Chronic Pain

When Neck Pain Becomes More Than Just A ‘Pain In The Neck’.

How many times have you had a fitful night’s sleep, resulting in a stiff neck? Or felt neck tightness after sitting at a computer for hours?

Most of us have experienced neck pain at some point. Years of bending, lifting, turning, and twisting can really take their toll. Considering all that repetitive stress, it’s no surprise that about two-thirds of people will experience neck pain at some point in their lives, according to the Mayo Clinic. Neck pain can have many causes not related to an underlying disease. Prolonged straining and looking up or down, sleeping in an uncomfortable position, stress, chiropractic manipulation, or wearing heavy necklaces. Neck muscles can be strained from poor posture – whether it’s leaning over your computer or hunching over your workbench-it’s a common complaint.

The cervical spine is made up of seven vertebrae, which are separated by discs filled with a cushioning gel-like substance. Cervical discs both stabilize the neck and allow it to turn smoothly in all directions. They also provide cushion for the body, acting as a shock absorber. Over time, these natural shock absorbers become worn and can start to degenerate. The space between the vertebrae narrows and nerve roots become pinched. This process is known as cervical degenerative disc disease. Cervical disc disease goes beyond just a pain in the neck, though. A degenerative process can cause radiating pain, as well as numbness and weakness in the upper extremity.

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Research finds that about 25% of people without symptoms under age 40, and 60% over age 40 have some degree of degenerative disc disease. This is important because often, we don’t even know this risk exists. I was one of those 60%! I had no idea I had any predisposition to injury. Sure, I’d had intermittent bouts of pain for years, but it always resolved. Unfortunately, as degenerative disc disease progresses, the neck becomes less flexible, and neck pain and stiffness occurs. Instead of heeding the signs, I kept up activities that made it worse like jogging and lifting weights. One day I was rock climbing with my daughter, stretched to grab a hand hold with my left arm and felt a horrifying pain in the neck, radiating to the left arm. After confirming it wasn’t a heart attack I knew it was my neck. I might have suffered fewer fusions if I had heeded the warning signs sooner.

Most neck pain improves gradually with conservative treatment. -K. Daniel Riew, MD

When the disc breaks open or bulges out, putting pressure on the spinal cord or nerve roots, it is known as a herniated disc or “slipped disc.” Although cervical disc disease is generally a slow process, a herniated disc sometimes can occur quickly after an injury or trauma to the neck. This is what happened when I was rock climbing. The most common and obvious symptoms of cervical degenerative disc disease is neck pain. When one or more of the many nerves running from the spinal cord is impacted it can also develop into pain, numbness, or weakness radiating into the shoulder, arm, and hand.

Even though degenerative disc disease is most often due to age, it can also be influenced by lifestyle factors. My adrenaline junky days of downhill skiing, gymnasttics, rock climbing, jogging, horseback riding certainly contributed to my neck pain. To make sure you keep your spine as healthy as possible, eat a balanced diet and exercise regularly with preferably low impact activities. Don’t smoke, because, aside from its other affects on your health, it is a risk factor for cervical disc disease. Also watch your posture, always keeping your neck straight and your back well supported.

Although neck pain from cervical disc disease can return, you’ll lower the chances if you take good care of your neck and the rest of your body. Most people don’t have constant neck problems throughout their lives. Usually it comes and goes with good odds are it won’t last forever.

Even if you have degenerative disc disease or a slipped disc, chances are good that you’ll be able to treat it without surgery. Tylenol , non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen, topical creams, muscle relaxants, ice or heat packs can help reduce pain and inflammation.  Steroids or narcotic painkillers can be used for a brief period of time if over-the-counter medications aren’t working. Physical therapy can significantly improve pain by increasing range of motion with ultra sound, deep tissue massage, TENS unit (Transcutaneous Electrical Nerve Stimulation unit is a device that sends small electrical currents to targeted body parts), and traction in some cases. Then they’ll teach you how to exercise and maintain a healthy neck on your own.

“Most neck pain improves gradually with conservative treatment.” says K. Daniel Riew, MD, Professor and Director of the Orthopaedic Spine Institute at the Washington University School of Medicine. “In six weeks, the vast majority of patients get better. On rare occasions, neck pain can be a symptom of a more serious problem. Seek medical care if your neck pain persists or is accompanied by numbness or loss of strength or shooting pain into your arm.”

Next week we’ll talk about simple preventative measures that can help keep neck pain from interfering with your life.

dsc_0323    –Dr. Courtney

Main image courtesy of:

nutritionallywealthy.com; Habits to prevent neck pain and rounded shoulders

Image of back courtesy of:

breakingmuscle.com; a guide for coaches and athletes

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