Neck Pain

Most of the patients who present with neck pain usually have postural or mechanical causes. They are usually treated with short term rest followed by Physical Therapy and exercises which can be done at home.

These exercises involve stretching and strengthening of the neck muscles. The patient may also use neck collar as well as ice or heat for a short period. This may help in improvement of the condition.

Occasionally, the patient may have radiation of pain with or without tingling and numbness from the neck into the arm. This is known as Cervical radiculopathy. If the symptoms are not relieved, then these patients may require medical attention to rule out disc disease.

X-ray of the cervical spine

Most of these patients of disc disease are treated with medications and some rest. If there is no relief of symptoms with these conservative means, then they may need to undergo advance imaging to confirm the diagnosis and help in deciding further treatment.

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Rarely, the patient may need to undergo neck and spine surgery which can either be done from the front of the neck or the back depending on the condition as well as patient characteristics. Recovery from neck surgery is usually smooth and carries a good prognosis. Most patients can return to their normal daily activities within 2 to 3 months.

Cervical spine vertebrae (posterior view)

The image above shows the cervical spine vertebrae from the back. Spinal nerves or the spinal cord may be compressed due to the disease of various structures surrounding the spinal nerve or the spinal cord.

The patient should look for red flags and contact the physician if any of the red flags are present. The patients who are not relieved with conservative treatment may need to undergo advanced imaging to find out the cause of pain and plan treatment.

PREVENTION OF NECK PAIN

• Perform relaxation exercises as well as stretching and strengthening exercises
• Maintain a good posture
• Computer screen should be adjusted to a eye level
• Frequent breaks should be taken from desk jobs allowing stretching of the neck as well as the back. If the job involves use of the telephone, then a headset is recommended.
• A pillow that keeps the neck straight should be used while sleeping.
• Wearing of seatbelts and helmets while driving as well as appropriate sporting gear while playing is recommended to avoid injuries.

RED FLAGS

Neck pain can sometimes be a presentation of some grave underlying disorder. The patients who have back or neck pain with or without radiculopathy, (radiating pain, tingling, numbness) who have any of these following conditions should seek medical attention as soon as possible.

• Cancer, neoplasia or malignancy.
• Unexplained weight loss of more than 10 pounds in the last 6 months.
• Immunocompromised comorbidities like on chemo or radiotherapy or having disease like HIV or AIDs or being on prolonged corticosteroid therapy.
• IV drug users.
• Urinary tract infection.
• Fever of more than 100 degrees centigrade.
• Significant trauma from a fall or accident.
• Bowel or bladder involvement in the form of incontinence or retention.
• Weakness in the major joint of arm or leg.