NECK PAIN ... CAUSES ... SYMPTOMS ... TREATMENT

Neck pain is a common complaint. Neck muscles can be strained from poor posture — whether it's leaning into your computer at work or hunching over your workbench at home. Wear-and-tear arthritis also is a common cause of neck pain.

Rarely, neck pain can be a symptom of a more serious problem. Seek medical care if your neck pain is accompanied by numbness or loss of strength in your arms or hands or if you're experiencing shooting pain into your shoulder or down your arm.

What are other symptoms that are associated with neck pain?

Neck pain is commonly associated with dull aching. Sometimes pain in the neck is worsened with movement of the neck or turning the head. Other symptoms associated with some forms of neck pain include numbness, tingling, tenderness, sharp shooting pain, fullness, difficulty swallowing, pulsations, swishing sounds in the head, dizziness or lightheadedness, and lymph node (gland) swelling.

Neck pain can also be associated with headache, facial pain,  shoulder pain, and arm numbness or tingling (upper extremity paresthesias). These associated symptoms are often a result of nerves becoming pinched in the neck. Depending on the condition, sometimes neck pain is accompanied by upper back and/or lower back pain, as is common in inflammation of the spine from  ankylosing spndylitis.

Neck Pain That Radiates Down the Arm

Pain that radiates down the arm, and possibly into the hands and fingers, is frequently caused by a cervical herniated disc or foraminal stenosis pinching a nerve in the neck.

The pain may be accompanied by numbness or tingling in the arms and/or hands. The symptoms may start suddenly or develop over time.

The approach to treatment for a cervical disc herniation is guided by how long the pain lasts, pain intensity and the degree to which the cervical nerve and/or spinal cord are affected.

Most commonly, the symptoms are temporary and can be treated successfully with nonsurgical care (such as medication, physical therapy, manipulations).

If the pain does not respond within 6 to 12 weeks of conservative treatments, then surgery may be recommended.

Tests and diagnosis

During the physical exam, your doctor will check for tenderness, numbness and muscle weakness. He or she will also ask you to move your head as far as it can go forward, backward and side to side.

v  Imaging tests

In some cases, your doctor may order imaging tests to get a better picture of what might be causing your neck pain. Examples include:

v  X-rays. X-rays can reveal areas in your neck where your nerves or spinal cord may be pinched by bone spurs or a bulging disk.

v  Computerized tomography (CT) scan. CT scans combine X-ray images taken from many different directions to produce detailed cross-sectional views of the internal structures of your neck.

v  Magnetic resonance imaging (MRI). MRIs utilize radio waves and a strong magnetic field to create especially detailed images of bones and soft tissues, including the spinal cord and the nerves coming from the spinal cord.

However, many people have X-ray or MRI evidence of structural problems in their neck without experiencing any symptoms. So it can be difficult to determine if your symptoms are actually being caused by what shows up on imaging studies.

v  Nerve tests

If your doctor suspects that your neck pain may be related to a pinched nerve, he or she may suggest electromyography (EMG). This test involves inserting very fine needles through your skin into a muscle to determine whether specific nerves are functioning properly.

v  Lab tests

Blood tests. Blood tests can sometimes provide evidence of inflammatory or infectious conditions that may be causing your neck pain.

Spinal tap (lumbar puncture). During a spinal tap, a needle is carefully inserted into your spine to obtain a sample of the fluid that surrounds your brain and spinal cord. This test can reveal evidence of meningitis.

Treatments and drugs

The most common types of neck pain usually respond well to home care. If neck pain persists, your doctor may recommend other treatments.

ü  Medications

Your doctor may prescribe stronger pain medicine than what you can get over-the-counter. Muscle relaxants or tricyclic antidepressant medications used for pain also may be prescribed.

ü  Therapy

·         Neck exercises and stretching. Your doctor may recommend that you work with a physical therapist to learn neck exercises and stretches. A physical therapist can guide you through these exercises and stretches so that you can do them on your own at home. Exercises may improve pain by restoring muscle function, optimizing posture to prevent overload of muscle, and increasing the strength and endurance of your neck muscles.

·         Traction. Traction uses weights and pulleys to gently stretch your neck and keep it immobilized. This therapy, under supervision of a medical professional and physical therapist, may provide relatively fast relief of some neck pain, especially pain related to nerve root irritation.

·         Short-term immobilization. A soft collar that supports your neck may help relieve pain by taking pressure off the structures in your neck. If used for more than two weeks, however, a collar may do more harm than good.

ü  Surgical and other procedures

·         Steroid injections. Your doctor may inject corticosteroid medications near the nerve roots, into the small facet joints in the bones of the cervical spine or into the muscles in your neck to help with pain. Numbing medications, such as lidocaine, also can be injected to relieve your neck pain.

·         Surgery. Surgery is rarely needed for neck pain. However, it may be an option for relieving nerve root or spinal cord compression.

Is it possible to prevent neck pain?

Neck pain can really only be prevented by avoiding injury to the neck. This would include minimizing the risks of injury during sports activities. Athletes who participate in collision sports can prevent neck injury with appropriate equipment, neck strengthening exercises, and occasional neck bracing.