Neck Pain

Neck pain, although felt in the neck, can be caused by numerous other spinal problems. Neck pain may arise due to muscular tightness in both the neck and upper back, or pinching of the nerves emanating from the cervical vertebrae. Joint disruption in the neck creates pain, as does joint disruption in the upper back.

The head is supported by the lower neck and upper back, and it is these areas that commonly cause neck pain. The top three joints in the neck allow for most movement of your neck and head. The lower joints in the neck and those of the upper back create a supportive structure for your head to sit on. If this support system is affected adversely, then the muscles in the area will tighten, leading to neck pain.

Neck pain may come from any of the structures in the neck including: vascular, nerve, airway, digestive, and musculature / skeletal or be referred from other areas of the body.

Major and severe causes of neck pain include:

The more common and lesser neck pain causes include:

Although the causes are numerous, most are easily rectified by either professional help or using self help advice and techniques.

More causes include poor sleeping posture, torticollis, head injury, rheumatoid arthritis, Carotidynia, congenital cervical rib, mononucleosis, rubella, certain cancers, ankylosing spondylitis, cervical spine fracture, esophageal trauma, subarachnoid hemorrhage, lymphadenitis, thyroid trauma, and tracheal trauma.

Treatment of neck pain depends on the cause. For the vast majority of people, neck pain can be treated conservatively. Recommendations which may help alleviate symptoms include applying heat or cold. Other common treatments could include medication, body mechanics training, ergonomic reform, or physical therapy.

Exercise plus joint mobilization and/or joint manipulation has been found to be beneficial in both acute and chronic mechanical neck disorders. Neither mobilization or manipulation without exercise however has been found to be helpful. Mobilization is equivalent to manipulation.Ultrasound has been shown not to be efficacious.

Analgesics such as acetaminophen or NSAIDs are recommended for pain.Muscle relaxants such as cyclobenzaprine have not been found to be useful and are therefore not recommended. Over the counter topical creams and patches containing counterirritants have little evidence to support efficacy.

Surgery is usually not indicated for most mechanical causes of neck pain. If neck pain is the result of instability, cancer, or other disease process surgery may be necessary. Surgery is usually not indicated for "pinched nerves" or herniated discs unless there is spinal cord compression or pain and disability have been protracted for many months and refractory to conservative treatment such as physical therapy.

About one-half of episodes resolve within one year. About 10% of cases become chronic.