Common Causes of Neck Pain

Back Be Nimble Newsletter - April 2002

While neck pain is not quite as common as lower back pain, many people experience neck pain or related arm pain at some point in their life. The good news is that most cases of neck pain will improve with time and those that can't are usually successfully managed with non-surgical treatments.

This issue of the newsletter provides a brief overview of common conditions that cause neck pain, including the primary symptoms and treatment options.

Most episodes of neck pain are due to a joint dysfunction, associated muscle strain and/or injury to ligaments or tendons. These types of injuries are usually caused by a sudden force (such as from a fall or impact from a car accident), or from straining the neck (such as cradling the phone or your shoulder for too long, sleeping with your neck at an odd angle, or a strain from carrying a heavy package or suitcase on one side). Stomach sleeping may also often lead to these dysfunctions.

Most minor injuries to the muscles, ligaments, or tendons in the neck will heal within a couple of days or weeks, as blood supply to these structures carries nutrients and proteins to help heal the injury. There is a range of treatment options that can significantly reduce the pain and discomfort while healing is taking place.

Typical treatments include applying ice and/or heat to the affected area( in acute cases, ice should be used for the first 48 hours before introducing heat), over-the-counter or prescription pain medications, chiropractic or osteopathic manipulations, and/or physical therapy.

For patients with neck pain that lasts longer than two weeks to three months, or who have arm pain, numbness or tingling, there may be a diagnosable condition causing the pain.

Chronic neck pain:

There are a number of conditions that may cause ongoing pain in the neck and/or arm. A few of the most common conditions include:

• A herniated disc or foraminal stenosis may cause pain that radiates down the arm (or into the hands and fingers). The symptoms are often temporary and can usually be treated with medication, physical therapy, and/or chiropractic or osteopathic manipulation. If the pain does not respond within 6 to 12 weeks of these treatments, then surgery may be recommended.
• Foraminal stenosis, i.e. a narrowing of the opening for nerve roots where they exit the verebral column, may be characterized by pain that develops slowly (e.g. over years) and tends to occur during or after certain activities or neck positions. If the pain is severe or prolonged, or if it causes difficulty with daily activities, then surgery may be recommended to get rid of the pinching on the nerve.
• Thoracic Outlet Syndrome is often associated with neck complaints and also may cause pain or numbness in the arm/hand, chest pain and arm weakness. Most of the time this is a condition caused by shortening of the pectoralis minor (chest muscle underneath the collarbone) which actually impinges on the nerve/artery complex going down the arm. Thoracic Outlet Syndrome may usually be treated conservative by chiropractic and or physical medicine. It is quite common for those who work at a desk with slumping shoulders or those who go to the gym and work their chest a lot more than the opposing back muscles. However, there are origins of this condition which can require surgical intervention.
• Cervical stenosis with myelopathy may cause pain that radiates down the arm along with lack of coordination in the arms and legs, difficulty with fine motor skills (such as writing), and/or occasional intermittent shooting pains. Symptoms may come and go over a long period (e.g. several years). Because this is an actual narrowing of the spinal cord canal, non-surgical treatments may help relieve the arm pain, but surgery may be needed to treat the spinal cord compression (which causes the coordination difficulties).

Finally, it is important to caution that if someone experiences weakness in the arms, or loss of feeling and coordination in the arms or legs, there could be nerve damage and it is important to seek immediate medical attention. Similarly, symptoms that include prolonged/increasing pain accompanied by loss of appetite, weight loss, nausea, vomiting, or fever/chills/shakes, could indicate a spinal tumor or infection and requires immediate medical attention.

As a general rule of thumb, if you are worried about your symptoms, or if the symptoms seem to be getting worse, it is always advisable to consult with your doctor. Also, don't forget that a balanced exercise program is a must in the overall treatment program of just about any musculo-skeletal condition. Therefore, if your physician doesn't recommend exercises, you might ask for them to do so.

We hope that a better understanding of different types of back and neck pain and related symptoms will help you better manage your health. At Back Be Nimble, We bend over backwards to help your back be nimble again...

Best Wishes,