Thousands of Americans suffer from episodes of acute or chronic neck pain each year as a result of injury, strain, overuse or aging. However, a pain in the neck should not be ignored and left undiagnosed and untreated. Problems in the cervical spine, the first seven bones (vertebrae) in the neck running from the base of the brain to just past the shoulder blades, require assessment and treatment to prevent further, more permanent, damage. The cervical spine is where the spinal cord lives. The spinal cord is the most delicate tissue in
the entire body. Even minor damage to the spinal cord cannot be repaired. Unlike low back pain, in which waiting to seek treatment may prolong the pain but usually doesn’t cause any further damage, untreated spinal cord compression can lead to irreversible damage.
Two Types of Neck Pain
There are two distinct types of cervical neck pain. The first type often involves a dull pain in the neck that radiates down the shoulders and arms. Patients may also notice weakness in specific muscles in the arms.A herniated (bulging) disc in the spine pinching a nerve root in the neck often causes this type of neck pain. Discs are found between each vertebra, or bone, in the spinal column. They serve as “shock absorbers” within the spine and have a gel-like center that makes them flexible, allowing the spine to bend and move. However, because the discs are soft they can also bulge and become misshapen. When this occurs, they can place pressure on the spinal cord or irritate one of the nerves leading from the spinal cord out to the arms and upper torso. If the bulge becomes severe, the disc may herniate and push into the spinal canal.
The result can be weakness, tingling, clumsiness and numbness in the arm and hands. Bulging discs can be caused by injuries like whiplash, stress on the spine by overuse, or by arthritis/degeneration in the spine. The second type of neck pain often isn’t experienced as ‘pain’ by patients at all. It usually involves numbness or weakness in the arms or legs, difficulty walking, loss of pain or temperature sensation in the hands and arms, poor balance and stiffness in the neck. In this case, there is pressure directly on the spinal cord.
Because this type of “pain” is not felt in the neck itself, it is easily misdiagnosed.We usually see patients with neck pain in one of three different scenarios. One, they’ve been in some sort of accident and have suffered a whiplash-type injury. Two, they have a chronic injury caused by overuse, most likely caused by working at a computer for endless hours. Or they’ve experienced one of the first two scenarios in the past and now have arthritis or a tissue degeneration problem.
A more common neck injury is whiplash. Symptoms include neck stiffness, shoulder or arm pain, headache, facial pain and dizziness. Aggressive physical therapy, time and medication are often the most effective treatment for whiplash injuries, unless there is a herniation of a disc in the cervical spine. If the symptoms still persist after four to six weeks, or if there is severe weakness in the arms, hands or legs, a consult should be considered.
The neck is also susceptible to osteoarthritis and degenerative disc disease, which can be caused by general wear and tear on the spine. The discs begin to lose their flexibility and ability to absorb stresses in the spine. Or, bone spurs develop on the vertebrae. In either case, the nerves in the cervical spine can become irritated or pinched, causing pain in the neck or the arms. If there is a great deal of degeneration in the cervical spine, the spinal cord and nerve roots may become compressed, causing irreversible damage. Cervical stenosis is another condition that may result from degeneration in the spine. It occurs when the spinal canal narrow