Cervical neck tension pain
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
The cervical spine is a complex structure. It supports the weight of the head- approximately 15 or more pounds- depending on how intelligent you are :-). It is also highly mobile.
The combination of complexity and mobility makes the neck susceptible to pain and injury.
The neck structure consists of seven vertebrae, intervertebral discs, joints, the spinal cord, eight nerve roots, vascular elements, 32 muscles, and several ligaments.
The nerve roots leave from the spinal cord through foramen in the vertebrae. Joints, muscles, and ligaments facilitate movement and serve to stabilize the structure.
The neck is capable of moving the head in many directions: 90 degrees of flexion (forward motion), 90 degrees of extension (backward motion), 180 degrees of rotation (side to side), and almost 120 degrees of tilt to either shoulder.
The causes of neck pain are varied:
Whiplash is an injury sustained during an auto accident. This is typically termed a hyperextension and/or hyperflexion injury because the head is forced to move backward and/or forward rapidly beyond the normal range of motion. The forceful movement strains the muscles and ligaments in the neck. Muscles react by tightening and contracting creating muscle fatigue resulting in pain and stiffness.
Degenerative disorders such as osteoarthritis, spinal stenosis, and degenerative disc disease all affect the spine. Osteoarthritis causes progressive deterioration of cartilage. The body reacts by forming new bone, termed osteophytes (bone spurs). Spinal stenosis causes the foramen, small neural passageways, to narrow, compressing nerve roots. Stenosis may cause neck, shoulder, and arm pain and numbness. Degenerative disc disease (DDD) can cause the intervertebral discs to lose water content resulting in decreased disc elasticity and height.
Poor posture, obesity, and weak abdominal muscles cause the neck to bend forward to compensate. Stress and emotional tension can cause muscles to tighten and contract resulting in pain and stiffness. Most stress is concentrated in the neck and shoulders. This causes muscles at the back of the neck to tense. When these muscles remain tensed and contracted, they can cause neck pain and tension headaches.
Obtaining a proper diagnosis is critical to determine the best course of treatment.
Treatment will depend on the diagnosis. Stress induced neck pain may respond to physical therapy and massage. More aggressive measures include prolotherapy with platelet-rich plasma or the use of Botox.
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