Is it merely a pain in your neck?

Your head and neck region is vulnerable to many different stresses. Bad posture can cause misalignment of your neck, head, and spine. Car accidents can cause whiplash. Age and wear and tear can cause arthritis. Even activities such as gum chewing and reading in bed can cause pain. How do we avoid these potential problems? And if we can’t avoid them, how can we recognize them and cope up with them?

Have you ever been tried to grab something just out of reach on an upper shelf of your wardrobe, and felt an immediate catch in your neck? Or did you ever wake up in the morning on your sofa, and have a painful, stiff neck that left you barely able to move your head a whole day? The chance of you answering ‘yes’ is nine out of ten. You are not alone! Neck pain is one of the common visits to clinics now a day. Most neck pain is caused by muscle strain or sprain, and although some people have this pain for a long time, it is usually not serious.

One of the most flexible regions of the spine is the neck (cervical) region, which consists of vertebrae, seven shock-absorbing discs, muscles, and vertebral ligaments to hold them in place. The uppermost cervical disc connects the top of the spinal column to the base of the skull. The spinal cord, which sends nerve impulses to every part of the body, runs through a canal in the cervical vertebrae and continues all the way down the spine. The cervical nerves spread down into the arms; because of this, arm pain is sometimes traceable to a problem in the neck.

While most people do not have serious medical problems, neck pain could be the sign of an underlying condition that requires medical attention. Neck pain may be caused by disc degeneration, narrowing of the spinal canal, spondylosis, arthritis, and, in rare cases, cancer or meningitis. For serious neck problems often a specialist such as a neurosurgeon should be consulted for an accurate diagnosis and proper treatment.

The neck is supported at the back by a staircase of seven bones called cervical spine. They are separated by what is known as a disc. These bones, discs and joints are prone for a variety of disorders that can result in a ‘bad neck’. Advancing age, injury, bad posture, or diseases such as arthritis can lead to degeneration of the bones or joints of thecervical spine, causing disc herniation or bone spurs to form. Sudden severe injury to the neck may also contribute to disc herniation, whiplash, vertebral injury, and, in extreme cases, permanent paralysis because of spinal cord injury. Herniated discs or bone spurs may narrow the canal through which the spinal cord runs or narrow the small openings through which spinal nerve roots exit. Pressure on a nerve root from a herniated disc or bone spur may cause pain in the arm and neck, numbness or weakness in the arm, tingling in the fingers or hand and difficulty in walking.

Cervical canal stenosis occurs when the spinal canal narrows and compresses the spinal cord and is most frequently caused by aging. The discs in the spine that separate and cushion vertebrae may dry out. As a result, the space between the vertebral bodies shrinks, and the discs lose their ability to act as shock absorbers. At the same time, the bones and ligaments that make up the spine become less pliable and thicken. These changes result in a narrowing of the spinal canal. In addition, the degenerative changes associated with cervical stenosis can affect the vertebrae by contributing to the growth of bone spurs that compress the nerve roots. All these result in neck pain, numbness and weakness in both hands, unsteady gait when walking, and muscle spasms in the legs. Mild stenosis can be treated conservatively for some time long as the symptoms are restricted to neck pain. Severe stenosis requires referral to a specialist neurosurgeon.

In addition to performing a thorough examination, a neurosurgeon may order diagnostic tests to help determine the cause and severity of your neck pain. These tests include x-rays, CAT scans, Magnetic Resonance Imaging (MRI), Electromyograms and Nerve Conduction Studies (EMG/NCS). A spinal tap for a cerebrospinal fluid analysis may be needed if meningitis (infection of the coverings of the brain) is suspected.

When to consult your doctor for neck pain?

• If it occurs after a blow to the head or neck
• If neck pain along with fever or headache
• If stiff neck prevents you from touching your chin to your chest
• If pain shoots down one of your arms
• It there is tingling, numbness or weakness in your arms or hands
• If there is difficulty in walk
• If your pain does not respond to over-the-counter pain medication in a few days
• If pain does not improve after a week to ten days

Non-surgical (conservative) treatment is the first approach in patients with common neck pain not involving trauma. For example, many patients with cervical disc herniations improve with conservative treatment and time and do not require surgery. Conservative treatment includes pain medication, collar, traction, bed rest, and physical therapy. Your doctor may prescribe medications to reduce the pain or inflammation. Sometimes an injection of corticosteroids may be used to temporarily relieve pain. Your neurosurgeon may advise surgery if you experience progressive neurological symptoms involving your arms and legs. Type of surgery varies depending on your disease, symptoms and MRI findings.

But is there any way you can prevent neck pain?

One of the most common causes of neck pain is poor posture. It’s easy to get into bad posture habits without even realizing it - even an activity as “innocent” as reading in bed can sometimes cause neck pain. The goal of ‘good posture’ is to keep your head centered over your spine, so gravity works with your neck instead of against it. Try these simple steps to a healthy neck!

· Take frequent breaks if you drive long distances or work long hours at your computer. Keep your head back, over your spine, to reduce neck strain. Try to avoid gritting your teeth.

· Adjust your desk, chair and computer so the monitor is at eye level. Knees should be slightly lower than hips. Use your chair's armrests.

· Avoid tucking the phone between your ear and shoulder when you talk. If you use the phone a lot, get a headset.

· Stretch frequently if you work at a desk. Shrug your shoulders up and down. Pull your shoulder blades together and then relax. Pull your shoulders down while leaning your head to each side to stretch your neck muscles.

· Balance your base. Stretching the front chest wall muscles and strengthening the muscles around the shoulder blade and back of the shoulder can promote a balanced base of support for the neck.

· No tummy sleeping please. That position puts stress on your neck. Choose a pillow that supports the natural curve of your neck.Reading in bed can cause neck strain—especially if you’re propped up on several pillows.

· Pillow talk. Does your pillow cause you to sleep with your neck at an angle, either too high or too low? If so, you may have to invest in a new pillow soon!