Cervical / Neck Pain

The Cervical Spine: Roles and Functionalities

The cervical spine maintains several crucial roles, including:

• Housing and protecting the spinal cord. A bundle of nerves that extends from the brain and runs through the cervical spine and thoracic spine (upper and middle back) prior to ending just before the lumbar spine (lower back), the spinal cord relays messages from the brain to the rest of the body.
• Supporting the head and its movement. The cervical spine literally shoulders a big load, as the head weighs on average between 10 and 13 pounds. In addition to supporting the head, the cervical spine allows for the head’s flexibility, including rotational, flexion/extension and lateral bending motions.
• Facilitating flow of blood to the brain. Vertebral openings (vertebral foramen) in the cervical spine provide a passageway for vertebral arteries to pass and ensure proper blood flow to the brain. These openings are present only in the vertebrae of the cervical spine.

The cervical vertebrae play a key role in maintaining these functions in the neck.

Types Of Neck Pain

While neck pain (in the cervical spine) is less common than lower back pain (in the lumbar spine), millions of people experience neck pain and/or related arm pain at some point in their life.

• The vast majority of episodes of neck pain will get better with time and can be addressed with non-surgical treatments. However, there are a few symptoms that are possible indications of a serious medical condition and patients with these symptoms should seek medical attention immediately.
• Progressive neurological deficit (weakness in the arms or loss of feeling and coordination in the arms or legs) could indicate nerve damage.
• If sustained or increasing pain is accompanied by lack of appetite, unplanned weight loss, nausea and vomiting, or fever/chills/shakes, there could be a spinal tumor or infection.

While many episodes of neck pain have no identifiable anatomical cause, certain types of neck pain and arm pain can be linked to a general cause (such as muscle strain) or a diagnosable condition (such as cervical herniated disc or cervical stenosis).

Acute Neck Pain

Most episodes of acute neck pain are due to a muscle strain or other soft tissue sprain (ligaments, tendons). This type of injury can be caused by a sudden force (such as whiplash) resulting from a car accident, or from straining the neck (such as a stiff neck| from sleeping in the wrong position, or a strain from carrying a heavy suitcase).

Chronic Neck Pain

There are many conditions that can cause chronic neck pain.

• Neck Pain That Radiates Down the Arm - Pain that radiates down the arm, and possibly into the hands and fingers, is frequently caused by a cervical herniated disc or foraminal stenosis pinching a nerve in the neck.
• Neck Pain That Is Related to Certain Activities or Positions - Neck pain that develops slowly (often over a number of years) and tends to occur during or after certain activities or neck positions is frequently caused by cervical foraminal stenosis. Usually, impingement of one nerve root on one side of the spine causes most of the symptoms.
• Arm Pain with Lack of Coordination - Pain that radiates down the arm, along with symptoms such as lack of coordination in the arms and legs, difficulty with fine motor skills, and occasional intermittent shooting pains, is commonly caused by cervical spinal stenosis with myelopathy. These symptoms, which are caused by either a cervical herniated disc or degenerative changes in the joints that can cause pressure on the spinal cord, generally develop slowly.