experienced because of a spinal cord injury, a stroke, or multiple sclerosis.
  • Central neuropathic pain is experienced because of a spinal cord injury, a stroke, or multiple sclerosis.
  • Mechanical neck pain is caused by stress, poor posture, and exercises/activities.
How do I know if I have chronic or acute neck pain?

You may experience neck pain as sharp shooting pain in one specific spot or as a pain that radiates to other regions. In such cases, you may also experience headaches, back pain, pain in the shoulder, etc., and in rare cases, pain in the arms and hands. Sometimes, the pain can be just mildly irritating and abate just as quickly as it started. At other times, it can affect your daily activities by reducing your range of movement.

Acute
Subacute
Chronic Pain

The duration of the pain, versus the type of pain, will help you diagnose whether you have acute or chronic pain.

  • Acute pain lasts for less than 4 weeks.
  • Any pain that lasts from 4 to 12 weeks is considered subacute
  • A pain that lasts beyond 12 weeks is classified as chronic
What are the risks associated with neck pain?

Often, neck pain is just a simple condition, with the pain abating on its own or with minimum intervention. Sometimes, it can develop into a chronic or acute condition requiring medical attention. There are some conditions where the neck pain can be a sign or a warning signal of something far more damaging. These include, among others:

Cancer

Congenital abnormalities

Fracture

Nerve Injury

Infection

Neck pain, when experienced with a specific set of other symptoms can also be a warning signal sent by the body indicating a more serious condition such as brain fever or meningitis, or a possible heart attack.

When should I see the doctor?

Neck pain could be a simple condition that resolves itself in a few days or it could be indicative of something more damaging. Please seek immediate medical attention if you begin experiencing these symptoms in addition to neck pain:

  • If you have had an accident or fall and your neck and head pain persist even after a couple of days
  • If you are experiencing shortness of breath, sweating, pain in the arm or jaw, nausea and/or vomiting, profuse sweating – these could be indicative of a possible heart attack.
  • If you have a stiff neck as well as a headache and fever – these could be indicative of a serious condition called meningitis or brain fever

If you have been experiencing neck pain in a sustained period of time or if there is a progression in the pain and has already lasted over a week, it is time to consult your doctor.

Additional symptoms that can cause concern, include:

  • A lump in the neck
  • Swollen glands
  • Headache
  • Shortness of breath
  • Severe unexplained neck pain
  • Weakness
  • Sensations of numbness or tingling in the neck or upper extremities
  • Movement of pain to the arms or legs
  • Loss of control over bladder or bowel movement
  • Loss of movement of limbs
How is neck pain diagnosed?

Along with a thorough evaluation of your medical history (to understand occupation, lifestyle, current symptoms, and genetic predispositions), your doctor should also conduct a physical examination to check for the following:

  • Tenderness, numbness, tightness or weakness of the muscles in the neck and upper extremities.
  • Range of movement of the head – forwards and backward, to the sides
  • Posture of the neck
  • Any abnormalities or lesions in the region
  • If the nerves in the neck are sending the right signals to the limbs – this is determined using reflex tests
  • If there are any unusual sensations in the specific region or radiating to other regions

To narrow down the diagnosis, the doctor is also likely to ask you to get some blood tests done along with other tests such as:

  1. X-rays — to identify vertebral fractures, spinal degeneration, and any possible tumors.
  2. CT scans — to identify even the minutest changes in the bone. Often, an additional procedure of injecting a dye into the spinal column is also performed to enable a better view. This is known as a myelogram.
  3. MRI scans — to create a detailed cross-section of the bones and the tissues surrounding them.
  4. Nerve conduction velocity test — to examine the electrical activity of the nerves in the limbs.
  5. Electromyography — to check the electrical activity in the muscles.
How is neck pain treated?

Neck pain can be treated in different ways depending on the severity and the underlying causes. It can include:

  1. Self-care remedies such as the application of ice/heat packs, stretching and massaging
  2. Over-the-counter medications to reduce inflammation and pain – muscle relaxants, opioids, non-steroidal anti-inflammatory drugs, etc.
  3. Physical therapy to improve neck flexibility and strength
  4. Alternative therapies such as acupuncture, massages, and manual manipulation
  5. The use of a cervical collar or pillow

In case these approaches do not help relieve the pain, your doctor at Advanced Pain Care may recommend beginning a course of therapeutic injection procedures which includes the following:

  1. Radiofrequency ablation to prevent the pain signals from reaching the brain. Pain Relief from this procedure may last up to 2 years.
  2. Trigger point injections to calm specific muscles that act as the trigger for the pain.
  3. Cervical epidural steroid injection to reduce inflammation caused by herniation or spinal degeneration. In this procedure, a cortisone steroid solution is injected into the cervical epidural space.
Will I need surgery for my neck pain?

In most cases, neck pain, however chronic or acute, responds to conservative treatments. In a few cases, though, surgery does become the last resort. Your doctor may recommend surgery if you are:

  • Experiencing a loss of bladder/bowel control or weakness in limbs which is usually indicative of acute herniation compression on the spine
  • Feeling an increase in the pain leading to numbness and/or weakness in extremities.
  • Having problems with your stability and fine motor skills and this condition is progressing
  • Progressively experiencing symptoms of degenerative disc disease

When any of these conditions put pressure on the spinal cord or the nerves in the region, surgery becomes an option.

What are the types of surgery for neck pain?

The types of surgery recommended fall under the categories of stabilization and decompression – to stabilize the spinal column or to remove any pressure on a nerve structure.

There are several surgical procedures to remove any tissue or herniation that is pressing on a nerve:

  1. Discectomy — a part or the whole damaged disc is removed using a procedure known as anterior cervical discectomy and fusion.
  2. Cervical disc replacement — the damaged disc is replaced with a metal or polymer prosthetic.
  3. Corpectomy — removal of whatever is compressing the spinal cord or nerve.
  4. Foraminotomy — removal of bone spurs pressing on nerves.

A spinal fusion may be needed to stabilize the spine. In most cases, this procedure is performed along with a decompression surgery to provide room for nerve function.

For patients who have additional risk factors, such as diabetes and smoking, a bone growth stimulator may also be recommended to help aid in bone healing.

What is post-surgery care like?

While complications (like bleeding or infections) are rare, your doctors will constantly monitor you for all side effects. Once you are discharged from our post-operative care, you will need to visit your surgeon at Advanced Pain Care for periodic evaluations as they dictate. Additionally, a list of do’s and don’ts will be given to you, which may include the following:

  1. Wearing a collar for 4 to 6 weeks
  2. Restricting activities such as driving
  3. Restricting the lifting of weights over 5 pounds for 6 weeks
  4. Restricting exercises to walking unless specified by the surgeon
  5. No sports or strenuous activities for a few weeks
  6. Proper care of the incision

In case you experience any of the following, call your doctor immediately:

  • Spike in body temperature beyond 101 F
  • Increase in pain, swelling, redness, or irritation around the incision
  • Lack of control over bladder/bowel movement
  • Difficulty in swallowing or breathing
  • Weakness
How can I prevent neck pain?

Your doctors and orthopedic specialists at Advanced Pain Care will tell you that simple and small changes in your lifestyle can go a long way in preventing incidents of neck pain.

Being conscious of your body posture and mechanisms

Stay active but be aware of how you are exercising

Get plenty of rest

Keep yourself hydrated

Use the right pillow

Find healthy ways to deal with stress

For more information on how to manage your neck pain or to get the right treatment for it, call us at Advanced Pain Care at 512-244-4272.

Frequently Asked Questions

Q: How do I relieve neck pain?

A: Neck pain can be relieved in the following ways:

  • Self-care remedies such as application of ice/heat packs, stretching and massaging
  • Over-the-counter medications to reduce inflammation and pain – non-steroidal anti-inflammatory drugs (Tylenol).
  • Physical therapy to improve neck flexibility and strength
  • Alternative therapies such as acupuncture, massages, and manual manipulation
  • Use of cervical collar or pillow
  • Correcting body postures
  • Severe pain may require prescription medications

Q: What is the best treatment for neck and shoulder pain?

A: Neck and shoulder pain can be treated in the following ways:

  • Self-care remedies such as application of ice/heat packs, stretching and massaging
  • Over-the-counter medications to reduce inflammation and pain – muscle relaxants, opioids, non-steroidal anti-inflammatory drugs (Tylenol).
  • Physical therapy
  • Alternative therapies such as acupuncture and massages
  • Use of cervical collar or pillow
  • Correcting body posture
  • Epidural Steroid Injections (ESI)
  • Radiofrequency ablation
  • Trigger point injections
  • Shoulder joint injections

Severe pain may require prescription medication

Q: What causes neck pain?

A: Some of the most common causes of neck pain are as follows:

  • Muscle strain and tension – This could be caused by poor posture, sitting with the shoulders hunched for prolonged periods of time, lifting heavy objects, bad posture during exercise, etc.
  • Injury – Any minor injury such as a fall or a strain where the ligaments and muscles in the neck move unnaturally, out of their natural range of motion, can cause neck pain. Pain caused by sudden and jerky movements of the neck (a fall, contact sports, etc.) is also known as whiplash.

Q: Is heat or ice better for neck pain?

A: The general approach to using ice or heat as a therapy for neck pain is:

Ice helps relieve the pain and swelling and is recommended for the first 48 hours post the injury or beginning of pain. Heat application helps to loosen the muscles and reduce the stiffness. It also increases the blood flow to the region. For both, however, application should be limited to 20 minutes, with a 2-hour gap between applications.

Q: Can neck pain be a sign of something serious?

A: In most cases, neck pain is not considered a serious condition and is only a side effect of poor posture, injury, or stress. Sometimes, neck pain along with other symptoms can be indicative of a more serious condition. Please see a doctor immediately if you are experiencing these symptoms along with the neck pain:

  • If you have had a serious accident or fall
  • If you are experiencing shortness of breath, sweating, pain in the arm or jaw, nausea and/or vomiting, profuse sweating – these could be indicative of a possible heart attack
  • If you have a stiff neck as well as a headache and fever – these could be indicative of a serious condition called meningitis or brain fever

Q: What is neck pain a symptom of?

A: An injury, irritation, inflammation, or abnormality can cause neck pain. Look for the following symptoms if you suspect a more serious condition:

  • A lump in the neck
  • Swollen glands
  • Headache
  • Shortness of breath
  • Severe unexplained neck pain
  • Weakness
  • Sensations of numbness or tingling in the neck and upper extremities
  • Movement of pain to the arms or legs
  • Loss of control over bladder or bowel movement
  • Loss of movement of limbs

Q: When should I be concerned about neck pain?

A: If you have been experiencing neck pain in a sustained manner or if there is a progression in the pain and it has already lasted over a week, it is time to consult your doctor. Additionally, see a doctor immediately if you are experiencing any of the following:

  • If you have had an accident or fall
  • If you are experiencing shortness of breath, sweating, pain in the arm or jaw, nausea and/or vomiting, profuse sweating – these could be indicative of a possible heart attack
  • If you have a stiff neck as well as a headache and fever – these could be indicative of a serious condition called meningitis or brain fever
Neck Pain Treatment

Our Pain Care Expertise

Are You Experiencing Pain?

If you are experiencing any back pain or stiffness, call Advanced Pain Care at 512-244-4272 to schedule an appointment with one of our pain care and management specialists.

We have a range of pain management treatment options available right from surgical interventions to non-invasive and minimally invasive treatment options. Our team will work with you to develop a pain management plan based on the severity of your condition.