Why do I have Neck Pain? Understanding Neck Pain

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The Neck

The neck is a complex structure in humans that connects the body to the head. Of particular importance is the cervical part of the spinal column. The spinal column is made up of bones and intervertebral discs, as well as the joints, ligaments, and muscles that connect each spinal segment.

It is within the spinal column that the spinal cord runs. At every disc space, a pair of nerves leaves the spinal cord to provide power and give sensation to the upper limbs.

What Causes Neck Pain?

Neck pain can arise from any of the structures mentioned above. Primarily, neck pain is usually from problems involving the intervertebral disc, the facet joints, and the muscles of the neck.

Disc related problems, ranging from tears in the disc to prolapse of disc material (slipped disc), to degenerated discs, can cause pain that is localised to the neck. In the case of slipped and degenerate discs, the discs may in addition cause compression on the spinal cord and nerves, giving rise to additional symptoms.

Facet joints lie to the side of the intervertebral discs and are important for neck movement and stability. Facet joints are often damaged as sequaelae from injuries involving the discs. In the neck, pain from facet joints often gives rise to pain in the neck, and this pain is sometimes referred to in the shoulders as well.

Muscles help to stabilise and move the neck and are very commonly injured. Neck pain arising from muscle injuries are localised to the neck and can radiate to the shoulders and upper back. A large diamond-shaped muscle, the trapezius is one of the most common causes of neck pain.

For most patients, their neck pain is a combination of different factors. Proper assessment of the underlying anatomy will allow better determination of the source of pain and allow targeted treatment.

What are some of the symptoms associated with neck pain?

Common symptoms include,

  1. Numbness and weakness of the upper limbs, and especially of the hands.

  2. Shooting pain (electric) down either or both upper limbs.
  3. Loss of hand agility, with difficulty manipulating small objects such as buttons, chopsticks, needles, and thread.
  4. Unsteadiness in walking, with a wide-stepping gait.
  5. Posterior headaches, and tingling sensation over the back of the head.

The lower limbs are less commonly affected by neck problems, and if there are lower limb complaints, these are more commonly due to concomitant lower back problems as well.

How will my neck pain be worked up?

Typically, you will undergo a medical interview with your doctor, who will ask about the pain and the associated symptoms. Based on the information gained during the interview, a focused examination will be conducted focusing on neck movements, pain on palpation of the neck, and on an examination of the nerves of the arms.

Based on the above information, the doctor will usually offer plain X-rays of the neck, which will provide a clue as to whether there are underlying degenerative changes in the neck. Based on whether you have any nerve symptoms, an MRI scan may also be offered to you.

The information gained from both the clinical evaluation and the radiological assessment will allow the doctor to come to a diagnosis. Treatment may then be offered based on the underlying problems detected.

For an assessment of your condition, please book an appointment with Dr. Yong Ren.

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Sarah Taylor

Obstetrics & Gynaecology