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What can cause neck pain ?

WHAT CAN CAUSE NECK PAIN ?

Neck pain can be caused by many things. The key is to get properly diagnosed so treatment can begin. Here are some common conditions:

Poor posture: Sitting or standing with your head tilted forward for extended periods.
Muscle strain: Overuse or sudden movement of neck muscles, often from activities like lifting heavy objects with improper body mechanics.
Sleeping habits: Using the wrong pillow or sleeping on your stomach.
Whiplash: A neck injury caused by sudden forceful movement of the head, often from a car accident.
Degenerative disc disease: Narrowing of the disc space between vertebra.
Arthritis: Inflammation of the cervical spine, including osteoarthritis and rheumatoid arthritis.
Herniated disc: When a spinal disc in the neck bulges and presses on nearby nerves.
Stress and tension: Muscle tension in the neck due to stress.
Trauma or injury: Falls, sports injuries, or other impacts to the neck .

Disc herniations

Stages of a Cervical Herniated Disc:

There are four stages of cervical disc herniation.

Disc Degeneration - Chemical changes associated with aging cause intervertebral discs to become weak but without a herniation.
Prolapse - The form or position of the disc changes with some slight impingement into the spinal canal or spinal nerves. This stage is also called a bulging disc or protruding disc.
Extrusion - The gel-like nucleus pulposus (inner part of the intervertebral disc) breaks through the tire-like wall (annulus fibrosus) but remains within the disc
Sequestration - The nucleus pulposus breaks through the annulus fibrosus and can move outside the interverterbral disc and into the spinal canal.

Symptoms:

Symptoms for cervical disc herniation can vary from person to person. They include the following:

Pain in the neck or upper back, sometimes radiating into the arm and into the fingertips
Numbness and tingling
Muscle spasms
Muscle weakness

CERVICAL SPONDYLITIS VS SPONYLOSIS

Ankylosing Spondylitis is a term used to describe a condition of the spine that causes inflammation in the joints and vertebrae. This condition has no known cause, but there is evidence of a genetic component. In severe cases of spondylitis the arthritis will deteriorate the joints causing the vertebrae to fuse together and limit mobility in that section of the spine. There is no known cure for spondylitis but several forms of treatment that can help reduce pain and increase mobility at the site of the condition.

Spondylosis is a broader term referring to degenerative age-related conditions affecting the spine such as osteoarthritis or degenerative disc disease. It is often caused by general wear and tear of the spine such as vertebrae compressing over time and deteriorating the discs found between the vertebrae. Spondylosis can lead to compression of nerves in the spinal column causing severe and chronic pain in the back and extremities.

Symptoms of ankylosing spondylitis

Pain and stiffness in the back
Limited mobility
Abnormal curvature of the spine
Limited range of motion for spine
Local and radiating pain in the back, hip, and/or extremities

Symptoms of spondylosis

Symptoms of spondylosis differ based on the individual and the severity of the spine condition. Most patients experience the following symptoms:

Limited flexibility
Tingling and numbness
Pain

Schedule an appointment with your physician to discuss your symptoms to help your physician determine the nature and severity of your condition. Together, you can create a treatment plan that will fit your needs and your lifestyle. Patients diagnosed with either of these conditions are often able to find relief through a course of conservative treatments with surgery being seen as a last resort.

Cervical Degenerative Disc Disease

Osteoarthritis of the spine. While not everyone gets cervical degenerative disc disease with age, there are some factors that can make it more likely to develop sooner and become symptomatic. These risk factors could include:

Genetics. Some studies of twins indicate genetics play a bigger role than lifestyle in determining when cervical degenerative disc disease develops and if it becomes painful.
Obesity. Weight has been linked to risk for developing degenerative disc disease.
Smoking. This habit can hinder nutrients from reaching the discs and cause them to lose hydration more quickly.

In addition, an injury to the spine such as a herniated disc can sometimes start or accelerate cervical degenerative disc disease.

Symptoms

Cervical disc degenerative disorder can be characterized by neck pain. This neck pain can be most prevalent when the patient is upright or moving the head and can be reduced by lying down or reclining. Often the disc will be associated with osteophytes or bone spurs. They can further reduce movement and lead to nerve compression. The cervical nerve roots innervate the back of the head and neck as well as the arms and hands. If they are affected, the patient could have burning, tingling, numbness, and pain in these areas. Sometimes headaches result from cervical degenerative disc problems.

Diagnosis

Cervical disc disorders if advanced enough are diagnosable on plain x-ray, which shows collapse or reduction in the height of the disc and possible bone spurs and bony end plate changes. An MRI is most useful diagnostic imaging for these conditions. The MRI shows if the disc is degenerated and best identifies the impingement on the nerves by bone or soft tissues surrounding them. Changes in the bony end plates with increased water content in the bone are known as Modic changes.

In patients with multiple degenerative discs and associated pain, it is often difficult to distinguish which disc or discs are the pain generators. In this circumstance, additional and more invasive types of testing may be required. They could include discography/CT, a technique of injecting the discs with dye and taking a CT scan in which the patient identifies the quality and severity of the pain in each individual disc tested. Another option might be epidural or nerve blocks that are used to determine the level that is causing the nerve symptoms.

SPONDYLOLISTHESIS

This condition is characterized by one vertebra slipping over adjacent vertebra. Several things can cause this. A fracture of the pars interarticularis, spina bifida, repetitive cervical extension, or degenerative disc disease. This condition can be resolved with physical therapy if not too severe. Grade 3 and grade 4 spondylolisthesis usually requires surgery.

POOR POSTURE

Poor posture whether sitting or standing can cause a condition known as upper crossed syndrome. Neck pain, shoulder pain, upper back pain and arm pain can be assoiciated with shortening of certain muscles and weakness in others. Sitting at a desk all day, texting and watching T.V. causes a slumped position and head tilt forward position over time sometimes referred to as "Nerd Neck". Athletes can cause a muscle imbalance much in the same way by training certain muscle groups of the chest, neck, and shoulders while neglecting other muscle groups of the same area. Upper Crossed Syndrome can result because of the aforementioned scenario. The overactive muscles combined with the under used or weak muscles overlap causing an "X" shape to develop. while standing a straight line should intersect with the knee, hip, deltoid, and ear. If the ear and deltoid are forward on this line, UCS may exsist. Symptoms occurring may include:

Neck Pain
Headaches
Pain in the upper back
Pain in the shoulders
Low back pain
Decreased range of motion in the neck and shoulders
Pain and numbness in the upper arms

Tight or overactive muscles usually associated are:

Pectorals
Upper Trapezius
Levator Scapula
Sternocleidomastoid
Sub Occipitals
Subscapularis
Latisimus Dorsi
Arm Flexors

Weak or underactive muscles affected are:

Longus Capitis
Longus Colli
Serratus Anterior
Rhomboids
Lower Trapezius
Rotator Cuff
Arm Extensors

Some simple strength exercises along with stretching are an effective way to correct this type of posture. Strength exercises would include:

Standing or Seated Rows
Prone Shoulder Blade Squeezes
Triceps Extension
Neck Bridges

Stretching the before mentioned tight muscles on a mat, standing, or with a foam roller must be incorporated with your strength training routine.

Bad posture can cause other problems along with back and neck pain. Fatigue, difficulty breathing, and headaches are also attributed. The

benefits of good posture are numerous. Fewer muscle tension headaches, decreased pressure on cervical disc and ligaments, increased lung

capacity, and decreased fatigue. Most of us are addicted to our mobile devices and that keeps our head down for long periods of time are bad

habits and contribute to poor posture. Other long term issues include TMJ, herniated or ruptured disc, and muscle spasms. Incontinence from

increased abdominal pressure, constipation, heartburn, and slowed digestion are all linked to poor posture. Althought pain is usually the first

sign of a problem, Look in the mirror and see if you have a protruding head and rounded shoulders.

Some good habits for poor posture everyone should do.

Have an ergonomic work station

Yoga

Yoga goes back 5000 years to ancient India. It combines midfulness with physical movement to live a long and healthy life. It improves

muscle strength, flexibility, and reduce stress. Many yoga poses can help with correcting poor posture.

Change your sedentary lifestyle

The human body was ment to move. Exercise of any type beats sitting on your couch all day. Self correct when you catch yourself slouching

and be mindful of your posture at all times and live a health

ier life.

CAN PHYSICAL THERAPY HELP WITH NECK PAIN ?

Physical therapy can definitely help resolve neck pain. Here is what to expect for your first visit.

Evaluation: The therapist will get a thorough history of your pain. How it started, When it started, Decription of your symptoms, Level of pain and any recent diagnostic tests. Next measurement of your cervical range of motion, maybe a test for sensatiion or lack of sensation of your upper extremities Strength assessment of certain muscle groups and a fuctioanl assessment.

Treatment plan: The plan may include stretching, strengthening, massage, ice or heat, traction, and a home exercise program.

Your physical therapist may also help with managing neck pain. Good posture, taking frequent rest breaks, making adjustments to desk or work station, and a healthy lifestyle and sleeping habits all will help reduce neck pain.