The neck, or cervical spine, serves many functions in the body. In addition to supporting and controlling movement of the head, it is comprised of a complex system of muscles, nerves and bones that, taken altogether, have great bearing on our health and well-being. Made up of seven bones (vertebrae C1-C7) connected by facet joints on each side, the neck is the most flexible part of the human spine. It also has discs between the vertebrae that provide padding and absorb impact, as in the rest of the spine. Muscles, ligaments and tendons work together to give the neck its range of motion. Nerves carry signals from the brain to the rest of the body. Because of the complexity of its makeup as well as its functions, the cervical spine can be particularly vulnerable to stress, injury and disease.

Also, the neck is affected by and bears the brunt of everything that goes on below it. The moment our feet hit the ground with an abnormal gait, or we sit with incorrect posture, or we experience an injury in another part of the body, the neck begins to adjust and compensate, causing pain and sometimes permanent changes in the way the bones and muscles of the body function and interact.

Symptoms
Pain that can be dull, stabbing or burning
Pain that radiates down through the shoulders or chest, or up to the head
Chronic headache
Stiffness
Aching
Limited ranged of motion
Numbness in the arms
Soreness

What causes neck pain?

Whiplash. One of the most common causes is a jerking of the head one might experience from being rear ended in a car accident. The colloquial term for this type of injury is whiplash, referring to a sudden extension and return of the neck. “Cervical acceleration-deceleration” (CAD) describes how the neck is actually injured. The more suddenly the neck is jerked, the more damage will be done to muscles (including the trapezius muscles), tendons, vertebrae, nerves, soft tissue and discs.

In some cases whiplash starts a degenerative process that may not be felt until decades after an accident.
Sports or exercise injury Abnormal gait
Footwear that does not support the foot properly as it moves
Arthritis Disc disease Herniated disc
Strain from working at a desk/computer that is not set up well ergonomically

Treatment

Mild neck pain, even if it is chronic, can be treated with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin
Topical analgesics stimulate nerve endings to produce the sensation of heat or cold and also reduce inflammation.
Physical therapy
Exercises for stretching the neck

Used mostly for mild but chronic back pain, traction uses weights to give a gentle pull to the skeletal structure and realign the spine.

TENS, transcutaneous electrical nerve stimulation, is a device that can be used in the home. With small electrodes attached to the skin, it sends small electrical pulses to painful areas.

Surgery

For disc and nerve problems, physicians start with the least invasive treatments, but surgery is a possible solution if these treatments don’t work.

Interventional therapy works by blocking nerve conduction between the painful element and the brain. Injection of local anesthetics, steroids or narcotics into the affected areas, including soft tissue, joints or nerve roots has shown to be effective in many cases. Nerve blocks are considered for chronic, intractable pain, as are low does of drugs administered by catheter directly into the spinal chord.

Cervical radiofrequency ablation (RFA) is used for chronic neck pain and chronic headache. RFA uses radiofrequency energy to disrupt nerve function. When this is done to a cervical medial branch nerve, the nerve can no longer transmit pain from an injured facet joint.

Nerve decompression in the neck is considered a minimally invasive procedure. A small amount of bone or muscle is removed to give the affected nerve more space.

Disk replacement surgery may be appropriate for a herniated disc. The damaged disk is removed and replaced with a flexible, artificial one.

Anterior cervical discectomy and fusion (ACDF) is a surgical procedure in which the entire disk is removed and replaced with a plastic device, kept in place with screws, that holds the gap open between the two vertebrae, allowing them to fuse and heal. It is one of the most common surgeries for this condition.

Integrative therapies
Meditation
Yoga
Mindfulness training
Cognitive-behavioral therapy emphasizing pain management
Dealing with depression
Deep abdominal breathing
Progressive muscle relaxation
Visualization and guided imagery
Tai chi
Acupuncture
Biofeedback
Best Exercise Regime
Moderate physical exercise
Stretching
Physical therapy
Strength training for joint support
Weight control
Information and resources

American Chronic Pain Association (ACPA)

P.O. Box 850
Rocklin, CA 95677-0850
ACPA@theacpa.org
http://www.theacpa.org
Tel: 916-632-0922 800-533-3231
Fax: 916-652-8190

National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse

1 AMS Circle
Bethesda, MD 20892-3675

NIAMSinfo@mail.nih.gov
http://www.niams.nih.gov

Tel: 877-22-NIAMS (226-4267) 301-565-2966 (TTY)
Fax: 301-718-6366

American Association of Neurological Surgeons

5550 Meadowbrook Drive
Rolling Meadows, IL 60008-3852

info@aans.org

http://www.aans.org

Tel: 847-378-0500/888-566-AANS (2267)
Fax: 847-378-0600

American Academy of Orthopaedic Surgeons/ American Association of Orthopaedic Surgeons
6300 North River Road
Rosemont, IL 60018

hackett@aaos.org

http://www.aaos.org

Tel: 847-823-7186
Fax: 847-823-8125

American Academy of Neurological and Orthopaedic Surgeons

10 Cascade Creek Lane
Las Vegas, NV 89113

aanos@aanos.org

http://www.aanos.org

Tel: 702-388-7390
Fax: 702-871-4728

American Academy of Physical Medicine & Rehabilitation

330 North Wabash Ave.
Suite 2500
Chicago, IL 60611-7617

info@aapmr.org

http://www.aapmr.org

Tel: 312-464-9700
Fax: 312-464-0227