Neck pain is a common complaint. Neck muscles can be strained from poor posture — whether it’s leaning into your computer at work or hunching over your workbench at home. Wear-and-tear arthritis also is a common cause of neck pain. Neck pain is a feeling of discomfort between the jaw and shoulders. The sensation may be described as a stiffness, ache, or soreness or as pain that is sharp, dull, or radiating.
Neck pain may be due to a disorder in the cervical vertebrae (C1-C7), intervertebral discs, ligaments, spinal nerves (cervical plexus, C1-C5 or brachial plexus, C6-C8), muscles, tendons, blood vessels, glands, and structures in the throat. Neck pain can also be a symptom of a condition arising outside the neck.
The most common causes of neck pain arising from neck structures are sports injuries, auto accidents (whiplash), compression of the spinal cord or nerves by spinal stenosis or disc herniation, muscle overuse or misuse, spasm (torticollis), carotid artery disease, and bone or joint degeneration (osteoporosis, arthritis). Less common causes include masses (tumors, blood clots, or cysts), infections in the cervical spine (osteomyelitis, discitis, shingles), parotid gland or throat, and diseases such as ankylosing spondylitis or Paget’s.
Causes of neck pain arising outside the neck include infections in the ears or central nervous system (such as meningitis and poliomyelitis), headache or migraine, and systemic disorders such as fibromyalgia and polymyalgia rheumatic (pain in many muscles). Neck pain can also be a symptom of heart attack, brain aneurysm, or subarachnoid hemorrhage.
Neck pain is evaluated by obtaining a thorough history, including any traumatic injuries or surgeries involving the neck. The symptom history and physical exam should include a complete description of the onset, duration, and nature of pain in the neck, face, or head; of any changes in sensation (such as numbness or tingling, dizziness or lightheadedness, tenderness to touch); and of any changes in function (muscle weakness, difficulty swallowing, abnormal movements).
Studies may include X-rays, CT, MRI, and specialized imaging; electromyography and nerve conduction; and laboratory evaluations for infection or other systemic causes of neck pain.
When neck pain is the only symptom and function remains normal, it is treated with analgesic medications and muscle relaxants. Physical measures such as an exercise prescription, ultrasound, massage, and alternative therapies such as acupuncture may be prescribed. Neck pain associated with loss of function or due to a mass or infection typically must be treated surgically.
Depending on the location and nature of the problem and numerous other factors, your doctor may choose an anterior or posterior approach; each has notable risks as well as potential benefits.
Rarely, neck pain can be a symptom of a more serious problem. Consult the doctors at the Florida Spine Institute if your neck pain is accompanied by numbness or loss of strength in your arms or hands, or if you’re experiencing shooting pain into your shoulder or down your arm.
