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The Facts Behind Neck Pain

Symptoms and diagnosis

By Neurosurgery Singapore

What is consider as neck pain?

Pain located in the neck is a common medical condition. Neck pain can come from a number of disorders and diseases and can involve any of the tissues in the neck. Examples of common conditions causing neck pain are degenerative disc disease, neck strain, osteoarthritis, cervical spondylosis, spinal stenosis, poor posture, neck injury such as in whiplash, a herniated disc, or a pinched nerve. Neck pain can come from common infections, such as virus infection of the throat, leading to lymph node (gland) swelling and neck pain. Neck pain can also come from rare infections, such as tuberculosis of the neck, infection of the spine bones in the neck, and meningtis (often accompanied by neck stiffness). Neck pain can also come from conditions directly affecting the muscles of the neck, such as fibromyalgia and polymyalgia rheumatica as well as from uncomfortable positioning of the neck while sleeping with the head on a pillow. Neck pain is also referred to as cervical pain.

Risk factors for neck pain include injury from involvement in contact sports, motor-vehicle accidents, bull or bronco horse riding, etc. Prevention of neck pain in the context of these activities should include neck strengthening exercises and often neck bracing.

What are some symptoms related to neck pain?

Neck pain is a symptom commonly associated with dull aching. Sometimes pain in the neck is worsened with movement of the neck or turning the head. Other symptoms associated with some forms of neck pain include numbness, tingling, tenderness, sharp shooting pain, range-of-motion difficulties, fullness, difficulty swallowing, pulsations, swishing sounds in the head, dizziness or lightheadedness, and lymph node (gland) swelling.

Neck pain can also be associated with symptoms such as headache, facial pain, shoulder pain, and arm numbness or tingling (upper extremity paresthesias). These associated symptoms are often a result of nerves becoming pinched in the neck. Depending on the condition, sometimes neck pain is accompanied by symptoms such as upper back and/or lower back pain, as is common in inflammation of the spine.

“If neck pain lasts more than four weeks or keeps coming back, or if there are other troublesome symptoms (for example, neurological symptoms), then it is important to consult a medical professional for an evaluation.”

What types of treatments?

  • The most common types of mild to moderate neck pain usually respond well to self-care within two or three weeks. If neck pain persists, your doctor might recommend other treatments.

    Medications

    Your doctor might prescribe stronger pain medicine than what you can get over-the-counter, as well as muscle relaxants and tricyclic antidepressants for pain relief.

    Therapy

    • Physical therapy. A physical therapist can teach you correct posture, alignment and neck-strengthening exercises, and can use heat, ice, electrical stimulation and other measures to help ease your pain and prevent a recurrence.
    • Transcutaneous electrical nerve stimulation (TENS). Electrodes placed on your skin near the painful areas deliver tiny electrical impulses that may relieve pain.
    • Traction. Traction uses weights, pulleys or an air bladder to gently stretch your neck. This therapy, under supervision of a medical professional and physical therapist, may provide relief of some neck pain, especially pain related to nerve root irritation.
    • Short-term immobilization. A soft collar that supports your neck may help relieve pain by taking pressure off the structures in your neck. However, if used for more than three hours at a time or for more than one to two weeks, a collar might do more harm than good.

    Surgical and other procedures

    • Steroid injections. Your doctor might inject corticosteroid medications near the nerve roots, into the small facet joints in the bones of the cervical spine or into the muscles in your neck to help with pain. Numbing medications, such as lidocaine, also can be injected to relieve your neck pain.
    • Surgery. Rarely needed for neck pain, surgery might be an option for relieving nerve root or spinal cord compression.

Things you can do to ease your pain

If neck pain is not debilitating and didn’t start as the result of trauma, then often the pain can be treated by oneself. Self-care options for neck pain can include:

    • Rest. With most neck strains and sprains, going easy for a few days is all that is needed while the muscles and tendons heal on their own. It is important to be careful to avoid strenuous activities or movements that are causing more pain.
    • Ice and/or heat. Applying ice can work as an anti-inflammatory to reduce swelling and pain. Initially, it’s better to apply ice or cold packs for neck pain because they can temporarily close small blood vessels and prevent swelling from becoming worse. After a couple days, ice or heat can be applied on an alternating basis. Applying continuous heat can cause increased swelling.

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