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The top seven bones of your spine form the neck. The neck has a network of nerves, bones, joints, and muscles. It helps provide support and mobility for the head, but sometimes it can become painful due to a number of reasons. Additionally, due to the sensitive nature of the tissues of the neck, problems in the neck can cause pain and unpleasant sensations in the shoulder, head, arm, and legs.
The most common symptoms observed are, pain and stiffness in the middle or on either side of your neck. This may also extend from the shoulder to the upper chest. You may feel weakness in your arms, muscle tightness and spasms, decreased ability to move your head or tension headaches.
Sometimes a nerve can be pinched by the surrounding tissue and cause numbness, pins and needles or a tingling sensation in your neck or arm. Clicking and grating noises may be heard as you move your head. This is a common symptom and is not a cause for worry.
Dizziness and blackouts can sometimes occur as a result of pinching of vertebral arteries as the blood flow is temporarily reduced, especially when you move your head to one side. Seek medical advice, if this happens.
Your neck is flexible and supports the weight of your head, so it can be vulnerable to injuries and conditions that cause pain and restrict motion.
Overuse of your neck muscle such as due to poor posture, or even gritting your teeth, can strain neck muscles and result in pain.
As we age, our joints wear down, problems like osteoarthritis can emerge and erode the vertebrae and intervertebral discs. Sometimes, as a consequence of inflammation, your body may form bone spurs. Herniated disks and bone spurs can hinder joint motion and impinge on nerves and cause pain.
Sometimes neck pain can be caused by injuries due to vehicular accidents, falling down the stairs etc. This can cause trauma to spine, neck and head. Certain underlying diseases, like autoimmune disorders, meningitis or cancer, can also cause neck pain.
Neck pain is diagnosed by your doctor using various parameter, such as, medical history, physical examination and diagnostic imaging scans.
Physical examination: Physical examination involves gauging the degree of motion, site of pain and evaluation of nerve and muscle using specific movements. In most cases, your doctor can offer you a diagnosis at this stage without further investigation.
Diagnostic imaging: Radiological evaluations such as X-rays, CT scans and MRIs may be ordered to investigate extent of degenerative changes and helps visualise all involved tissues like bone, muscles, nerves, ligaments and cartilage. These scans may be necessary when your doctor suspects a more serious condition that warrants further investigation.
A diagnosis is necessary for your doctor to plan a suitable treatment.
Mild to moderate neck pain is usually treated without surgical intervention and through simple self- care measures. Pain relief medications, muscle relaxants and some types of antidepressant medication can be useful in neck pain.
Physiotherapy can help your correct posture, alignment and strengthen your neck through exercise; using cold or hot compress or electrical stimulation can help relieve pain and reduce recurrence. Under supervision of a physical therapist, weights, pulleys or an air bladder may be used to gently stretch your neck and relieve pain due to pinched nerves.
For some people, a soft collar can give support to the neck and relieve pain by taking pressure off sensitive structures in the neck. These collars should be used as recommended and not be used for more than 3 hours at a time.
Your doctor might inject corticosteroids near the nerve roots, into the joint spaces in the bones of the cervical spine or into the muscles in your neck to help with pain. Anaesthetics (numbing medication) can also be injected to relieve your neck pain.
Rarely needed for neck pain, surgery might be an option for relieving nerve root or spinal cord compression. Minimally invasive surgery like endoscopy is preferred as there is less chance of infection as well as maximum preservation of essential structures.