Neck pain

Pain in the neck can be due to injury, a mechanical or muscular problem, a trapped nerve caused by a bulge in one of the discs between the vertebrae or from arthritis of the neck. It can range from mild discomfort to severe, burning pain.

What causes neck pain?

Many things can trigger neck pain. These include:

• trauma or injury
• worry and stress
• falling asleep in an awkward position
• prolonged use of a computer keyboard.

 

The underlying problem could be due to stress causing increased muscle spasm, hence reducing spinal flexibility, very occassionally a slipped disc, brittle bones (osteoporosis), deformed natural curvature of the spine (scoliosis) and, very rarely, structural damage due to tumours or infection. Finally, road traffic accidents involving whiplash injury may result in acute or chronic neck pain that takes several months to improve.

 

What does neck pain feel like?

• General pain located in the neck area, as well as stiffness in the neck muscles.
• The pain may radiate down to the shoulder or between the shoulder blades.
• It may also radiate out into the arm, the hand or up into the head, causing a one-sided or double-sided headache.
• The muscles in the neck are tense, sore and feel hard to the touch.
• Acute pain can give rise to abnormal neck posture in which the head is forced to turn to one side. This condition is known as torticollis.
• The pain at the base of the skull may be accompanied by a feeling of weakness in the shoulders and arms,
• There may be a prickly or tingling sensation in the arms and fingers.

 

Danger signals associated with neck pain

 

In some cases, neck pain may be a symptom of menegitis. In some cases, neck pain can be a symptom of head injury or disc trouble in the neck.

Your Chiropractor will be able to tell from his or her specialised examination exactly what is causing your neck pain.

 

What can you do yourself?

Remember that neck pain is rarely caused by a serious illness and will often disappear within a week. However, if you have had pains in the neck for a longer period, it may be advisable to consult a physical therapist such as a chiropractor.

 

The following symptoms may indicate a more serious underlying problem than simple mechanical neck pain and require that you seek further advice from your GP:

• co-existing illness, such as unexplained weight loss
• actual tenderness or pain in the neck bones (vertebrae)
• the pain simply continues to get steadily worse despite treatment
• if one or both of your arms become affected, eg persistent numbness, weakness or clumsiness.

 

How does the chiropractor make a diagnosis?

In most cases, a neck problem can be diagnosed by carrying out a thorough examination that may include all or some of the following:

 

 

• testing the movement of the neck
• testing for trapped nerves
• examination of the muscles
• examination of the movement of the joints of the spine, neck and hands

 

How is neck pain treated?

Acute pain at the base of the skull may well disappear without treatment.

For short-term problems, manual treatment (chiropractic) and pain-relieving medicine are recommended.

With longer-term pain (ie three months or more) there’s the following choice of treatment:

• chiropractic treatment ideally with soft tissue therapy and exercise therapy
• intensive muscle training
• physiotherapy, including advice on posture and the use of a supportive pillow
• acupuncture provides relief for significant numbers of people with chronic neck and shoulder pain, although this is not routinely available on the NHS.

 

What medication is given?

Painkillers taken on a regular basis, eg paracetamol, are often sufficient alone. Medicine used in the treatment of mild muscle pain includes non-steroidal anti-inflammatory drugs (NSAIDs). These are generally effective in those who can tolerate them. But they may cause side-effects in patients with a past medical history of indigestion or asthma and be unsuitable for certain patients with kidney impairment, heart failure and high blood pressure.

 

Consult your doctor or pharmacist if you think this might apply to you.

Stronger painkillers, such as codeine phosphate, may be used if NSAIDs are not working well or are unsuitable. Sometimes a muscle relaxant (eg diazepam) may be prescribed on a short term basis of up to 1 to 2 weeks depending on progress.

 

Exercise

People with weak neck muscles are more prone to neck problems, and in such cases an exercise programme to strengthen the neck is a good idea. A good chiropractor will advise on a suitable exercise programme tailored specifically for you.

 

Future prospects

This depends on the underlying cause of the pain. The prognosis is generally good, provided you remain active and obtain the correct treatment without delay.

 

 

Related articles

• Study comparing spinal manipulation, advice with exercises and medication for neck pain. (peverellchiropracticclinic.co.uk)