Understanding Neck Pain
By Jakob van Vlijmen
M Chiro, DC
Many different injuries can literally be a pain in the neck. Neck pain is quite common and it’s estimated that over 60% of the population will have experienced neck pain at some point.
Because your neck is the mechanical connection of your body/spinal column to the skull/brain, it is quite sensitive and vulnerable to particular stresses, injuries, conditions, and infections that can cause you to feel neck pain and discomfort. The cervical spine is made up of 7 vertebrae. The first 2, C1 and C2, are highly specialized and are given unique names: atlas and axis, respectively. The C3 - C7 are more classic vertebrae, having a body, pedicles, laminae, spinous processes, and facet joints. Each vertebral body is separated by an intervertebral disc which acts as force dissipaters, transmitting weight bearing loads when upright and throughout movement of the head.
Certain injuries can result in neck pain and it is important to understand the characteristics of the pain to better understand what injuries and structures are involved in generating your neck pain.
Disc Bulges/Prolapse – Often characterised by sharp localised neck pain often associated with numbness and pins and needles shooting from your neck to a particular part of your arm/hand. It is often one sided though can progress to both limbs depending on the direction of the disc bulge onto the nerve or spinal cord.
Facet Joints – A localised sharp catchy sensation of pain, though a sprain of this joint is less often associated with a radiating sensation of pain and numbness/tingling to the limbs.
Muscle Spasm - Muscle spasm is often an accessory characteristic to injuries of both facet and disc pain. Though muscle pain can be a primary neck pain generator in itself also. Poor posture is often a primary generator of muscle mediated neck pain. Poor posture can change the load bearing capacity of the muscles that move and stabilise the movement of the neck/head. When your neck is in an awkward position for an extended period of time i.e. when you are reading in bed, sleeping on stiff pillows, sitting in front of a computer, carrying a shoulder bag — it can strain your neck and cause pain. Neck pain that results from poor posture tends to show up as more an achy sore/stiff sensation of pain.
Whiplash - Considered being the most common trauma to the neck, which involves a combination of the above primary pain generators. It is caused (without going into too much detail) by rapid uncontrolled movement of the neck commonly flexion/extension movement and also associated with other nonspecific signs such as a headache.
Other - More systemic causes of neck pain need to be ruled out and assessed by a health professional as they may require more specialised medical care also. This pain will generally be more constant in nature and pain is often associated with other non-specific signs such as fever, muscle wasting, nocturnal pain, changes in bowel/bladder habits and sometimes very intense headaches, dizziness, blurred vision, etc. Some of these conditions include Tumours (of the brain and spinal cord), Meningitis and other viral infections, Spinal Stenosis (a degenerative condition which narrows of the joint spaces/openings around the spinal cord and nerve roots), and autoimmune conditions such as Ankylosing Spondylitis.
General and Orthopaedic assessment needs to be performed by a qualified primary health practitioner to not only diagnose the cause of your neck pain but to also eliminate the possibility of any underlying serious conditions which may require immediate medical referral.
The level of research into conservative (non-surgical) treatment of mechanical pain in the cervical spine (including chiropractic) compared to medication is improving. There is growing body of work whereby recent studies suggest that conservative treatment is just as if not more effective as drug therapy in both short and long term time frames. The benefits of conservative (non-surgical) care, particularly chiropractic care focuses on precise interventions (cervical adjustments, mobilisations, soft tissue releases) to the tissues that is irritated/damaged/dysfunctional thereby addressing the cause of the pain (i.e. the anatomical structure generating the sensation of pain), rather than just masking the symptom of the pain you feel.
As mentioned above postural overlay to neck pain is often a primary factor relating to the recurrent nature of the mechanical neck pain you may feel. As with any mechanical complaint early diagnosis and treatment optimises your ability to heal and addressing the underlying mechanism of injury (i.e. the quality of your movement or easing the aggravating load to the injured tissues), outcomes can be longer lasting.