Common sources of neck pain include Facet joints, Herniated discs, Muscles etc. The causes are almost similar to that for back pain. Other causes include degenerative disc disease and arthritis. Neck pain may also be caused by vehicular accidents causing whiplash neck injuries, some chronic diseases like Ankylosing spondylitis, Arthritis, Fractures and Dislocations, Myelopathy, Osteoporosis, Spinal Cord Injury, Spondylolysis, Stenosis etc.
The cervical spine in your neck is made up of seven bones called vertebrae, which are separated by discs filled with a cushioning gel-like substance. Aging causes these shock absorbers to wear & tear. The space between the vertebrae narrows and nerve roots become pinched. This process is known as cervical degenerative disc disease. As degenerative disc disease progresses, the neck becomes less flexible, and you may feel neck pain and stiffness, especially towards the end of the day.
When the disc breaks open or bulges out, putting pressure on the spinal cord or nerve roots, it is known as a herniated disc or "slipped disc." The pressure causes pain, numbness, or weakness radiating down your shoulder, arm, and hand.
To diagnose your cervical disc disease, thorough medical history along with detail examination of neck and if required, neurological examination of strength, reflexes, and the sensation in arm and hand. Commonly done tests are X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans to visualize your spinal cord to pinpoint the source of your neck pain.There are good chances that slipped disc can be treated with conservative measures, without surgery. The first line in treatment for cervical disc disease is pain medications which help to reduce pain and inflammation. Some muscle relaxant, antidepressant medicines may be added for chronic neck pain. Along with this physiatric can be used to reduce your pain and stiffness.
The next step is Epidural cortisone injection under live x-ray control. Other non-surgical treatment options are transforaminal selective nerve root injection, pulsed RF, discography, Percutaneous Nucleotome Discectomy as discussed in back pain section. >95% of moderate to severe neck pain do respond to these therapies. Surgery for spine pain is the last resort therapy & should always be avoided
Cervical facet arthropathy causes neck pain, or pain may get refered to occipital region(Posterior part of head), shoulder, upper back, upper arm. Upper cervical facetal arthropathy causes cervicogenic headache, occipital neuralgia.
It is managed initially with simple measures like pain medications & physiotherapy. If it is not getting controlled , interventional therapies like facet joint injection, Radiofrequency ablation of medical branch which supplies facets.
Neck pain (or cervicalgia) is a common problem, with two-thirds of the population having neck pain at some point in their lives.
Neck pain, although felt in the neck, can be caused by numerous other spinal problems. Neck pain may arise due to muscular tightness in both the neck and upper back, or pinching of the nerves emanating from the cervical vertebrae. Joint disruption in the neck creates pain, as does joint disruption in the upper back.
Neck pain may come from any of the structures in the neck including: vascular, nerve, airway, digestive, and musculature / skeletal or be referred from other areas of the body
Exercise plus joint mobilization and/or joint manipulation (spinal adjustment) has been found to be beneficial in both acute and chronic mechanical neck disorders. Neither mobilization or manipulation without exercise however has been found to be helpful. Mobilization is equivalent to manipulation. Ultrasound has been shown not to be efficacious
Analgesics such as acetaminophen or NSAIDs are recommended for pain. Muscle relaxants such as cyclobenzaprine have not been found to be useful and are therefore not recommended. Over the counter topical creams and patches containing counterirritants have little evidence to support efficacy.