Neck Pain

Neck Pain:

Most people will have a minor neck problem at one time or another. Our body movements usually do not cause problems, but it is not surprising that symptoms develop from everyday wear and tear, overuse, or injury. Neck problems and injuries most commonly occur during sports or recreational activities, work-related tasks, or projects around the home.

Neck pain may feel like a "kink," stiffness, or severe pain. Pain may spread to the shoulders, upper back, or arms, or it may cause a headache. Neck movement may be limited, usually more to one side than to the other. Neck pain refers to pain anywhere from the area at the base of the skull into the shoulders.

Emergency care is required for a neck injury that causes damage to the spinal cord. Symptoms of a spinal cord injury include loss of movement or feeling, numbness, tingling, difficulty controlling the muscles of the arms or legs, or loss of bowel or bladder control.

Conditions That Cause Neck Problems:

Neck problems may not be related to an injury. Arthritis or damage to the discs of the neck can cause a pinched nerve. Neck pain caused by a pinched nerve generally affects one side of the neck and also the arm on that side. Other symptoms may develop, such as numbness, tingling, or weakness in the arm or hand. Meningitis is a serious viral or bacterial illness that causes inflammation around the tissues of the brain and the spinal cord. Symptoms come on quickly and include severe headache, stiff neck, fever, and sometimes vomiting. The neck stiffness makes it hard or impossible to touch the chin to the chest.

The flu, which usually is not serious, can cause symptoms similar to meningitis. When neck pain is caused by flu, the neck and the rest of the body tend to ache all over, but severe neck stiffness is absent. Neck pain that occurs with chest pain may be caused by a serious problem with the heart, such as a heart attack. Stress and tension may make the muscles that run from the back of the head across the back of the shoulder (trapezius muscle) feel tight and painful. You may not be able to move your head without pain. Torticollis is caused by severe muscle contraction on one side of the neck, and the head tilts to one side. The chin is usually rotated toward the opposite side of the neck. Torticollis may be present at birth (congenital) or caused by injury or disease.

Treatment of Neck Problems:

Treatment for a neck problem or injury may include first aid measures, physical therapy, manipulative therapy (such as chiropractic or osteopathic), medicine, and in some cases, surgery. Treatment depends upon the location, type, and severity of the injury, and your age, health condition, and activities (such as work, sports, or hobbies).

Neck pain may be caused by an injury to one or more of these areas: bones and joints of the cervical spine (vertebrae of the neck), the discs that separate the cervical vertebrae and absorb shock as you move, or the muscles and ligaments in the neck that hold the cervical spine together. The injury may have another cause. Home treatment will often help relieve neck pain caused by minor injuries. However, review the "Emergencies" and the "Check Your Symptoms" sections to determine if and when you need to see a doctor.

Activities That May Cause Neck Pain:

Neck pain is often caused by a strain or spasm of the neck muscles or inflammation of the neck joints. Examples of common activities that may cause this type of minor injury include: holding your head in a forward posture or an odd position while working, watching TV, or reading. Other causes are: sleeping on a pillow that is too high, too flat, or doesn't support your head; sleeping on your stomach with your neck twisted or bent; spending long periods of time resting your forehead on your upright fist or arm ("thinker's pose"); work or exercise that uses your upper body and arms; or stress. Tension may make the muscles that run from the back of the head across the back of the shoulder (trapezius muscle) feel tight and painful.

Sudden (Acute) Injuries:

Minor neck injuries may result from tripping, falling a short distance, or excessive twisting of the spine. Severe neck injuries may result from whiplash in a car accident, falls from significant heights, direct blows to the back or to the top of the head, sports-related injuries, a penetrating injury such as a stab wound, or external pressure applied to the neck, such as strangulation.

Pain from an injury may be sudden and severe. Bruising and swelling may develop soon after the injury. Acute injuries include: an injury to the ligaments or muscles in the neck, such as a sprain or strain. When neck pain is caused by muscle strain, you may have aches and stiffness that spread to your upper arm, shoulder, or upper back. Shooting pain that spreads down the arm into the hand and fingers can be a symptom of a pinched nerve (nerve root compression). Shooting pain is more serious if it occurs in both arms or both hands rather than just one arm or one hand. Pain may occur from a fracture or dislocation of the spine. This can cause a spinal cord injury that may lead to permanent paralysis. It is important to immobilize and transport the injured person correctly to reduce the risk of permanent paralysis. See "First Aid for a Spinal Injury". Pain may occur from a torn or ruptured disc. If the tear is large enough, the jellylike material inside the disc may leak out (herniate ) and press against a nerve or the spinal cord (central disc herniation). You may have a headache, feel dizzy, sick to your stomach, or have pain in your shoulder or down your arm.

Causes of Neck Pain:

Causes of neck pain include: abnormalities in the bone or joints, trauma, poor posture, degenerative diseases, tumors, and, most commonly, muscle strain/sprain caused by cumulative trauma or repetitive strain injuries.

Causes of Whiplash:

Whiplash is caused by an abrupt acceleration and deceleration or jerking motion of the head, either backward or forward, and often occurs as a result of a car accident.

Whiplash, also called neck sprain or neck strain, is injury to the neck. Whiplash is characterized by a collection of symptoms that occur following damage to the neck. In whiplash, the inter-vertebral joints (located between vertebrae), discs, and ligaments, cervical muscles, and nerve roots may become damaged.

Symptoms of Whiplash:

Symptoms of whiplash may be delayed for twenty-four to seventy-two (24 to 72) hours or more after the initial trauma. However, people who experience whiplash may develop one or more of the following symptoms, usually within the first few days after the injury.

Diagnosis of Whiplash:

In most cases, injuries are to soft tissues such as the disks, muscles and ligaments, and these cannot be seen on standard X-rays. Specialized imaging tests, such as CT scans or magnetic resonance imaging (MRI), may be required to diagnose whiplash.

Treatment of Whiplash:

ART® treatments have been scientifically proven effective for whiplash, but pain relieving medications such as Motrin or Aleve along with gentle exercises, physical therapy, traction, massage, heat, ice, injections and ultrasound all have been helpful for certain patients. In the past, whiplash injuries were often treated with immobilization in a cervical collar. However, the current trend is to encourage early movement instead of immobilization. Ice may be applied for the first twenty-four (24) hours, followed by gentle active movement.

Myofascial Pain Syndrome (Muscle Pain):

Myofascial Pain Syndrome (Muscle Pain) or (MPS) is a fancy way to describe muscle pain. It refers to pain and inflammation in the body's soft tissues. Myofascial Pain is a chronic condition that affects the fascia (connective tissue that covers the muscles). Myofascial Pain Syndrome may involve either a single muscle or a muscle group. In some cases, the area where a person experiences the pain may not be where the Myofascial Pain generator is located. Experts believe that the actual site of the injury or the strain prompts the development of a trigger point that, in turn, causes pain in other areas. This situation is known as referred pain.

Causes of Myofascial Pain:

Myofascial Pain may develop from a muscle injury or from excessive strain on a particular muscle or muscle group, ligament or tendon. Other causes include: injury to inter-vertebral disc; general fatigue; repetitive motions; medical conditions (including heart attack, stomach irritation); and lack of activity (such as a broken arm in a sling).

Symptoms of Myofascial Pain:

Myofascial Pain symptoms usually involve muscle pain with specific "trigger" or "tender" points. The pain can be made worse with activity or stress. In addition to the local or regional pain associated with Myofascial Pain Syndrome, people with the disorder also can suffer from depression, fatigue, and behavioral disturbances.

Diagnosis of Myofascial Pain:

Trigger points can be identified by pain that results when pressure is applied to an area of a person's body. In the diagnosis of Myofascial Pain Ssyndrome, four types of trigger points can be distinguished. An active trigger point is an area of extreme tenderness that usually lies within the skeletal muscle and is associated with a local or regional pain. A latent trigger point is a dormant (inactive) area that has the potential to act like a trigger point. A secondary trigger point is a highly irritable spot in a muscle that can become active due to a trigger point and muscular overload in another muscle. A satellite myofascial point is a highly irritable spot in a muscle that becomes inactive because the muscle is in the region of another trigger pain.

Treatment of Myofascial Pain:

Most cases are treated with combinations of Active Release Techniques® (ART® ), physical therapy, and joint manipulations. In select cases, medication is used to treat other conditions that often occur with Myofascial Pain, such as insomnia and depression. The treatment of soft tissue neck and shoulder pain includes the use of anti-inflammatory medication (such as Aleve or Motrin) and/or acetaminophen (Tylenol). Pain also may be treated with a local application of moist heat or ice. Local corticosteroid injection is often helpful for arthritis of the shoulder. For both neck and shoulder pain movement exercises may help. For cases in which nerve roots or the spinal cord are involved, surgical procedures may be necessary.