Neck Pain/Cervical Pain

Dealing with neck pain is exactly how the saying goes. It’s a real “pain in the neck.” The reason why neck pain is so bothersome is because there are multiple reasons why a person might experience pain in their neck, and the symptoms can vary depending on the cause. Also, You are always using your neck, so if You feel pain in the neck, then there’s a great chance that quality of life and ability to perform daily tasks is both limited and done in pain. Thankfully, there are several treatment options available to manage all symptoms of neck pain. The Nevada Advanced Pain Specialists in the Reno, Sparks, and Carson City areas help patients suffering from neck pain find relief.

What is Neck Pain?

Neck pain, also known as cervicalgia, is any pain that felt in or around the area of the spine below the head. People also refer to the neck area as the cervical spine. Unfortunately neck pain is a common result of many injuries as well as medical conditions, and can affect everyone. 

Neck pain can be axial, so felt mostly in the neck, or radicular, which is when it spreads to other parts of the body, such as the arms and shoulders. The pain can be acute, meaning that it lasts from days to weeks, or chronic, which is when the pain is felt for three months or longer. 

While anyone is at risk for experiencing neck pain, it is more common in women. Additionally, the chance of experiencing neck pain increases with age. While neck pain is common, the symptoms aren’t. Neck pain varies from person to person and can feel like: 

• Persistent ache
• Stabbing or burning pain
• Shooting pain that travels through the shoulders and arms
• Dull pain

Often, neck pain can also lead to other symptoms and issues. People who experience neck pain can also suffer from: 

• Headaches
• Stiffness in the neck, shoulders and upper back
• Reduced range of motion in the neck
• Loss of balance and coordination
• Numbness or tingling in the arms and shoulders

It’s important to note that if you are experiencing sudden blindness, paralysis, vomiting, fever, bladder/bowel changes or weight changes, it’s important to seek the care of a medical professional immediately. 

Cervical Spine Anatomy

The greatest benefit of the neck is also what allows it to be susceptible to pain. Not only does the cervical spine provide support and mobility for the head, but it also helps protect the top portion of the spinal cord that connects to the brain. The neck, being the most flexible part of the spine, allows the head to move through a wide range of motion. The neck’s flexibility allows for overuse, overextension, and fractures.

The cervical spine consists of seven vertebrae, supporting discs in between each vertebrae that help to provide cushion, and muscles, ligaments, joints and nerves. The top two vertebrae are the axis and atlas, and they allow for the majority of the head’s rotational movement. They form a joint that connects the head to the rest of the spine, and help with coordination and balance. 

The ligaments and muscles help to provide strength and movement, and the nerves that attach to the cervical spinal cord and exit the spine help to provide sensation to the surrounding skin, muscles, surrounding structures and upper extremities. 

All of these vertebrae and soft tissue structures work together to allow a person to move their head comfortably and safely. The downside is that due to the complexity of the neck, and all of these structures needing the other, when there is an injury or medical condition that results in pain, it could be felt throughout the neck, back and upper extremities. This is what makes a proper diagnosis so important to find effective treatment options. 

What Causes Neck Pain?

There are many reasons why a person might experience neck pain. The most common general causes include aging, physical strain, injury (most often whiplash), mental stress, growth, tumors, infections, and other medical conditions such as cancer or meningitis. Traumatic injuries or strains often cause most cases of acute neck pain, while most cases of chronic neck pain involve issues with the joints, discs, ligaments or surrounding muscles. 

The most common causes of neck pain that most people experience include: 

• Muscle strain: overuse of the neck muscles, lifting something too heavy or lifting something improperly, and sleeping in awkward positions can all lead to muscle and tendon strain and nerve irritation. In fact, myofascial (muscle related) and ligament injury are the main reasons why a person will experience acute or chronic neck pain. 
• Disc disease: another very common cause of neck pain, disc disease occurs when a person injures themselves or suffers from degenerative disc disease, which is the gradual breakdown of the intervertebral over time and with use. This can lead to the discs collapsing, decaying or herniating, which can lead to irritation and spinal cord compression. 
• Nerve compression: certain nerves located in the cervical vertebrae provide sensory information to the head and face, so when these nerves become damaged, pain can radiate to the head and face. Other nerves located in the cervical spine innervate the upper extremities, so compression to those particular nerves can lead to both neck pain as well as feelings of numbness or tingling in the arms and shoulders. 

Whiplash: most often the result of rear end motor vehicle accidents, hyperextension of the neck can lead to soft tissue damage, inflammation, tension and strain. An additional stressor is that this particular type of neck pain can become worse with movement, making daily movements difficult. 

• Neck arthritis: also known as cervical spondylosis, this condition occurs when there is a breakdown of the cervical vertebrae and the surrounding fact joints, which are located on either side of the back of the neck vertebrae. Most often, symptoms begin around 40 years of age and worsen as arthritis progresses. 
• Osteoporosis: thinning of the bones can lead to a greater chance of fracture, herniated discs, and possible nerve compression
• Spinal stenosis: this happens when there is narrowing of the spinal canal, which causes pressure on the spinal cord and the nearby nerves. So in addition to neck pain, patients can expect to experience cramping, shooting pain and numbness in the shoulders, arms, back and legs. 
• Cancers: less likely but still possible, cancer of the mouth, mouth area and neck can lead to neck pain, especially if metastatic tumors are found on the spine. 

How is Neck Pain Treated?

The best and most important way to treat neck pain is to partner with a pain management specialist who is well versed in all causes of neck pain as well as all treatments of neck pain. Receiving a proper diagnosis is essential for deciding upon the best treatment method to remedy each specific cause of neck pain, and prevent it from occurring again. 

Your healthcare provider will perform a physical exam, review your medical and family history, as well as utilizing imaging tests such as X-rays, MRIs and CT scan. Once the cause of the neck pain is determined, your provider will recommend the least invasive treatment options first with a goal to help you most comfortably find relief, before discussing surgical options. Most cases of neck pain improve and people can manage them at home, which is great.

Below are some of the most common treatment options for finding relief from neck pain. Many patients even find it most helpful to combine treatment options, such as physical therapy and pain medications. Your pain management specialist will help find the best treatment options for your specific type of neck pain, with a goal to control and treat the pain with as few side effects as possible. 

• At-home methods: investing in a better pillow that allows you to sleep more comfortably, focusing on a healthy diet, and utilizing exercise methods that work to increase flexibility and range of motion are all simple and effective ways to begin your treatment journey. Hot therapy (heating pad) and cold therapy (ice pack) have also proven effective. 
• Physical therapy: a trained physical therapist is able to recommend specific movements that help to increase range of motion as well as build muscular strength, all of which help the body to protect itself against trauma
• Biofeedback: learning how to manage involuntary body responses, including heart rate and blood pressure, help a person to manage feelings of pain by relaxing the body and mind
• Stress reduction techniques: practicing meditation, yoga and breathing exercises can help to reduce tension in the neck that could be a contributing factor of neck pain
• Alternative therapies: acupuncture, massage and chiropractic care all provide relief by decreasing stress, tension, muscular spasms and correcting nerve transmissions in the spine

More

• Pain medications: Non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, muscle relaxants, and membrane-stabilizing medications have all proven effective for treating neck pain, and are especially useful for making physical therapy more comfortable
• Injections: both cervical epidural steroid injections and trigger point injections use a steroid (and possibly an anesthetic) to reduce pain, irritation and inflammation, as well as muscle spasms
• Nerve stimulation: transcutaneous electrical nerve stimulation (TENS), occipital nerve stimulation and cervical spinal cord stimulation (SCS) use a mild electrical current to disrupt the pain sensations from reaching the brain. Most patients experience a light buzzing sensation, which is reported as being far better than any level of pain, and it’s proven quite effective for those who are experiencing chronic pain symptoms. 
• Nerve blocks: nerve blocks help to both confirm the location of the pain sensations, as well as prevent the pain stimulations from being transferred from the nerves to the brain. The most common blocks in regard to treating neck pain include occipital nerve blocks that target the nerves at the back of the head, and cervical medial branch blocks, which target the medial branch nerves that travel through the facet joints. Both options utilize a local anesthetic and corticosteroid to reduce inflammation and pain. 
• Radiofrequency ablation: if medial branch blocks have proven helpful, radiofrequency ablation could be the next step in providing long-term pain relief. This method uses heat to destroy the nerve that a block has shown is sending pain signals to the brain, thereby halting the signals from being sent. 

Your pain management specialist will help find the best treatment options for your specific type of neck pain, with a goal to control and treat the pain with as few side effects as possible. 

• Racz procedure: also known as cervical lysis of adhesions, this treatment option involves removing excessive scar tissue from the epidural space that could be trapping nerves and causing pain
• Infusion techniques: inserting a small catheter next to the affected nerves in the epidural space allows for a constant ability to infuse local anesthetic and other medicines that block the nerves and provide profound and long-lasting pain relief 
• Neck surgery: When all other methods have been exhausted, surgical methods have proven effective in providing relief from otherwise untreatable chronic pain conditions. Surgery does have higher risks and possible complications. 

The recovery period or healing time varies from person to person, and depends on the specific type of cause or causes of pain. Pain caused by sprains and strains could resolve in a matter of weeks, but it could take longer if the pain is caused by a nerve issue, degenerative disc disease, or compression issues with the spinal cord. 

The best way to understand the cause of your neck pain and find the most appropriate treatment method is to partner with a trained pain management specialist. The neck takes a lot of abuse over the years and it’s important to utilize not only the best treatment option for the current issue at hand, but also to make sure any small issue doesn’t get worse with time. The Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas are dedicated to helping their patients live a healthy and comfortable life, free of pain. If you’re experiencing neck pain, please schedule an appointment today.