The term “ pain in the Neck” shows how much of an irritation this neck pain is. Neck pain is of different causes but most of them settles. It is also one of the most common work place diseases next only to low back ache.
The neck has a bony spinal column protecting the spinal cord and nerves. The bones are supported by muscles and ligaments which play a key role in supporting the head.
The neck is prone to lot of injuries because of its very precarious position compared to the rest of the spine. Neck pain can occur in any age groups from the third decade: it can also occur in either sexes.
How the Neck Pain Occurs?
Neck pain can occur due to injuries, degeneration of spine, disc disorders, Postural arthritis or rarely in cancers.
Injuries:
Because of its very wide range of movement, the neck is prone to lot of injuries, especially in high velocity road traffic accidents, sports and games. The neck can also get injured in falling from heights. The spinal cord is tightly enclosed in the spinal canal and can be injured when the neck bones are broken or dislocated. If the spinal cord is injured then paralysis of the limbs can occur which mandates immediate surgery.
Degeneration of Spine:
The very common “ cervical spondylosis” is degeneration of neck joints and the intervertebral discs. As we age and work, there is wear and tear of the joints and the soft disc in between two bones. This often leads to pain. Pain here is due to the degenerated bones and joints pinching the nerves and muscles causing radiating pain to shoulder, upper back or even back of head. Very often pain due to degeneration decreases
with physiotherapy, medicines, exercises and modification of lifestyle. Very rarely if the pressure on a nerve is so high to cause weakness or loss of sensation, surgery may be indicated.
Disc Disorders:
There are seven neck bones and between each bone is a soft rubbery structure called as a disc. This disc acts as a shock absorber and aids in movements as well. Sometimes due to over work or lifting heavy weights or due to injury, the disc may bulge out from its original position and press on the nerve or spinal cord. When this happens there is a sharp shooting pain from the neck to shoulder, arm or even up to the finger tips.
When the compression is more on the nerve, then the pain may be associated with numbness & weakness of muscles. This is an extreme case and may require surgery. However most people with disc disease of the neck tend to live with it with occasional pain. With correct postural habits, and by not overstraining along with neck exercises prescribed by the doctor or physiotherapist, neck pain can be avoided. Most often a course of pain killers, muscle relaxants, physiotherapy and rest will suffice.
Surgery:
When it comes to surgery for disc disorders, the offending disc is removed and imp lace a piece of bone taken from else where is placed and fixed with plate and screws. Alternatively an artificial disc can also be kept in carefully selected individuals.
Disc disorders are very common in the general people so it is mandatory to avoid some strenuous activities. When there is shaped to cradle the head and neck. Avoid sleeping on sides which may cause strain on one side of the neck. If you are working on a computer make sure the monitor and eye level are same. Have a comfortable chair to avoid low back pain as well.
Neck Pain due to infection:
In our country, tuberculosis can come in any form and not uncommonly it can affect the spinal bones. The tuberculosis(TB) bacteria, travels though the blood and affects the spinal bones and the disc between them. There may be destruction of bone and disc and pus formation which may press on the spinal cord and cause quadriplegia.
Severe neck pain not controlled with rest and pain killers are to be seen with a high degree of suspicion. An MRI scan will reveal if there is any infection along with some blood tests. Once TB of spine is diagnosed, surgery to remove the pus and cleaning of dead tissue is to be performed and medicines for TB is to be started.
Cancers of bone in neck:
Very rarely cancer of the bone or the spinal cord can occur in the neck which may lead to intractable pain which gradually increases and there may be weakness and numbness of hands & feet. Again x-ray, MRI and CT scan may reveal the cancer and remedial measures are to be started.
Most often neck pain arises due to strain, disc disorders or degeneration and nearly 95% of patients can be managed without surgery with medicines, physiotherapy and modification of lifestyle. However those who develop symptoms of weakness, numbness and MRI proven disorders may require surgery immediately to alleviate these symptoms.
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