Neck pain can present in a variety of ways. Most cases of neck pain will involve headaches, stiffness, cramping, and difficulty turning the head or bending the neck. In more severe cases, other symptoms like fever, nausea, vomiting, pain or numbness radiating down the arms and hands however, can indicate more serious conditions that demand medical attention.
Fortunately, most varieties of neck pain can be successfully managed with conservative treatment options.
Neck Pain Basics
Neck pain is extremely common. Two-thirds of the population will complain of chronic neck pain sometime during their lifetime. Many of our repeated daily activities we don’t give a second thought to could be contributing to the development of neck pain. For example, acute or chronic neck strain can be a result as something as simple as poor posture while working at a computer or sleeping on your stomach with your neck turned to one side. A forceful injury such as whiplash, however, is considered a neck sprain. Both types of injury can cause muscle spasm, limited range of motion, and varying degrees of discomfort and pain.
Strain or Sprain?
Neck strains and sprains are similar in as much as they can cause severe pain and be potentially disabling. They are different, however, in terms of the soft tissue they affect.
A neck STRAIN is an injury to a tendon or muscle caused by overuse or trauma.
A neck SPRAIN is an injury to a ligament caused by overuse or trauma.
Whiplash (technically a hyperextension and hyperflexion injury) is a common form of SPRAIN. Muscle pain that develops from repeated cradling the phone between the ear and shoulder is an example of a STRAIN.
Different types of Neck Pain will feel different…
Strains and Sprains – Technically, most cases of strain or sprain are not considered serious injury. The pain and dysfunction caused, however, can seem anything but trivial. Some of the symptoms include:
Mild to moderate pain in neck and/or shoulder
Difficulty in moving or rotating the head or neck
Radiculopathy (pinched nerve) – This is when a nerve root becomes compressed. Possible causes include herniated disc and/or degenerative changes alter the anatomy of the spine affecting the nerve roots branching out from the spinal cord. Symptoms include:
Pain that radiates to the shoulder or down the arm
Numbness and/or tingling in the arms or hands
Weakness with or without muscle atrophy
Myelopathy – Compression of the spinal cord itself. This can happen due to the usual wear and tear that comes with age, or sometimes through infection or disease. Myelopathy is one of the most common forms of neck pain in people over 55 in the US and possibly the world. Symptoms include:
Loss of normal coordination in the arms or hands
Difficulty with fine motor movements (e.g. writing, buttoning)
Difficulty grasping/holding on to objects
Heaviness or weakness in the affected arm or hand
Disturbances in gait/balance
Meningitis – A stiff neck accompanied by high fever, nausea, vomiting, or sensitivity to light could indicate meningitis. This is a potentially serious condition that requires immediate medical attention.
Alongside some of the more common causes of neck pain mentioned above (forceful injury, poor posture, sleep posture, etc.), there are a variety of other possibilities as well. Including:
Injury to the bones, joints or ligaments
Degenerative changes in the spine
Vertebral compression fracture
Medical conditions such as arthritis, migraine headache
Narrowing of the spinal canal (e.g. spinal stenosis)
Disease (e.g. cancer)
The good news is most varieties of neck pain can be successfully treated with conservative and minimally invasive interventions. In most instances, surgery is not needed. Persistent or recurrent neck pain, though, may require diagnostic testing and more aggressive treatment.
Usually your doctor will be able to make a diagnosis with just your history and a comprehensive physical exam. If this is not sufficient, he/she may order imaging studies. X-rays, or CT scans. MRI, or EMG (electromyography) may be conducted to confirm a diagnosis or rule out other disorders.
Conservative treatments shown to relieve pain and restore function include:
Anti-inflammatory drugs to reduce swelling and pain, muscle relaxants to calm spasm, and non-narcotic or narcotic analgesics to alleviate pain
Physical Therapy (PT)
Interventional techniques can be a faster and more definitive method of pain relief for neck pain. These treatments are useful in the presence of severe pain that has failed conservative medical treatment and/or medication.
Cervical Epidural Steroid Injection – This procedure is considered a very effective treatment for neck pain. It is basically the same treatment a woman will receive during childbirth to eliminate pain. Under fluoroscopic guidance, your physician will place a small needle into the epidural space and inject a small amount of medication to eliminate the pain.
Transforaminal Epidural Steroid Injection – This procedure is similar to the one above; however, in this case the medication is focused directly onto the nerve fibers that make up the sciatic nerve – the result is more medication delivered to the affected area.
Spinal Cord Stimulation (SCS) – When the inflammation in and around the affected nerves is too great for an epidural injection, SCS is an excellent and effective treatment option that can eliminate the pain without surgery. In SCS, an electrical pulse is delivered directly to the spine, blocking certain neuron fibers’ access to the brain and consequently the brain’s ability to sense the previously perceived pain.
Radiofrequency Ablation (RFA) – Radio waves are applied to a nerve, subsequently stunning it and preventing from transmitting pain.
These days, if patients require surgery they have more options than ever before. Minimally invasive surgery drastically limits damage to surrounding tissue and enables surgeons to operate with greater precision. For patients, the benefits of these advanced surgical techniques include small incisions, fast recovery, and a better surgical outcome than with many conventional approaches.
Schedule an Appointment Today
Our doctors at the Ainsworth Institute of Pain Management are experts in using the most cutting edge and advanced methods for treating neck pain. Call and schedule an appointment today with one of our board-certified pain management doctors and find out what treatment options would best suit your symptoms.