Neck Pain

Neck Pain

The neck is also known as the cervical spine is made up of vertebrae that begin in the upper torso and end at the base of the skull. The vertebrae along with the ligaments and muscles help provide stability to the spine. The muscles in the cervical spine allow for support and motion of the neck. 

The neck has the ability to move in certain directions and helps support the weight of the head. However, since it’s the less protected part of the spine, the neck can be vulnerable to injury and multiple disorders that produce pain and restrict motion. 

For most people, neck pain is a temporary condition that can disappear with time. For others with more severe cases a medical diagnosis by a physician may prescribe physical therapy or for worst case scenarios, surgery might be the next step.

Woman experiencing neck pain

What are the Causes of Neck Pain?

The quick answer is the causes of neck pain may result from abnormalities in the soft tissues: the muscles, ligaments, and nerves in the cervical spine as well as in bones and disks of the spine. The most common causes of neck pain are soft-tissue injuries such as a sprain or a muscle spasm or prolonged wear and tear such as when a person sits at a desk for extremely long periods of time. Watch this VIDEO to learn more about pinched nerve in neck.

In some people, neck problems may be the source of pain in the upper back, shoulders, or arms which can also cause tightness in the neck. The following list is some common causes with a brief description.

• Whiplash: Usually happen after a car accident when hit from behind. The neck and head moved backward after the body stops moving after the head is moved forward. Usually, this causes strains as well as possible tears in the neck.
• Degenerative Disc Disease: This usually happens as we get older in age. As we get older the disc in between the vertebra starts to dry out. As this happens, the distances between the vertebra get smaller thus causing bone on bone as well as narrowing the actual disc.
• Herniated Disc: A disk herniates or ruptures when part of the center pushes through the outer edge of the disk and back toward the spinal canal. This puts pressure on the nerves. Spinal nerves are very sensitive to even slight amounts of pressure, which can result in pain, numbness, and tingling.
• Cervical Spondylosis: A type of degenerative disease that affects your neck. With cervical spondylosis, these disks become compressed. When this happens, the cartilage that lines the vertebrae on each side of the disc, where they touch, can wear away. Once this protective cartilage is gone, spurs may develop on your vertebrae where they rub together. Nerves attached to your spinal cord may have less room to pass between the vertebrae on their way out of the spine.
• Cervical Spine Stenosis: Stenosis refers to a narrowing of the spinal canal to a degree where the spinal cord or nerve roots may be compromised. Spinal stenosis may occur throughout the spine, however, is more dangerous in the neck due to the presence of the spinal cord.

Diagnosis of Neck Pain

If neck pain is the result of trauma or if it keeps coming back a doctor will probably request diagnostic testing for more information about what might the medical cause.

• X-ray: An X-ray gives a good picture of the bones. This can be used to identify spinal degeneration, fractures, or even tumors.
• CT scan: A CT scan provides a series of cross-section images, which enables better viewing of the bones than a regular X-ray. CT scans are better than MRI’s for identifying subtle bone changes.
• MRI scan: An MRI detects variations in the anatomical structures of different tissues to create a series of detailed cross-sections of the soft tissues and bones. Unlike an X-ray or CT scan, an MRI can show soft tissues and does not use radiation.
• Nerve conduction study: Could be performed to test the electrical activity of the nerves neck and arms. These tests measure the speed at which electrical signals are being sent along nerves and can give clues as to the location of where a nerve might be having a problem.
• Bone scan: A bone scan can identify areas of increased bone activity. This can identify subtle fractures, as well as areas of bone degeneration. While it is a useful study, there is a significant radiation dose associated with bone scans. Physicians are becoming more cautious because of the concern for the long-term effects of radiation.

Physical Therapy Treatment of Neck Pain

Your first visit with the physical therapist will comprise of a complete evaluation. He or she will assess how well you can move your neck. You may be asked about symptoms such as pain in the neck or between the shoulder blades, pain that radiates down the arm to the hand or fingers, or numbness or tingling in the shoulder or arm. Your strength, reflexes, and other potential sources of pain will be checked. 

The therapist will also assess joint function in your neck and back to identify limitations or dysfunctions that may contribute to your pain. There are several types of manipulations and exercises your physical therapist or can use to relieve stiffness/tightness in the neck. 

The therapist will also prescribe strengthening and stabilization exercises to help maintain posture in the neck. Treatments such as cold or heat application, deep tissue massage, electrical stimulation, and ultrasound may be used prior and after treatments. They will also provide a program on the proper way to stretch your neck and increase motion. 

One device used by physical therapists to provide pain relief and improve motion is cervical traction via machine or manual (therapist provided traction). Traction gently extends the neck, opening the spaces between the cervical vertebrae and temporarily alleviating pressure on the affected discs. Neck traction can either be done continuously or intermittently, alternating between short periods of pulling and resting.

Neck Pain Physical Therapy

If you are interested in receiving physical therapy, visit us at one of our 12 rehab physical therapy centers or three spine centers. Posture while working at your desk at work or while working at home plays an important role in your pain in the neck.  Please look at this illustration of the proper posture while seated at your desk. Taking breaks to stretch out the muscles of your shoulder and neck can really decrease your neck pain.

Neck Pain can be caused by your posture at your desk
 

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