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Neck Pain and Spinal Injuries

The neck (cervical spine) is composed of 7 vertebrae which begin at the base of the skull and end in the upper torso . The bony vertebrae along with the ligaments 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, in the adult weigh between 14-16 pounds. 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. For many people, neck pain is a temporary condition that disappears with time. Others need medical diagnosis and treatment to relieve their symptoms.

This information helps explain some of the causes of and treatment for neck pain. However, does not replace an examination or the advice of a physician.

What causes neck pain?

Neck pain may result from abnormalities in the soft tissues – the muscles, ligaments, and nerves – as well as in bones and joints of the spine. The most common causes of neck pain are inflammation of the joints and soft tissue abnormalities due to injury or prolonged wear and tear. In some people, neck problems may be the source of pain in the upper back, shoulders or arms since the nerves that supply the shoulders arms and hands originate in the neck.

This information helps explain some of the causes of and treatment for neck pain. However, does not replace an examination or the advice of a physician.

Degenerative and inflammatory diseases – Degenerative diseases that cause neck pain include osteoarthritis and rheumatoid arthritis. Osteoarthritis usually occurs in older people as a result of wear of the joints between the bones in the neck. Rheumatoid arthritis can cause destruction of the joints of the neck. Both of these major types of arthritis can cause stiffness and pain. When the spine is injured and any of these conditions exist, the pain can be more intense than if these conditions were not present.

Cervical disk degeneration also can cause neck pain. The disk acts as a shock absorber between the bones in the neck. In cervical disk degeneration (typically age 40 onwards), the normal gelatin-like center of the disk degenerates and the space between the vertebrae narrows. As the disk space narrows, added stress is applied to the joints of the spine causing further wear and degenerative disease. The cervical disk may also protrude and cause pressure on the spinal cord or nerve roots when the rim of the disk weakens. This is known as a bulged, herniated or ruptured cervical disk.

Injury – 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 add to injury of the neck since it fixes the upper and lower body in place and as a result more force occurs in the neck. However, it prevents or minimizes more severe head or chest injuries. 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, this is commonly called whiplash. Most common injuries are to the soft tissues, i.e., muscles. ligaments and discs. Severe injury with fracture or dislocation of the neck may damage the

When should you seek medical care?

The Back Pain Institute specializes in the care for neck and back pain. We have on staff medical doctors, chiropractors and physical therapists because they are specifically trained in the musculoskeletal system, including the diagnosis, treatment, and prevention of problems involving the muscles, bones, joints, ligaments and tendons.

If there has not been an injury, you should seek medical care when neck pain is:

continuous and persistent
severe
accompanied by pain that radiates down the arms or legs
accompanied by headaches, numbness, tingling, fever or weakness

What should you do when you have a neck injury or pain?

Determining the source of the pain is essential to recommend the right method of treatment and rehabilitation. Therefore a comprehensive examination is required to determine the cause of neck pain.

We will take a complete history of the difficulties you are having with your neck and ask you about other illnesses, any injury that occurred to your neck and any complaints you have associated with neck pain. Previous treatment for your neck condition will also be noted.

Next, we will perform a physical examination. This examination may include evaluation of neck motion, neck tenderness, and the function of the nerves and muscles in your arms and legs.

X-ray studies often will be done to allow us to look closely at the bones in your neck. These simple diagnostic techniques often help to determine the cause of neck pain and to prescribe effective treatment.

Patients who require further evaluation may undergo one or more of the following examinations:

MRI (magnetic resonance imaging). This non X-ray study allows an evaluation of the spinal cord, nerve roots and disc as well as other soft tissue.
CT (computed tomography). This specialized X-ray study allows careful evaluation of the bone and spinal canal.
EMG (electromyogram). This test evaluates nerve and muscle function.

Treatment

How neck pain is treated depends on what the diagnosis reveals. However, most patients are treated successfully with rest, medication, immobilization, chiropractic, physical therapy, exercise, activity modifications or a combination of these methods.

For example, if pain is caused by inflammation as a result of stretching muscles and ligaments beyond their limits, you may be prescribed rest and a neck collar for a specified period of time, as well as medication to reduce inflammation. If medication is prescribed to reduce pain, it should be used only as directed and should not be taken for extended periods of time. In addition, remember that if you are prescribed rest, it is vital that you follow instructions carefully.

When neck pain persists or is chronic, you may be recommend a rehabilitation program that includes an exercise program and various types of physical therapy and/or chiropractic manipulation to help you relieve your pain restore function and prevent it from coming back.

Very few patients require surgery to relieve neck pain. For the vast majority of patients, a combination of rest, medication chiropractic and physical therapy will relieve neck pain. Although very rare, surgery may be necessary to reduce pressure on the spinal cord or a nerve root when pain is caused by a herniated disk or bony narrowing of the spinal canal. Surgery may also be required following an injury, to stabilize the neck and minimize the possibility of paralysis such as when a fracture results in instability of the neck.

Our physicians have extensive training in the diagnosis and treatment of the musculoskeletal system, including bones, joints, ligaments, tendons, muscles and nerves.

If you are injured it is always best to have an examination as soon as possible to detect any indication of significant or hidden injury. It is not uncommon for the effects of an injury to show up days, weeks, months or even years after an injury.

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Neck Pain and Spinal Injuries

What causes neck pain?

What should you do when you have a neck injury or pain?

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