We all know what it feels like to have limited neck motion, as most of us have had neck pain at some point in time. It makes doing simple things like backing up a car, rolling over in bed, reading, and watching TV difficult-to-impossible. The goal of this article is to review some of the many causes of neck pain and what to do about it! Let’s take a look at the various types of tissues that can generate pain:
1) MUSCLES: There are MANY layers of muscles in the neck. There are the very small, deep “intrinsic” muscles that are important for stability of the spine and fine, intricate movements while the larger outside “extrinsic” muscles are long and strong, allowing us to sustain stresses like playing football, rugby, hockey, or falling on the ice. Long car drives/rides, computer work, studying/reading, or having a conversation with someone not sitting directly in front of you are just a few examples of how these muscles can experience overuse that can generate neck pain!
2) LIGAMENTS: These are tough, non-stretching tissues that hold bone to bone and can tear in trauma like whiplash, while playing sports, or in a fall. Because ligaments are important in keeping our joints stable, disrupted ligaments can lead to excessive “play” in a joint and can wear down the cartilage or the smooth, silky covering at the ends of bones, which can lead to premature osteoarthritis (OA) – the “wear and tear” kind that everyone gets eventually.
3) WORN JOINTS: There is something called “the natural history of degeneration” that naturally occurs if we live long enough. As previously discussed, ligament tearing leads to instability of the involved joint(s), and excessive motion in the joint leads to OA. In the neck, there are two sets of small joints between six of the seven vertebrae called facet joints and uncinate processes that are vulnerable for OA and are frequent pain generators.
4) DISK INJURY: The disks rest between the big vertebral bodies and act as shock absorbers. They are like jelly donuts, and when the disk’s tough outer layers tear, the jelly can leak out and this may or may not hurt, depending on the direction, the amount of the leaked out “jelly,” and if the “jelly” pinches pain-sensitive tissues. A “herniated disk” is the most common cause for a pinched nerve (see next entry).
5) NERVE COMPRESSION: The nerves in the neck travel into the arms, and nerve compression or pinching can result in numbness/tingling/burning pain in the arm and/or hand with or without weakness. Each nerve has a different role, and by mapping the numbness area and testing reflexes and muscle strength, it can help your doctor identify the specific nerve that is injured.
6) DISEASES: Though significantly less common, neck pain can arise from certain diseases such as rheumatoid arthritis, meningitis, and/or cancer. When these are suspect, blood tests and special tests such as bone scan, CT/MRI, and/or biopsy can help to specifically identify the condition.
WHAT TO DO: Make an appointment and your doctor of chiropractic will perform a history, physical examination, and possibly take x-rays to help determine what is generating your pain. Once the diagnosis is understood, he or she will put together a treatment plan for you. This usually includes procedures done in the office as well as those that they will teach you how to do at home and/or work to help you manage your neck pain back and return to normal activities as quickly as possible!
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