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Neck Pain

Posted: May 1, 2006

The neck has a significant amount of motion and supports the weight of the head. However, because it is less protected than the rest of the spine, the neck can be vulnerable to injury and disorders that produce pain and restrict motion. For many people, neck pain is a temporary condition that disappears with time. Others need medical diagnosis and treatment to relieve their symptoms.

What causes neck pain?
Neck pain may result from abnormalities in the soft tissues – the muscles, ligaments, and nerves – as well as in bones and joints of the spine. The most common causes of neck pain are soft tissue abnormalities due to injury or prolonged wear and tear. In rare cases, infection or tumors may cause neck pain. In some people, neck problems may be the source of pain in the upper back, shoulders or arms.

Degenerative and inflammatory diseases. Degenerative diseases that cause neck pain include osteoarthritis and rheumatoid arthritis. Osteoarthritis usually occurs in older people as a result of wear of the joints between the bones in the neck. Rheumatoid arthritis can cause destruction of the joints of the neck. Both of these major types of arthritis can cause stiffness and pain.

Cervical disk degeneration also can cause neck pain. The disk acts as a shock absorber between the bones in the neck. In cervical disk degeneration (which typically occurs in people age 40 or older), the normal gelatin-like center of the disk degenerates and the space between the vertebrae narrows. As the disk space narrows, added stress is applied to the joints of the spine, causing further wear and degenerative disease. The cervical disk may also protrude and cause pressure on the spinal cord or nerve roots when the rim of the disk weakens. This is known as a herniated cervical disk.

Injury. Because the neck is so flexible and because it supports the head, it is extremely vulnerable to injury. Motor vehicle or diving accidents, contact sports, and falls may result in neck injury.

Most common injuries are to the soft tissues, i.e., muscles and ligaments. Severe injury with fracture or dislocation of the neck may damage the spinal cord and cause paralysis (quadriplegia).

Much less common causes of neck pain include tumors, infections, or congenital abnormalities of the vertebrae.

When should you seek medical care?
If severe neck pain occurs following an injury (motor vehicle accident, diving accident, fall), a trained professional, such as a paramedic, should immobilize the patient to avoid the risk of further injury and possible paralysis. Medical care should be sought immediately.

Immediate medical care should also be sought when an injury causes pain in the neck that radiates down the arms and legs. Radiating pain or numbness in your arms or legs causing weakness in the arms or legs without significant neck pain should also be evaluated.

If there has not been an injury, you should seek medical care when neck pain is:

• Continuous and persistent
• Severe
• Accompanied by pain that radiates down the arms or legs
• Accompanied by headaches, numbness, tingling, or weakness

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