Neck Pain
INTRODUCTION
Neck pain is one of the commonest symptoms, lasting for a day or years together. Majority of people would have experienced it at least once in a life time.
Neck region consists of seven vertebrae from C1 to C7. C1 attaches to the base of the skull and continues below at the C7 level as a dorsal spine. These vertebrae are attached to each other by an intervertebral disc. There are many muscles, ligaments attached to these vertebrae from the skull to the dorsal region. The cervical region is one of the most important areas of the body, wherein the cervical cord lies. From it, eight pairs of nerves leave from the intervertebral foramen to supply the upper limb muscles.
Symptoms
The pain typically involves nape of neck. The pain may be exaggerated with neck movements. There can be stiffness of neck. The neck pain may be sudden onset as in injury or sprain. It can be a gradual onset and progressive as in cervical spondylosis. It can be a short duration, eg. Pain after a bad posture while sleeping can be effectively cured very early with supportive treatment. The pain may continue for a longer time, if the inciting cause may persist eg. prolong sitting in front of computers and bending. There may be radiation of pain to the back of the head or in upper limbs. There can be numbness or tingling in the upper limbs. The pattern of pain and numbness would depend on the cervical nerves affected. Only in case of severe affection of spinal cord and nerves, can there be a weakness of hands and lower limbs.
When to consider meeting a specialist
- Prolonged neck pain, not responding to conservatives means at home or over the counter drugs or drugs.
- Other symptoms like weakness, numbness, tingling, or thinning of limbs.
Causes
Any disturbances of the spine, its muscles or the cerebro spinal fluid passing through the spinal canal can cause neck pain. There are various causes. Depending on the causes, the pain may be acute or chronic.
- Bad posture while sleeping. There can be spasm of the cervical muscles.
- Long hours of being hunched in front of the computer.
- Strain to the neck or any form of injury.
- Cervical spondylosis
- Spinal tumors
- Rheumatoid arthritis
- Meningitis
- Subarachnoid hemorrhage
- Cancers, either of the spine of the brain
How are such patients managed?
There cannot be one single pattern for such a problem. The neurosurgeon will examine you after taking a through history.1Investigations
Some patients may be advised x-rays or MRI of the spine.
2Management
The majority of patients except having any lesion in the spine are managed conservatively.
3Drugs
Pain killers with muscle relaxants
Gabapentin and its analogs
Topical gels eg Voveran Emulgel
Vitamins and calcium
Gabapentin and its analogs
Topical gels eg Voveran Emulgel
Vitamins and calcium
4Physical therapy
Physiotherapy plays an important role in neck pain/spasm.
Hot fomentation either with the hot bottle, electric pad.
Ultrasonic massage. Here sound waves are applied through a probe over the affected area.
Hot fomentation either with the hot bottle, electric pad.
Ultrasonic massage. Here sound waves are applied through a probe over the affected area.
Trans Cutaneous Nerve Stimulation (TENS)
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This procedure relieves pain by stimulation of nerves.
Immobilization with cervical collar
Surgery
Surgery is indicated in the case of a large disc, tumor, or any compression affecting the spinal cord, cervical nerves.
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