Prepared By: Lale Altan Professor, MD
Why does neck pain occur?
The neck provides the connection between the head and the body. It supports our head and keeps it in a balanced position. It provides comfortable movement of the head in many directions. It is responsible to protect the nerves leading from the head to the large vessels, spinal cord and arm. The neck has the most complex joint structure in the body and is the most active part of the spine. Therefore it is open to acute or occupational trauma.
Neck pain is a common health problem and can be seen in any sex and age. One in every three people suffers neck pain at least once in their lifetime. The majority of them are mild and temporary. It is rarely painful, or even severe enough to cause disability. Neck pain is common in especially people who work at the desk and use computer. The incidence of neck pain increases with age. Stress in daily life and work increases neck pain. Back-shoulder pain, numbness in the hands, dizziness, imbalance and headache may accompany neck pain. Neck problems can occur suddenly after an accident.
The neck consists of 7 vertebrae. There are pillows between the neck vertebrae called as discs. The task of the discs is to convey the amount of load to the lower levels in a balanced manner and to prevent friction of the vertebrae with each other. The spinal cord passes through the neck vertebrae. In addition, the nerve roots leading to the arms stem from from the neck vertebrae. For these reasons, diseases affecting the neck may cause pain, numbness, loss of strength and sensation in the arms. In addition, the vertebral artery, which provides the posterior part of the brain, the cerebellum and the brain stem, passes through the cervical vertebrae. If this structure remains under pressure, findings such as dizziness, visual impairment and syncope may occur.
Problems Causing Neck Pain
Neck pain may originate from the bones and joints of the spine, as well as from soft tissues such as muscles, ligaments and nerves. The most common cause of neck pain is soft tissue strain.
Muscle and Ligament Injuries
It is the most common cause of neck pain. It is usually caused by excessive stretching of the muscles supporting the neck. Carrying anything heavy, excessive sports, work activity, incorrect desk work can cause muscle spasm.
In addition, sleeping in the wrong position, high pillows and bad travel conditions can muscular strain. Mostly spasms and stiffness are resolved with simple treatment modalities.
Traffic accidents can cause serious injury to the neck. In addition, sports such as wrestling and falling from height can cause similar neck problems. The most common situation in the traffic accidents that cause neck pain is that the car is hit from the back. While the body is being thrown forward, neck moves backwards. Then the car strikes something else in front, the body stops, but the head goes forward. The most dangerous condition is the sudden movement of the neck to the back and serious injury to the ligaments. Head supports on the top of the car seats are important safety precautions that prevent head going back. It should be paid attention to use seat belts.
Osteoarthritis of the neck is caused by wear and tear of the joints. These changes in the neck start at the age of 20-30, but usually do not cause any complaints.If the aforementioned damage in joints and new bone formation on the disc edges limit the normal movements of the neck, stiffness may appear as well as pain. Pain and stiffness may occasionally occur with the periods of exacerbation and recovery. New bone formations that grow from the edges of the joints can compress the nerve roots during neck movements.As a result, pain can occur along the spreading area of the nerve (on the shoulders and arms).Nerve damage may also cause numbness, needling, and muscles may become weak. Sometimes in severe cases, bone protrusions may also compress the spinal cord and weakness and loss of sensation may develop in the lower part of the body.
Servical disc hernia
Servical disc hernia is the overflow of the disc tissue which is jellylike cartilage that serves as a cushion between two sequent cervical vertebrae to the spinal cord and nerves leading to the arm. Depending on the size and effectiveness of the compression, neck and arm pain, loss of strength in the arm muscles, loss of sensation in hands, numbness and clumsiness may be seen.In case of compression to the spinal cord, difficulty in walking, weakness in the legs and urinary complaints can be seen. If the patient does not have complaints despite medical treatment or if there is severe spinal cord and nerve compression; then the treatment option is surgery.
Diseases such as rheumatoid arthritis and ankylosing spondylitis may permanently limit neck movements. However, in contrast to mechanical pain, in these diseases, pain decreases with prolonged rest and increases especially at night. Joint stiffness and movement difficulty lasting more than half an hour in the morning is typical for rheumatic diseases.
Narrowing of the Spinal Canal
The narrowing of the canal through which the spinal cord and / or nerves pass, and the disruption of the spinal cord feeding occur. Especially in older ages, numbness, weakness and incompetence in hands, difficulty in walking, and feeling in hand-feet can be seen.