What is Neck Pain?
Neck pain can be explained as varying levels of discomfort or tenderness felt in the cervical (top) area of our spine.
The neck is made up of seven small bones called vertebrae. Combined together they form a support network between your head and the rest of the body. Nerves, blood vessels and various other body tissues are all carried along this biological bridge.
This is why it can be a symptom of a wide number of causes, spanning from minor to the severe. It’s also considered one of the most common types of musculoskeletal complaint reported, with a frequency of up to 75 percent in some parts of the world.(1)
Causes
It can be tricky to pinpoint the exact cause of the neck pain. Some causes may not even be identified.
There are three classifications of neck pain: acute neck pain, chronic neck pain and non-specific neck pain. Acute is pain which lasts less than three months, whereas chronic will go on for more than three months.
If there is no definitive cause, it will be classified as ‘non-specific neck pain’. (2)
Here are a few conditions which can cause neck pain:
Cervical Dystonia
Cervical dystonia, or spasmodic torticollis, is a painful disorder which causes the muscles in the neck to contract unintentionally.
When the muscles tighten up, the neck is seen to twist and turn, it can even cause the head to move forward or backward, which can be very painful.
Though the disorder is rare, it can affect any one. However, it is more often reported within the middle aged bracket and women tend to develop it more than men. (3)
Cervical Spondylosis
This is a condition where the spinal discs located in the neck are worn as a result of usage over time.
As we grow older, the space between the vertebral bodies can become smaller and cause slight bone growth along the edges, which leads to osteoarthritis. (4)
Osteoarthritis is most common in the knees, hands or hips. But it can affect the spine as well, causing pain and stiffness.
Fibromyalgia
Fibromyalgia is a condition which causes widespread pain in the muscles.
It also has complications in the form of fatigue or sleep issues, it can cause memory or mood swings and sometimes even lead to depression and anxiety.
In the US about two percent of the adult population is affected by fibromyalgia. (5)
Cervical Disc Herniation
A disc can be described as a fluid filled cushion between the bones, these run the length of the spine. The ones near to the neck are called cervical discs.
If a disc tears fluid will leak out and cause a hernia. This can put pressure on and irritate the nearby nerves, causing pain in the neck area.
The discomfort can continue down the arms through the fingers and depending on where the hernia took place, can be on one or both sides of the body.
Some may even experience weakness or numbness in the arms or legs.
Meningitis
Meningitis is where an infection strikes the membrane surrounding the brain and spinal cord, causing serious inflammation.
This inflammation can cause stiffness in the neck and sometimes pain. Some people will show febrile (fever) symptoms or seizures and even behavioral changes. In severe cases it can lead to brain damage or stroke. (6)
Cervical Stenosis
This condition occurs when the spaces between the vertebrae become smaller causing nerves to be compressed. This can lead to pain, weakness and even numbness in the neck.
Spinal stenosis more often affects people over 50 years of age. However, it can also affect younger people who’ve suffered spinal injuries or infants born with a diminished spinal canal. (7)
Bad Posture
When many people sit down they have a tendency to bend the spine, thereby placing the back in an awkward position. This can cause tension in the muscles which can lead to pain and stiffness in the neck, even headaches.
Another example is where people don’t sit up straight, instead they lean forward. This puts more strain on the neck and causes pain.
Heavy Bags
This is a common cause of neck pain, especially in women. It’s very easy to overload one’s bag or purse, yet it can have serious impact upon the spine and the neck.
It’s also a common cause of discomfort for school children. Officials recommend a school bag should not weigh more than 10 to 15 percent of the child’s body weight. (8)
However, even with this directive, around 50 percent of school children still carry a bag that is too heavy. (9)
Whiplash
Whiplash is a type of injury resulting from a severe jerk to the neck. Many people suffer from this condition when involved in traffic accidents, yet participating in certain sports can also be a risk factor.
The symptoms of whiplash usually emerge within a day of the injury, neck pain and tenderness is normally one of them.
This type of injury should be checked by a doctor to make sure no further damage has been done. However, if you feel a tingling sensation or numbness and weakness in your legs or arms, seek medical attention right away.
Symptoms
For many people neck pain is usually not a sign of anything serious. It’s easy for the neck to feel tired or tender at the end of a long day.
Neck pain is usually divided into two categories: axial neck pain and radicular pain. Axial pain is felt in one specific area, whereas radicular pain spreads along the nerve, maybe to the back of the head or into an arm.
However, should neck pain accompany any of the following symptoms, medical attention should be sought urgently.
Restricted Movement
If you find it difficult to move, for instance your arms or fingers and get a sensation of pins and needles, this could be a sign of nerve damage and an early clue of paralysis.
Poor Sense of Balance
If you find your sense of balance is way off or your coordination is somewhat to be desired it could be an indicator of a serious injury.
Constant Pain
Following an accident or injury, if the pain doesn’t feel as though it’s getting progressively better, it could be a sign of something more serious. For obvious reasons it should be highlighted to your a doctor.
Weight Loss
In some cases neck pain is followed by a drop in weight, now this could be due to a lack of appetite following a traumatic experience.
However, weight loss which you cannot explain can also be a red flag of serious conditions such as cervical spondylosis or types of arthritis. (10)
Febrile symptoms
Febrile (fever) symptoms often occur when the body is affected by an infection or inflammation. It’s a natural response for the body to elevate its temperature.
Yet when febrile symptoms develop in association with back or neck pain, it could be a sign of a serious infection called epidural spinal abscess. This condition causes fluids and germs to build up around the outer part of the spine.
The standard treatment is antibiotics and operative drainage of the fluid. (11)
Diagnosis
When diagnosing the cause of neck pain, doctors have a few different methods.
Neck pain can be brought on by the most insignificant of factors, such as a long day, tension or carrying a heavy bag. Neck pain is not always caused by serious issues. (12)
The diagnosis process would follow along the lines of:
Medical History
First of all your doctor will ask you a series of questions to understand and determine why the neck pain started.
Questions may include: any recent accidents or injuries, the exact location of the pain and whether or not it’s causing any physical strains.
Inform your doctor if you have recently been exposed to mental stress as it can help diagnose the cause.
Physical Examination
After the initial questions, your doctor will perform a physical examination.
Your doctor might feel your neck and ask you to move your hands to check if your reflexes and muscle strength is normal.
Further Tests
If a clear diagnosis is still not conclusive, your doctor will suggest further in depth tests to either rule out or confirm certain causes.
These can include: CT scans, MRI scans or an x-ray.
The reason why doctors don’t jump straight to imaging techniques, is because irregularities of bones and spinal discs are not usually the source of the pain. (13)
If there is suspicion of possible infection, your doctor might also order blood tests.
FAQ
What is neck pain? Neck pain is the term used to describe pain or tenderness in the cervical region of the spine.
What causes neck pain? There are many reasons for neck pain. It can span from nothing serious which can be easily rectified across the board to a severe bacterial infection affecting the brain.
How do doctors test for neck pain causes? Doctors diagnose the cause of neck pain by asking various questions followed by a physical examination. If there is reason to believe further investigation is required, then, CT or MRI scans and x-rays will be done. In the case of a possible infection, a blood test might be ordered. (14)
When should you go see a doctor with neck pain? If the pain is accompanied by other symptoms, for example unexplained weight loss, fever, loss of balance or range of motion, you should see a doctor. If you have been in a serious accident and received injuries to the neck, medical attention should be sought immediately.
Can you prevent neck pain? Yes, correcting your posture and doing different stretches and exercises can help prevent minor neck pain.
What can relieve neck pain? Non-specific neck pain can easily be relieved with strengthening exercises, cold or hot applications, over the counter painkillers and massages. People with chronic pain might need pain management therapy which teaches how to deal with the symptoms to lessen the negative impact on daily life. (15)
Does neck pain require surgery? Only when it can bring significant improvement, such as removing spinal disc tissue which is pinching a nerve, although it’s not always needed. Neck surgery can be risky, therefore it is only actioned when it’s absolutely necessary. (16)
Should physical activity be avoided when experiencing neck pain? Only if other serious symptoms are present. In normal cases physical activity is emphasized as it can prevent further complications.
Summary
We have seen neck pain can be a hassle and can also be a debilitating pain to experience, yet it’s often a minor issue with nothing to worry about.
However, it can be accompanied by other symptoms which can be a sign of something far more sinister.
Therefore it’s vital to know how to identify and interpret when and how soon to seek medical help to ensure the best prognosis.