The cervical spine and neck can often cause pain, especially as the body ages. There are seven cervical vertebras with multiple joints contributing to the core structure. The spine and multiple nerves traverse the region. Multiple muscles and ligaments contribute to motion and stability.
On top of the neck is the head with all its structures and below are the torso, shoulders and arms. Pain perceived as from the neck may come from any of the structures in the region. All pain fibers from the mid shoulder blade and chest level on up travel through the same area of the brain. As a result, the brain can have difficulties in determining the exact location that is generating the pain signals.
Acute Neck Pain
Neck pain may be described as headaches that originate in the neck or it may be specific pain in the neck. Acute pain may be as simple as a muscle strain if there was no significant trauma. More chronic pain often comes from a deeper structure in the neck, such as:
- Cervical facet joints
- Cervical discs
- Cervical nerve irritation
- Degenerative changes irritating the nerves
Shoulder problems can also be misinterpreted as neck pain.
Chronic Neck Pain Causes
The most common causes of chronic neck pain are cervical facets joints, cervical degenerative changes, discs irritating nerves in the neck, and secondary muscle spasms in the neck. Trauma over time often contributes to the changes that have caused pain. The result is felt as neck pain, muscle tightness, and decreased range of motion of the neck. Determining the cause starts with a good history and physical exam. If simple solutions such as exercise, massage, heat and ice, and over the counter medications have not worked, then a physical medicine pain physician would be extremely helpful in coordinating future care.
Chronic neck pain that is limiting function warrants help from an expert. Muscle spasms and pain are the symptoms most commonly reported by patients. The cause is often a combination of problems such as:
- Degeneration of discs, bones, and joints
- Nerve irritation
- Muscles tightening to prevent further pain and movement of the head
After age 30, almost everyone will show a degree of degeneration of the cervical spine and these normal changes can also contribute to pain.
Treatment Options for Chronic Neck Pain
Treatment of neck pain starts with determining the causes, and often requires a complex plan that addresses each of the contributing factors that are maintaining the symptoms. Chronic pain often involves multiple causes and a simple treatment is often not available. Patient frustration is common since we all want a simple treatment. If there are multiple structures involved and pain is chronic, expect that more than one thing will be necessary to manage the symptoms.