Neck pain or cervicalgia is a common problem, with two-thirds of the population having neck pain at some point in their lives.
Neck pain, although felt in the neck, can be caused by numerous other spinal issues. Neck pain may arise due to muscular tightness in both the neck and upper back, or pinching of the nerves emanating from the cervical vertebrae. Joint disruption in the neck creates pain, as doe’s joint disruption in the upper back.
The head is supported by the lower neck and upper back, and it is these areas that commonly cause neck pain. The top three joints in the neck allow for most movement of your neck and head. The lower joints in the neck and those of the upper back create a supportive structure for your head to sit on. If this support system is affected adversely, then the muscles in the area will dysfunction and minimally tighten, leading to spinal dysfunction and resulting in neck pain, sometimes mild and sometimes unrelenting intense debilitating contracted pain.
The origin of neck pain should be sought for a proper treatment resolution, one should not just merely medicate the warning signal and medicate the communication away
Neck pain may come from any of the structures in the neck including: vascular, nerve, airway, digestive, and musculature / skeletal or be referred from other areas of the body.
Major and severe causes of neck pain include:
Carotid artery dissection
Referred pain from acute coronary syndrome
Infections: retropharyngeal abscess, epiglottitis, etc.
Spondylosis - degenerative arthritis and osteophytes
Spinal stenosis a narrowing of the spinal canal
Spinal disc herniation protruding or bulging discs, or if severe prolapse.
The more common and lesser neck pain causes include:
Stress – physical and emotional stresses
Prolonged postures – many people fall asleep on sofas and chairs and wake with sore necks
Minor injuries and falls – car accidents, sporting events and day to day minor injuries
Referred pain – mostly from upper back problems
Over-use – muscular strain is one of the most common causes
More causes include poor sleeping posture, torticollis, head injury, rheumatoid arthritis, Carotidynia, congenital cervical rib, mononucleosis, rubella, certain cancers, ankylosing spondylitis, cervical spine fracture, esophageal trauma, subarachnoid hemorrhage, lymphadenitis, thyroid trauma, and tracheal trauma.
Treatment of neck pain depends on the cause. Chiropractic care has focused on spinal and musculoskeletal conditions for over 110 years. Many of the professional sports teams and professional athletes consult Chiropractic doctors regularly for conditions involving the spine and musculoskeletal system. If your pain persists the problem involving the cervical spine should be evaluated by a health care practitioner. Common treatments could include physiotherapy like ultra sound or interferential, body mechanics training, ergonomic reform and chiropractic manipulation.
Exercise plus chiropractic joint mobilization and/or joint manipulation has been found to be the most beneficial in both acute and chronic mechanical neck disorders. Mobilization or manipulation without corrective exercise technique training allows a condition to resurface years later. The use of heat or cold may provide short term pain relief. Chiropractic ultrasound has been shown not to be efficacious also.
Analgesics such as acetaminophen or NSAIDs are recommended for pain by most physicians not taught in musculoskeletal therapy like manipulation or physio-therapy. Muscle relaxants such as cyclobenzaprine have not been found to be useful and are therefore not recommended. Over the counter topical creams and patches containing counterirritants have little evidence to support efficacy. Khwaja SM, Minnerop M, Singer AJ (January 2010). "Comparison of ibuprofen, cyclobenzaprine or both in patients with acute cervical strain: a randomized controlled trial". CJEM 12 (1): 39–44. PMID 20078917
Surgery is usually not indicated for most mechanical causes of neck pain. If neck pain is the result of instability, cancer, or other disease process surgery may be necessary. Surgery is usually not indicated for "pinched nerves" or herniated discs unless there is spinal cord compression or pain and disability have been protracted for many months and refractory to conservative treatment such Chiropractic or Acupuncture and some Physical Therapy.