Neck pain (or cervicalgia) is a common problem, with two-thirds of the population experiencing neck pain at some point in their lives. Neck pain, although felt in the neck, can be caused by numerous other spinal problems. It may arise due to muscular tightness or joint disruption in both, the neck and upper back or pinching of the nerves emanating from the cervical vertebrae.
The head is supported by the lower neck and upper back, and the top three joints in the neck allow for most movement of the neck and head. The lower joints in the neck and those of the upper back create a supportive structure for the head to sit upon. If this support system is affected adversely, then the muscles in the area tighten, leading to neck pain.
Major and severe causes of neck pain (roughly in order of severity) include:
- Carotid artery dissection
- Chronic partial rotator cuff tears
- Head and neck cancer
- Spinal disc herniation
- Spinal stenosis
The less common neck pain causes include:
- Stress – physical and emotional stress
- Referred pain – mostly from upper back problems
- Over-use – muscular strain is one of the most common causes
- Minor injuries and falls – car accidents, sporting events and day to day minor injuries.
- Herniated disc
- Pinched nerve
Treatment of neck pain depends on the cause. For the vast majority of people, neck pain can be treated conservatively. Recommendations which help alleviate symptoms include applying heat or cold to the affected area. Other common treatments could include medication, body mechanics training, ergonomic reform, and physical therapy.
Exercise plus joint mobilization and/or joint manipulation (spinal adjustment) has been found to be beneficial in both acute and chronic mechanical neck disorders. Both cervical manipulation and cervical mobilization produce similar immediate and short-term changes. Thoracic manipulation may also help improve pain relief and functionality.
Analgesics such as acetaminophen or NSAIDs are recommended for pain management. Muscle relaxants are also often prescribed and are known to be effective.
Surgery is usually not indicated for mechanical causes of neck pain. It is usually not indicated for “pinched nerves” or herniated discs as well unless there is spinal cord compression involved or extreme pain and the disability has been protracted for several months.
*If neck pain is the result of instability, cancer, or other severe diseases, surgery may be necessary.
Neck pain affects about 330 million people globally as of 2010 (4.9% of the population). It is more common in women (5.7%) than men (3.9%). It is less common than low back pain.
About one-half of the episodes resolve within a year, and approximately 10% of the cases become chronic and may last for long periods of time.