Neck pain is one of the most silent debilitating pains a person can have, where
symptoms vary from a mild ache in the neck to headaches to upper back pain,
shoulder blade pain, a tingling sensation radiating into hands and so on, which if
unattended can lead to weakness in both hands. Instability in the cervical spine and
muscles surrounding it can be due to degeneration, injury, or inactivity of muscle
groups along with sedentary lifestyle. Whether you are a software employee, a
housewife or an adolescent always on the phone, you have a chance of getting neck
pain.
THE STRUCTURE OF YOUR NECK
Your spine is stacked like building blocks with 33 bones, out of which 7 are present in
your neck. These bones/ vertebral bodies are held together by many ligaments and
muscles which provide stability to the spine while we move our head in all directions.
There are small cushion like structures called inter vertebral discs between these
bones to provide more freedom of movement, while also providing shock absorption.
They are made of thick fibrous outer-layer and a gel-like inner layer. The spine while
passing through the vertebral column, which is just behind your vertebral bodies,
gives off small branches on either side which control all your muscles and sensations
in your hands.
SYMPTOMS OF NECK PAIN:
- Deep, dull aching pain in the neck: this may be due to strain in the neck
muscles surrounding your cervical spine. - Stiffness: (what we clinically call as limited range of motion) happens
because of tightness/strain in your muscles. Tightness in the muscles can be
either due to overactivity, limited use or a protective mechanism against pain. - Headaches: having neck pain can lead to having headaches which are also
called tension headaches. These may occur as a result of the pressing of tiny
nerves in the back of your head. - Radiating pain: people with neck pain may have shooting pain radiating to
the shoulder blades, arms or hands. - Tingling and numbness: a person with significant degenerative changes in
the spine, and compression of nerves as a result of that, may experience a
tingling sensation in one or both the hands. - Muscle weakness: In chronic degenerative conditions, or in case of injury, a
person might experience progressive muscle weakness in one or both the
hands.
You may not experience all the symptoms mentioned above but may have a cluster
of the above-mentioned symptoms.
CAUSES OF NECK PAIN:
- Improper posture: doing work in improper posture might not be a direct
cause of neck pain but having muscle imbalance ( weakness in certain
muscles) due to a sedentary lifestyle and regularly engaging in improper
posture might cause you neck pain. - Degenerative changes: as we age, our bones start degenerating because of
wear and tear. Just like how a motorcycle or car gears keep getting old with
time and need regular servicing and usage to keep them in the right condition,
the space between the vertebral bodies may reduce and cause the disc to
protrude or press on to the nerves that exit from the spine. - Injury to your neck or head: you may experience neck pain when you have
injury anywhere around the head and neck. Examples of injury include a
whiplash injury, car accidents, blunt force trauma etc. - Muscular strain: overworking or over-exertion of the muscles of your neck,
may also cause neck pain. Neck muscle strain may occur while sleeping,
lifting heavy weights etc. - Autoimmune disorders: in some cases of rheumatoid arthritis or in case of
ankylosing spondylitis, the patient may have severe neck pain. - Tumours and infections: in cases of tumours in the bone or spinal cord, or in
case of infections like TB of the spine, the patient may experience debilitating
neck pain along with other symptoms.
HOW IS NECK PAIN DIAGNOSED?
It is important to know that whenever you have an injury or chronic pain which lasts
more than 10 days, it is better to consult your doctor.
Your doctor may do the following to identify the cause of your neck pain:
Ask for your medical history.
Conduct a thorough physical examination.
Ask you to get an X-ray, MRI, or a CT scan to see the changes within your
spine.
A Nerve-conduction study may be prescribed if there are any changes in your
sensation or if there is any weakness in your hands.
A bone density scan may be performed to check the health of you bones. This scan specifically helps in knowing if you have osteoporosis (soft bones
due to lack of minerals).
Ultrasound scan or doppler test if you the doctor feels that you are having
pain due to improper blood supply.
Blood work depending on your history and symptoms.
WHAT HAPPENS AFTER DIAGNOSIS?
MEDICAL TREATMENT
Depending on the cause of neck pain your doctor may prescribe you medical
treatment which may include medication and topical ointments/analgesics to
help reduce the pain/muscle spasm.
PHYSIOTHERAPEUTIC MANAGEMENT:
In most cases where you don’t have a tumour or infection, your doctor may
prescribe physiotherapy treatment.
Initial phases of rehabilitation include pain management which includes
passive physiotherapy followed by active rehabilitation where your muscles
will be strengthened to improve your strength and functionality, thereby
preventing recurrence of pain.
MORE ABOUT THE PAIN MANAGEMENT PHASE:
Once you are suggested to take physiotherapy, you will be meeting a
physiotherapist. The physiotherapist will assess you by checking your mobility,
strength and flexibility and will perform a few special tests.
The initial stage of rehabilitation is the pain management which may last from 5 to 10
days or even more depending on the intensity and extent of pain.
Treatment includes:
- Electrotherapy: electrotherapy modalities like IFT, Ultrasound, TENS,
LASER therapy, Shockwave therapy or Infrared Therapy. All of them help in
reducing the intensity of pain. Based on your assessment, the physiotherapist
will be the best person to choose the modality that best suits you. - Heat therapy or Cryotherapy: you may be suggested to use an ice pack or
hot water pack by your physiotherapist. - Gentle stretching: in this phase, passive or gentle stretches may alleviate
the tension in your muscles. - Gentle isometrics: Gentle isometric exercises help in working your muscles
without moving your head, these help in improving blood circulation to the
painful areas, and also help in keeping the muscles active.