Neck Pain

Pain in the neck region is common and affects about 10% of the adult population. The more common causes of neck pain are:

•     Bony conditions; such as cervical spondylosis or rheumatoid arthritis
•     Nerve conditions: such as pressure on nerves by cervical disc prolapse
•     Muscular conditions e.g. whiplash injury

Cervical Spondylosis

X-ray evidence of cervical spondylosis (degenerative changes in the cervical spine) are almost universal by middle age; but there is little connection between severity of x-ray findings and the facet joints. As the disease progresses the cervical nerve roots are compressed causing nerve pain in the arm.


Symptoms include neck pain and stiffness. The pain can be referred to the face, anterior chest, head - especially at back, and shoulders. There may also be neck tenderness and muscle spasm.


As with back pain investigations include plain x-ray of the neck; CT scans and MRI scans. Treatment includes improvement of mobility with physiotherapy, with heat, massage, exercise. Neck traction, non-steroidal anti-inflammatory drugs (NSAIDS) - painkillers are also given to reduce inflammation.


Other treatments include local injections or local anaesthetic and/or steroids in the painful sports (trigger areas), or facet joint injections or cervical epidurals under x-ray control. The onset of nerve pain causing numbness or weakness in the arm demands further investigation by an orthopaedic or neurosurgeon.

Whiplash Injury

Rapid changes of velocity from car or sports injuries cause violent flexion and extension movements in the neck. Damage can be severe causing severe tears in ligaments, muscles, herniation of intervertebral discs or vertebral fractures.


Severe whiplash causes severe neck pain and spasm in neck muscles and occipital headache. Dizziness and visual disturbances are also possible. Less severe trauma cause partial tearing of neck ligaments and muscles.


The patient suffers from pain and spasm in the upper neck and occiput, especially on neck movement. Symptoms may not arise until the following day. Initially treatment is with painkillers; injections into painful spots or cervical epidural injections.

The neck is supported with a soft collar, or in severe cases with an unstable neck with a brace.

Physiotherapy with heat and stretching exercises is started as soon as the acute episode settles usually within 2-4 weeks. In over 33% of cases symptoms may persist beyond 2 years particularly in the elderly because of associated neck degeneration.


Source:www.privatehealth.co.uk
Last Editorial Review: 18/1/2010