Understanding Neck Pain

Is your head too heavy to hold up? Are your neck and shoulder muscles perpetually tense? Is posture a pain in the neck? Can you turn your head to safely check for blind spots when driving? Why do items fall between the back seats just as you are reaching awkwardly for them? 
Each pain experience is different. You might experience stiffness and restriction, a sharp or stabbing neck pain in a specific spot, or a more general, widespread ache. Pain may start in your neck but spread up to the head, or radiate down into your shoulder, arm or hand. Neck pain may gradually occur over time or be the result of a specific trauma or event. At the Headache, Neck & Jaw Clinic we take great pains to help you find and treat the source of your neck problems.


Neck pain is increasingly common with global studies indicating up to 80% of the world’s population experience neck pain at some stage while 15% struggle with reoccurring neck pain. Neck pain is ranked 4th highest as having the greatest impact on function and ability to work. The most common causes of neck pain are poor posture or injury from motor vehicle, sports, or work-related accidents. Neck pain can also be a symptom of more serious conditions such as meningitis or spinal cord compression. If your neck pain is associated with fever and headaches, or sudden onset loss of bladder and bowel function, numbness, tingling or weakness in the arms or legs, please seek medical advice.

Anatomy Lesson

Your neck involves your vertebrae, muscles, discs, ligaments, and nerves all working together to balance your head on top of your body during movement. It’s a tough, full time job requiring considerable strength to stabilise a 4-5kg bowling ball during every conceivable movement of the head, body or arms. If only we had eyes in the back of our head or the ability to set our head down beside us, our neck wouldn’t have to work so hard.
The shape of the seven cervical vertebrae in your neck enable extensive mobility so you can look over your shoulder, down to your chest or up to the ceiling. There are 6 fibrous discs in the cervical spine which separate the vertebrae and act as shock absorbers to help cushion the force from the weight of the head during these movements. Problems with this dynamic movement occur when segments get stuck at awkward angles leading to restriction, pain, irritation and overuse in the rest of the cervical spine and/or body to compensate. Cervical spinal segments may get stuck due to unbalanced load on the neck from repeated poor movements and/or postures. In addition, asymmetry of the bones, muscles, discs, cartilage or ligaments may compromise the ability of the neck to maintain a comfortable, neutral posture. 

The structural integrity of the cervical spine may be compromised through trauma, disease or the natural ageing process. It is normal for joints and discs in the neck to deteriorate with age from daily wear and tear. In particular, the discs decrease in size and lose their shock absorbing ability as the gel-like interior substance dries out with age. If the fibrous outer rings of the disc are damaged, the inner substance can bulge out between the vertebrae which is called disc herniation. Sometimes the herniated disc presses on the nerve roots which also pass between the vertebrae. This is called radiculopathy and can lead to pain, tingling or weakness spreading down into the neck, shoulder and/or arm.


In some cases, the normal wear and tear on the joints in the neck is so pronounced, bony changes occur to help keep your neck functioning. In osteoarthritis and degenerative disc disease, the vertebrae may form bony spurs to increase the deteriorated joint’s weight bearing capacity. Unfortunately, the altered shape of the bone limits the joint’s ability to move leading to pain and stiffness in the neck. In other cases, you may struggle with excessive joint movement if the ligaments which prevent extreme positions of the vertebrae are injured by trauma or naturally lax from inherited hypermobility. Here at The HNJ Clinic we are highly skilled and experienced in treating all neck conditions - be it a stiff neck from sleeping funny last night through to chronic neck pain from congenital fusion of cervical vertebrae.

 

Author: Karri Field