Your neck is made up of small bones called vertebrae which are stacked on top of each other and held in place by ligaments, muscles and joints. This spinal column supports the head and protects the spinal cord. The spinal cord is the main structure which links the brain to the rest of the body. All the messages and sensations like pain, touch travel from the body to the brain via the spinal cord and vice versa.
Because of the structure, the neck has a significant amount of motion and is less protected as compared to the rest of the spine. Any injury, inflammation or abnormality can cause neck pain. In some people the pain may radiate to shoulders, arms and even fingers.
What causes neck pain?
Neck pain can happen due to abnormalities in the bones (vertebra and disc) or the soft tissues surrounding the bones (muscles, ligaments) or the nerves. In rare instances, neck pain may be the result of a tumor or infection.
Many people develop pain and stiffness in the neck due to no specific reason. It may happen due to a minor twisting injury or muscle soreness. This is called non-specific neck pain and is a very common type of neck pain. Sleeping or lying down in an awkward position also predisposes to neck pain. Worry and stress is also a risk factor.
Cervical Spondylosis
The vertebrae have discs between them which act as shock absorbers and protect the vertebrae and other important structures. Cervical spondylosis is a condition where this disc degenerates and start to move out of its position reducing the space between the vertebrae. As this happens, the stress on the vertebrae and the joints increases leading to wear and degenerative disease. This disc may also move backwards (herniated disc) and irritate the spinal cord and the nerves. Cervical spondylosis typically occurs above the age of 40 years but younger individuals are also getting affected nowadays.
Injury
Because of the flexibility of the neck it is extremely prone to injuries. The injuries can happen after falls, in contact sports or in accidents. Commonly the muscles and ligaments are injured but severe injuries can also cause fracture of the vertebrae which can be life threatening.
Neck pain Symptoms
Pain and stiffness
Initially the pain starts in the middle of the neck or on either side and can spread to upper back, shoulders, arms and the fingers. Sometimes, the pain travels to the back of the head and the eyes. This pain causes muscle spasms which makes the movements of the neck difficult and painful. It is more painful when the neck is moved after sleeping or sitting a long time.
Numbness and Tingling
If the nerves or the spinal cord is compressed or getting irritated, then you may have numbness or tingling sensation in your fingers or hands. Prolonged involvement of the nerves may damage them permanently. This should not be taken lightly and treatment should be started early to prevent permanent damage.
Dizziness and vertigo
Noises from the neck
When to consult a doctor?
If you’ve had an accident and have pain in the neck, you need to consult immediately. A cervical spine injury can cause paralysis and can be even life threatening.
Numbness or pain radiating to the arms, hands or fingers even without significant pain in the neck.
If your neck pain is severe, persistent for days and not relieved by analgesics.
How to diagnose Neck pain?
Your doctor will take a detailed history and examine your neck. He/she will check the presence/absence of any tender spots, muscle spasms, whether there is any numbness or muscle weakness, movements of your neck.
Your doctor may also advice any of the following investigations to arrive at a diagnosis
X-ray
An X-ray of the cervical spine shows the cervical vertebrae with the disc spaces in between them. Bone spurs and degenerative changes are seen in the x-ray. In acute injuries fractures can be diagnosed. Tumors can also be diagnosed in advanced stages.
MRI
MRI is the investigation of choice for detailed imaging of soft tissues specially spinal cord and nerves. Bone edema, ligament injuries, herniated discs are very well visualized on MRI.
It is possible to have changes in the X-rays and MRI without any symptom. So the imaging should always be correlated with history and physical examination.
Blood tests
Blood tests provide evidence of inflammation and infection in the spine. They are also used to diagnose Vitamin D and Vitamin B12 deficiency which may be contributing to your symptoms.
How to treat Neck pain?
Most of the neck pain can be treated by conservative measures, avoiding injury and gradual rehabilitation.
Applying hot packs for 10 minutes at a time for 3-4 times in a day
Medications such as muscle relaxants, analgesics are used for relief in acute pain. Supplements and steroids are also used in selected patients.
Cervical collar – Short term immobilization provides rest to your neck and helps in reducing muscle spasm and reducing inflammation.
In severe conditions, localized steroid injections and surgery are needed.
10 Tips to prevent Neck Pain
1. Use a good posture specially while working. Keep the monitor at eye level. People working on a laptop usually hunch or look down on the screen which causes stress on the neck. Your gaze should be directly at the top third of the screen.
2. Exercise and stretch your neck everyday. Slowly stretch your head in side-to-side and up-and-down motions.
3. Avoid cradling your phone between your neck and shoulder. Hold the phone with the hand or if your hands are busy use hands-free/earphones/headset.
4. Avoid overuse of mobiles. Looking down on a mobile phone puts stress on the neck. Try to limit the usage or take frequent breaks in between. Also while using it keep it at a higher level to lessen neck bending.
5. Carry weights evenly. If your carrying a backpack, make sure to carry it over both the shoulders. For items such as briefcase or a purse, try to travel light and carry essential items only.
6. Stay hydrated
7. Massage your neck. Gentle neck massaging relieves tension and stress in your neck muscles making it relaxed.
8. Sleep on your back or use a soft pillow. The natural alignment is the head being between the shoulders. Try to maintain this while sleeping whether on your back or on your side.
9. Watch TV siting upright and unsupported. Posture must be maintained.
10. Avoid looking at one side to talk to people. This puts stress on your neck. Face poeple while talking to them.
Neck stretching exercises to relieve neck pain
Exercises and gentle stretches makes the neck muscles stronger and limber. A strong neck helps with the pain in the shoulders and upper arms also.
If your pain increases with these exercises, stop right away and consult a doctor.
10 sets of each should be done in each sitting
1. Backward and Forward Tilt
This can be done while standing and when you’re seated.
Keep your back straight and your head squarely over your shoulders.
Tilt your chin towards the ceiling and bring the back of your head towards your back. Hold for 15-20 seconds and return to the start position.
Next lower your chin towards your chest and hold for 15-20 seconds. Relax and return to the original position.
2. Side Rotations
This can be done while standing and when you’re seated.
Keep your back straight and your head squarely over your shoulders.
Slowly turn your head to the left until you feel a stretch in the side of the neck and shoulder. Hold for 15-20 seconds. Relax and return to the original position.
Now repeat on your right side.
3. Side Tilt
This can be done while standing and when you’re seated but standing with feet a bit apart and arms down by your sides is a better position.
Gently tilt your head to the left shoulder and try touching your ear to it without raising your shoulder. Stop when you start feeling a stretch.
Hold for 10-15 seconds and return to the original position.
4. Shoulder Rolls
This is best done in a standing position.
Raise your shoulders straight up and move them in a circle going forward. Do it 5-10 times.
Return to the starting position. Raise your shoulders again and now move them in a circle going backward. Do it 5-10 times.