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Neck Disorders Overview

with Dan Heffez, M.D., Neurosurgeon, Columbia St. Mary’s Spine Center

Posted: May 1, 2006

Neck disorders can be more than just a pain in the neck. Patients with severe neck pain who come to the Columbia St. Mary’s Spine Center generally have disorders caused by structural and degenerative problems that affect the spinal cord and the nerves in the neck.

The human neck is composed of a series of bones called vertebrae that begin in the upper torso and end at the base of the skull. Although the neck has a significant amount of motion and supports the weight of the head, it is less protected than the rest of the spine. It can be vulnerable to disorders and injuries that may cause pain and restrict motion.

Causes of neck pain
Neck pain can be a symptom of several conditions including herniated disc, bone spurs, osteoarthritis, osteoporosis, ankylosing spondylitis and Chiari malformation.

In the case of a herniated disc, the disc that cushions the vertebrae ruptures and compresses the nerve roots or the spinal cord, causing neck pain, numbness down the arms and into the fingers, and weakness.

Bone spurs are formations that develop along the ligaments in conjunction with degenerated discs. Bone spurs can pinch the spinal cord or spinal nerves, causing neck and arm pain.

Osteoarthritis occurs when moving joint—facet joints—between the vertebrae degenerate, resulting in pain and loss of flexibility.

Another degenerative disease, osteoporosis, is a condition characterized by loss of bone minerals and strength. Bones gradually weaken and become vulnerable to injury. Weakened vertebrae may collapse or fracture, causing pain and a loss of height.

Ankylosing spondylitis is an inflammatory or arthritic condition affecting the spine that results in abnormal calcification of ligaments. It generally starts as low-back pain. When the ligaments of the spine become calcified, they ultimately fuse the vertebrae, limiting motion and causing stiffness and pain in the neck or back. Patients can be susceptible to unusual fractures. This condition is most commonly experienced by young men.

A much less common condition, but one that is often misdiagnosed, is Chiari malformation. Although the Chiari malformation is a congenital problem, it rarely causes problems in children. The malformation occurs at the junction of the skull and the spine, resulting in a compression of the lowest brain stem. This may result in many vague symptoms including headache, neck and arm pain, numbness and tingling.

When any of these degenerative changes become severe enough to impinge on the spinal cord or nerves, pain might radiate up into the head or down into the arms or back. Dizziness is a very common symptom, associated with neck disorders. Patients also can experience numbness, weakness, tingling and clumsiness of the hands.

Don’t ignore severe symptoms
When the changes get even more severe, people can begin to develop difficulties controlling their bladders, and even their bowels. They also can develop problems maintaining their balance when they are upright.

None of these serious symptoms should be ignored. If you are experiencing them, it’s important to consult with your primary physician or contact the specialists at the Spine Center at Columbia St. Mary’s.

Treatment of neck pain depends on the diagnosis of the problem. For many patients, the pain is temporary and over-the-counter medications may be recommended. Sometimes relatively mild problems can be aggravated by poor posture and body mechanics. Simply addressing that situation can make a great difference. Other noninvasive measures include immobilization and rest, physical therapy, exercise, modified activities, or a combination of these methods. Surgery may be needed to reduce pressure on the spinal cord or a nerve root when a herniated disc or a bony narrowing of the spinal canal causes pain and does not respond to non-surgical treatment.

Dan Heffez, M.D., Neurosurgeon
Columbia St. Mary’s Spine Center
414-961-5005
414-438-6500

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