Chronic Neck Pain
The Neck
The neck is a very important part of the body, as an extension of the spine it supports the weight of our head day in and day out. It is made up of seven vertebrae that are called the cervical vertebrea, they are similar to the ones found in the spine. Just as the vertebrea in the spine they contain discs, these vertebrea protect the spinal cord and a series of nerves that control functions throughout the body. Other structures in the neck are ligaments, veins, arteries, the trachea, esophagus, larynx, lymph glands, parathyroid glands, and muscles . The muscles and ligaments of the neck are very strong and flexible, but they are also easy to injure if not taken care of properly or they become severely stressed. Just as back pain can be frustrating neck pain can be just as well. It is estimated that over 13 percent of American's suffer from chronic neck pain. Almost 75 percent of adults can atleast remember a time when their neck was considered to be either stiff or sore. However, with the technology we have today most neck pain or injuries can be relieved or greatly reduced with a little medical assistance.
Causes of Neck Pain
The most common injury to the neck is having a sprain or strain, these can result from to much stress on the muscles or ligaments in the neck. This is considered to be a minor injury, it can however cause mild to severe pain and may result in your neck becoming very stiff and sore. Most often this can be a result straining your neck while you sleep, it is also common after being a car accident or a major fall.
Like disks in the back, the discs in the neck can become herniated or ruptured as well. As we progress in age these discs can become thin and brittle putting extra stress on the joints. This can cause the disc to press against a nerve, this may cause severe pain, numbness or a tingling feeling in one of your arms. Arhtritis can also become an issue as we get older, this can cause damage joints in the neck resulting in stiffness and severe pain as well. These are only a few of the conditions that can cause chronic neck pain, below this paragraph are a few more along with there description.
* Rheumatoid Arthritis - is a type of chronic arthritis that typically occurs in joints on both sides of the body (such as hands, wrists, or knees). In addition to affecting the joints, rheumatoid arthritis may occasionally affect the skin, eyes, lungs, heart, blood, or nerves.
* Osteoarthritis - is a disease of the joints. Unlike many other forms of arthritis that are systemic illnesses, such as rheumatoid arthritis and systemic lupus, osteoarthritis does not affect other organs of the body.
* Cervical Disc Degeneration - as we age, the discs in our cervical spine begin to flatten and wear down. When a disc flattens, it forces the vertebrae closer together, which can put added stress not only on the disc itself, but also on the surrounding joints, muscles, and nerves. This process is called Cervical Disc Degeneration, and can lead to several painful conditions.
* Vertebral Compression Fractures - this occurs when the bones of the neck are broken due to trauma. The force required to fracture these types of bone is quit substantial. Most often patients who are suffering from osteoporosis end up with this type of fracture, cancer patients, and the elderly may not require as much force either.
* Fibromyalgia - results in widepread musculoskeletal pain, this is a chronic disorder and effects multiple points of the body. It most particularly effects the hips, neck, back, shoulders, and knees. It causes the person to suffer severe pain, morning stifness, anxiety, and fatigue. There will be a section dedicated to this disorder in a later chapter.
* Muscle Strains - A sprain occurs when the ligaments in the neck are stretched or torn beyond their normal range of motion. This may happen during sudden movements that causes the neck to extend, then snap back, with extreme force. This is also refered to as whiplash, they can all so be the result of a fall, impact or contact with another person, object or surface.
* Spinal Stenosis - a medical condition in which the spinal canal becomes narrow, it then compresses the nerves in the neck and the spinal cord. This is usually the result of spinal degeneration that normally occurs with aging. It can also sometimes be caused by spinal disc herniations, osteoporosis, or a tumor.
* Cancer - is any of various malignant neoplasms characterized by the proliferation of anaplastic cells that tend to invade surrounding tissue and metastasize to new body sites. There are several different types of head and neck cancer, categorized according to the specific tissue or organ where the cancer originates these can tend to cause chronic pain throughout the body as well as the neck. There will be a section later in this website where we discuss this horrible condition.
Symptoms of Chronic Neck Pain
Just because you are experiencing some of the following symptoms please do not assume you are automatically suffering from chronic neck pain. This is not a substitute for a professional medical opinion in any way. These symptoms may indeed be caused by other conditions and you should consult your physician
* Shoulder Pain * Tingling Sensations
* Muscle Spasms * Loss of Motion in the Neck or Arms
* Muscle Aches * Numbness in the Arms and Shoulders
* Dull Pain * Pain Radiating Down the Arms
* Sharp Pain * Burning Pain
Diagnosing Neck Pain
When diagnosing neck pain it is important to be completely honest with your physician. To diagnose chronic neck pain you will need to first speak with your doctor, by explaining your families medical history and having a thourough medical examination done he/she may be able to identify any dangerous conditions that may be associated with why you are having pain. During the examination you should describe any previous conditions you feel may be contributing to why you are in pain. Go into detail about any movements or events that bring on pain, where the pain is located, how severe it is, how long the pain usually last, and any physical limitations that it may cause during your normal daily activity. By doing this he/she will be able to give you the best assessment and a treatment plan for your condition. Your doctor may also perform an examination that first requires you to relax your neck, you will then be asked to move your neck in several different directions to test the range of motion. After this a neurological test should be performed to pin point the cause of pain or wether nerve involvement is present. The tenderness of the neck can be detected during the necks palpations.
There are many different methods used to determine what may be causing you to be in pain, the following are the most common test that would be performed to diagnos neck pain:
* MRI - this is know as magnetic resonance imaging, the scanning equipment creates a magnetic field around the body, this in turn causes the water molecules inside your bodies tissues to realign. Radio waves are then passed through the body to detect the relaxation of the molecules, the molecules then move back into a random alignment which triggers a resonance signal at different angles throughout the body. A computer then processes the resonance and creates a three-dimensional image of the scanned tissue. It can differentiate between soft tissues, bone, and fluid filled spaces. This procedure is used to evaluate a patient for conditions such as injury or disease to tissue, neveres, blood vessels, muscles, ligaments, and bone degeneration in the necks cervical region. This type of test is most often used to diagnose conditions that may need immediate and urgent surgical treatment.
* X-Rays - are most likely the first imaging device to be used, a technician passes a concentrated beam of ionized radation through the body that can produce an image within minutes. The images show the clear bony structure of the neck and can be used to determine if there are any broken bones, injured vertebra, or fractures. This may be performed at a hospital, doctor's office, or health clinic.
* Myelography - is a type of imaging examination that involves inserting a special needle into the spinal/cervical canal. Contrast material is then injected into the space around the nerve roots and the spinal cord. This procedure uses a real time x-ray called a fluroscopy to view the postion of the contrast material, this can determine if is any damage to the spinal cord, nerve roots, or meninges. Meninges are membranes which surround and cover the nerve roots and spinal cord.
* CT Scan - also known as computerized tomography are used to diagnose damage to the vertebrae, spinal stenosis, and ruptured disc. These test may be conducted at a hospital or within a mobile command unit. The test consist of X-rays passing through the body at a varity of different angles to produce images called slices, these are picked up by a computerized scanner. The images produce a two-dimensional picture of the neck that a physican can use to determine the source of your pain.
* EMG - known also as electrodiagnostic procedures, this is a type of nerve conduction test that includes electromyography (EMG) and evoked potential studies (EP). The EMG test uses two sets of electrodes that are placed over a particular muscle, very fine needles are then inserted to measure the electrical activity transmitted from the brain/spinal cord to a particular part of the body. When the first test is conducted a mild shock is used to stimulate the nerve of the particular muscle, the second electrode is then used to record the nerves electrical signal. An EP test is quit similar and uses two electrodes as well, the first set is used to stimulate a sensory nerve while the other is placed on the scalp to record transmissions to the brain. These test can be used by the doctor to determine wether or not nerve damage is the result of your pain.
Treatment Options for Chronic Neck Pain
There are many different options avaliable for the treatment of chronic pain. Some are considered to be invasive procedures, while others may be simple as going to see your chiropractor. Most treatments depend on the beliefs of the patient and what type of plan he/she has discussed with their doctor. This is usually refered to as a treatment plan, it can consist of multiple different procedures, surgeries, or medications. As for now we will not discuss the types of different procedures, I plan to dedicate a section of this site to the many different types in pain managment chapter. As most of these can be used to treat more than just neck pain alone.
Preventing Chronic Neck Pain
While there is no guranteed way to prevent you from ever suffering from neck pain there are a few tips that can lesson the chances of it happening to you. For example, when you are planning to take a long trip or spend alot of time in front of a computer make sure to take breaks as often as possible. These are considered to be stationary activities, remaining in these positions for a long period of time can result in unnecessary strain on muscles in the neck. You can also reduce the strain on your neck by maintaining good posture, don't slouch or keep your neck in an akward position for long periods of time. This will prevent you from developing a crick in the neck.
When sleeping at night it is best to rest on your back or side, this will help the body to maintain the appropriate posture throughout the night and lesson the chance of developing sleep related strains. You may also find that using a supportive pillow will help the neck relax and increase your sleep efficency. When you awake in the morning it is always good to strectch the neck, back, and shoulders from the previous nights rest. This will help the body to stay loose and comfortable throughout the day as well, you may also stretch a few times during the day as needed. Never pop your neck as if you are a chiropractor, not doing this properly can result in serious injury. It has been know to break the neck and cause irreversible damage, make sure that your chiropractor or a trained professional are the only ones who attempt to perform this type of procedure.
When working in an office always make sure the desk chair, keyboard, and monitor are at the appropriate height. This will help you to remain comfortable during work hours, when most people are confined to a chair with little or no movement throughout the day. This is a common reason for neck injuries and strains. You should also make an attempt to walk around as much as possible, this will prevent the body from becoming stiff and sore. Try to take mirco breaks during a time when you have completed a set amount of work, then take the time to stretch before moving on to the next project.
These are only a few or the things that can help prevent you from developing chronic neck pain. Most importantly you should always exercise and take care of your body. Eating the proper foods and making sure the body gets the rest it needs each night will also help you to stay fit and strong. This will be an important factor in reducing injury and it helps the body recover faster if/when it does become injured.
Chronic Neck Pain Research
There are many different studies that are focused on identifying and treating chronic neck pain. However, it has been discovered that the majority of patients suffering from this condition benefit more from alternative medicine therapies than any other. Chiropractic therapy and theraputic massage are the most popular, though little is know about the effectiveness for long term relief of this condotion.
In a study funded by the National Center for Complementary and Alternative medicine, it was found that after 10 weeks of theraputic massage treatment the study group showed significant improvement in symptoms and over all function. The evidence showed that the strongest amount of improvemnet was shown at the 4 week period than at any other time during the study. This study was made in comparison with a group that performed self-care and had little or no success in their treatment.
As for chiropractic treatment a study in May of 2002, showed that 70 percent of all patients with chronic neck pain felt better and showed significant improvement after just 6 weeks of chiropractic therapy. This is in comparison with a self-care group, where only 30 percent of patients who underwent this study showed signs of relief after the same period of treatment. It is however recommended that more studies are needed before chiropractic therapy can be recommended for being an effictive treatment for relief of chronic neck pain.
Resources
* The American Academy of Orthopedicac Surgeons
* U.S. National Library of Medicine