The neck (cervical spine) is composed of vertebrae that begin in the upper torso and end at the base of the skull. The bony vertebrae along with the ligaments (which are comparable to thick rubber bands) and muscles provide stability to the spine. The muscles allow for support and motion.
The neck has a significant amount of motion and supports the weight of the head. However, because it is less protected than the rest of the spine, the neck can be vulnerable to injury and disorders that produce pain and restrict motion.
Neck pain may result from abnormalities in the soft tissues—the muscles, ligaments, and nerves—as well as in bones and discs of the spine. The most common causes of neck pain are soft-tissue abnormalities due to injury (a sprain) or prolonged wear and tear. In rare instances, infection or tumors may cause neck pain. In some people, neck problems may be the source of pain in the upper back, shoulders, or arms.
Spine Degeneration (Spondylosis)
Spondylosis is a broad term that simply refers to some type of degeneration in the spine. Most often, the term spondylosis is used to describe osteoarthritis of the spine, but it is also commonly used to describe any manner of spinal degeneration. As with many other terms to describe spinal problems, spondylosis is more of a descriptive term than it is a clinical diagnosis. Literally it can be translated to mean that one has both pain and spine degeneration, regardless of what is causing the pain or where the degeneration is occurring.
The disc acts as a shock absorber between the bones in the neck. In cervical disc degeneration (which typically occurs in people age 40 years and older), the normal gelatin-like center of the disk degenerates and the space between the vertebrae narrows. As the disc space narrows, added stress is applied to the joints of the spine causing further wear and degenerative disease. The cervical disc may also protrude and put pressure on the spinal cord or nerve roots when the rim of the disc weakens. This is known as a herniated cervical disc.
Because the neck is so flexible and because it supports the head, it is extremely vulnerable to injury. Motor vehicle or diving accidents, contact sports, and falls may result in neck injury. The regular use of safety belts in motor vehicles can help to prevent or minimize neck injury. A “rear end” automobile collision may result in hyperextension, a backward motion of the neck beyond normal limits, or hyperflexion, a forward motion of the neck beyond normal limits. The most common neck injuries involve the soft tissues: the muscles and ligaments. Severe neck injuries with a fracture or dislocation of the neck may damage the spinal cord and cause paralysis.
Nonsurgical treatment is effective in treating the symptoms of herniated discs in the majority of patients. Most neck pain will resolve gradually with simple measures.
- Rest and over-the-counter pain relievers may be all that is needed.
- Muscle relaxers, Compound Topical Creams, analgesics, and anti-inflammatory medications are also helpful.
- Cold compresses or ice can also be applied several times a day for no more than 20 minutes at a time.
- After any spasms settle, gentle heat applications may be used.
Any physical activity should be slow and controlled, especially bending forward and lifting. This can help ensure that symptoms do not return, as can taking short walks and avoiding sitting for long periods. For the neck, exercises and traction may be helpful. To help avoid future episodes of pain, it is essential that you learn how to properly stand, sit, and lift.
Injections can be very helpful for this condition and they may include:
- Cortisone (Corticosteroid)
- Platelet Rich Plasma (PRP)
- Trigger Point Injections