Shivam
Pain Management
Centre
Help Line - 079-26301986, 26308976
     
     
 
Neck Pain
 
Neck pain (or cervicalgia) is a common problem, with two-thirds of the population having neck pain at some point in their lives. 
Neck pain, although felt in the neck, can be caused by numerous other spinal issues. Neck pain may arise due to muscular tightness in both the neck and upper back, or pinching of the nerves emanating from the cervical vertebrae. Joint disruption in the neck creates pain, as does joint disruption in the upper back. 
 
The head is supported by the lower neck and upper back, and it is these areas that commonly cause neck pain. The top three joints in the neck allow for most movement of your neck and head. The lower joints in the neck and those of the upper back create a supportive structure for your head to sit on. If this support system is affected adversely, then the muscles in the area will tighten, leading to neck pain. 
 
Neck pain may also arise from many other physical and emotional health issues. 
 
Differential diagnosis
Neck pain may come from any of the structures in the neck including: vascular, nerve, airway, digestive, and musculature / skeletal or be referred from other areas of the body.
Major and severe causes of neck pain include:
Carotid artery dissection
Referred pain from acute coronary syndrome
Infections: retropharyngeal abscess, epiglottitis, etc.
Spondylosis - degenerative arthritis and osteophytes
Spinal stenosis – a narrowing of the spinal canal
Spinal disc herniation – protruding or bulging discs, or if severe prolapse.
The more common and lesser neck pain causes include:
Stress – physical and emotional stresses
Prolonged postures – many people fall asleep on sofas and chairs and wake with sore necks
Minor injuries and falls – car accidents, sporting events and day to day minor injuries
Referred pain – mostly from upper back problems
Over-use – muscular strain is one of the most common causes
Whiplash /li>
Although the causes are numerous, most are easily rectified by either professional help or using self help advice and techniques. 
 
More causes include poor sleeping posture, torticollis, head injury, rheumatoid arthritis, Carotidynia, congenital cervical rib, mononucleosis, rubella, certain cancers, ankylosing spondylitis, cervical spine fracture, esophageal trauma, subarachnoid hemorrhage, lymphadenitis, thyroid trauma, and tracheal trauma.
 
Treatment
Treatment of neck pain depends on the cause. Many acute problems in the spine/neck generally resolve themselves in as little as a few days to a few months. Persistent problems involving the cervical spine should be evaluated by a health care practitioner. Common treatments could include medication, body mechanics training, ergonomic reform, or physical therapy.
Neck Pain and Cervical Disc Disease
Our body constantly degenerates. Decades of bending, lifting, turning, and twisting can really take their toll on your neck. Considering all that repetitive stress, it's no surprise that about two-thirds of people will experience neck pain at some point in their lives. 
A cervical degenerative process can cause neck pain, radiating pain, as well as numbness and weakness in your shoulders, arm, and hand. That discomfort and loss of mobility can have a major impact on your career, family, and quality of life. 
Neck pain may also be caused by vehicular accidents causing whiplash neck injuries, some chronic diseases like Ankylosing spondylitis, Arthritis, Fractures and Dislocations, Herniated Disc, Myelopathy, Osteoporosis, Radiculopathy, Spinal Cord Injury, Spondylolysis, Stenosis etc. 
 
Cervical Discs: Your Natural Shock Absorbers
The cervical spine in your neck is made up of seven bones called vertebrae, which are separated by discs filled with a cushioning gel-like substance. Your cervical discs both stabilize your neck and allow it to turn smoothly from side to side and bend forward to back. "Without discs, the spine would be very stiff." Discs allow our body to move in the way that we want. They also provide cushion for the body, acting as a shock absorber. 
 
Aging causes these shock absorbers to wear & tear. The space between the vertebrae narrows and nerve roots become pinched. This process is known as cervical degenerative disc disease. The pressure causes tingling & numbness. Pain is caused only when there is inflammation of nerves. Research finds that about 25% of people without symptoms under age 40, and 60% over age 40 have some degree of degenerative disc disease. As degenerative disc disease progresses, the neck becomes less flexible, and you may feel neck pain and stiffness, especially towards the end of the day. 
 
When the disc breaks open or bulges out, putting pressure on the spinal cord or nerve roots, it is known as a herniated disc or "slipped disc." Although cervical disc disease is generally a slow process, a herniated disc sometimes can occur quickly after an injury or trauma to the neck. 
 
The most common and obvious symptoms of cervical degenerative disc disease are neck pain and a stiff neck. When one of these conditions presses on one or more of the many nerves running through the spinal cord, you also can develop pain, numbness, or weakness radiating down your shoulder, arm, and hand. 
 
Diagnosing Your Cervical Disc Disease
To diagnose your cervical disc disease, your doctor will first take a medical history to find out when your symptoms started, how severe they are, and what causes them to improve or worsen. You'll likely have a neurological exam to test your strength, reflexes, and the sensation in your arm and hand, if they are affected.
 
Imaging tests such as X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans can help your doctor visualize your spinal cord to pinpoint the source of your neck pain. 
 
What to Do About Cervical Disc Disease
Even if you have degenerative disc disease or a slipped disc, chances are good that you'll be able to treat it without surgery. The first line in treatment for cervical disc disease is pain medications, including Paracetamol, and nonsteroidal anti-inflammatory medications such as ibuprofen; acetaminophen and naproxen. These medications can help reduce pain and inflammation. Some muscle relaxant, antidepressant medicines may be added for chronic neck pain. 
 
Physical therapy is another treatment option for cervical disc disease. The therapist at PCI can use Interferrential therapy (IFT), US (Ultrasound), cervical traction, or gently manipulate your muscles and joints to reduce your pain and stiffness. The physical therapist can also help you increase your range of motion and show you exercises and correct postures to help improve your neck pain. 
 
Your neck pain should improve with these conservative treatments. If you also have continued pain & disability or significant numbness or weakness, contact pain specialists at PCI right away. You and your doctor will need to consider the next step in your treatment. The next step is Epidural cortisone injection under x-ray control. 
 
Other non-surgical treatment options are transforaminal selective nerve root injection, pulsed RF, discography, Percutaneous Nucleotome Discectomy. >95% of moderate to severe neck pain do respond to these therapies. 
 
The main surgery for degenerative disc disease is called a discectomy. During this procedure, the surgeon removes the deteriorating disc. Discectomy is often followed up by artificial disc replacement, in which a metal disc is inserted in place of the disc that was removed. Discectomy may also be followed by cervical fusion, in which a small piece of bone is implanted in the space between the vertebrae. As the bone heals, it fuses with the vertebrae above and below it. 
 
After You Heal: Keeping Your Neck Healthy
Even though degenerative disc disease is most often due to age, it can also be influenced by lifestyle factors. To make sure you keep your spine as healthy as possible, eat a balanced diet and exercise regularly. Don't smoke, because, aside from its other affects on your health, smoking is a risk factor for cervical disc disease. Also watch your posture, always keeping your neck straight and your back well supported. 
 
Although neck pain from cervical disc disease can return, you'll lower the chances if you take good care of your neck and the rest of your body. Most people don't have constant neck problems throughout their lives. Usually it comes and goes. ”If you have a problem with your neck now, the odds are it won't last forever."