Neck pain is a typical source of discomfort. If you have neck pain, your one of at least 70% of people that have to deal with some type of neck pain in their lives. Neck pain and injury can be very scary, as there a lot of vital structures that run through the neck. This article will discuss basic neck anatomy, common neck injuries and some self-help strategies that you can try to reduce your pain.

Neck anatomy

Your neck is composed of 7 spinal column bones called vertebrate. Each vertebra has small areas, called facets, where one vertebra contacts the one above and below. These facet joints are the joints of your neck and is where movement of your neck occurs.

Between your vertebra are soft tissue spacers called intervertebral discs (discs). Your spinal cord runs inside a canal in these vertebrae. At each vertebral  there are symmetrical openings (foramen), where spinal nerves exit. These nerves will go to supply muscles and skin in the head, arms, upper back and chest area. There are also major veins and arteries that lie in the neck that supply and drain blood supply to and from the brain. In your neck is also your swallowing tube (esophagus), breathing tube (trachea), vocal structures and major hormonal producing gland (thyroid).

Posture

We can’t discuss your neck without discussing its part in maintaining good posture alignment. In our technology current technology age, you likely spend a lot of time in unnatural and uncomfortable sustained positions and your neck often pays the price.

What is good posture? From your shoulders up, good posture is when your ears are positioned directly above the shoulders and the top of your head is in line with the rest of your spine. In this position stresses to your neck are minimized.

A common poor posture position is known as forward head posture happens. This common posture is seen when your head is further in front of the shoulders rather than directly above them. This unnatural position can lead to increased stress on the neck, muscle overload and hunched upper back, which in turn can cause mid-back and shoulder problems.

The following photos will show how to correct forward head postures and the load on your neck while texting, sitting at the computer and reading. Our previous article discussed optimal work station ergonomics to reduce strain on your neck.

 
These corrections work well for screens, but reading isn’t the same as using a screen. A simple reading stand can make a huge difference on your neck symptoms when used properly and consistently.

So what’s the source of my neck pain?

A common misconception is that if you have neck pain you should get an X-Ray or MRI to determine what to do. These imaging techniques are used in medical management to determine what surgical procedures are required to resolve pain that isn’t getting better with appropriate conservative management. Conservative management isn’t based on imaging results, but rather on where your pain is, which movements bother you and what make it feel better. We’ll start discussing some of the more common conditions below.

Neck strains and sprains

Strains and sprains are often used interchangeably. Strictly speaking, a strain is an injury to the muscles of your neck and a sprain is an injury to the ligaments of your neck. These injuries happens when your neck structures are stretched too much or the muscles have been forced to contract too strongly.

Often muscle strains can be prevented muscle strain by avoiding aggravating postures and observing proper ergonomics.  Our previous article discussed optimal work station ergonomics to reduce strain on your neck

If you’re already experiencing  pain from a muscle strain or joint sprain there are several ways to manage them:

1. Modify your activities by avoiding or modifying painful positions.
2. Apply ice within 48 hours of injury (why ice ? See our previous blog on when to use ice versus heat) .
3. Do the following simple neck stretches (without pushing through pain).
4. Go for a walk to loosen up your muscles.

Whiplash

Whiplash is a neck strain sustained as a result of forceful and fast back and forth movement of your neck. It often occurs as a result of a car accident, sport’s injury or a fall. There are many possible whiplash symptoms including neck pain and stiffness, dizziness and fatigue. Many securities studies advise that early movement will help speed up your recovery and minimize long lasting effects from your whiplash. More information on whiplash is available through our previous post.

 It's important to see a health care provider that’s experienced in treating neck injuries, such as doctor or physiotherapist if your neck pain started as a result of a severe trauma, or is getting worse.

Degenerative Disc Disease

Degenerative disc disease is considered to be part of the natural aging process. As you get older, your discs lose their shock absorbing abilities. Pain from this condition can refer to the upper back, shoulder, jaw and the head. It can even be felt down your arm, if one of your spinal nerves is compressed by the narrowing of the foramen due to a decreased disc height.

 Manual therapy together with properly prescribed exercises have been supported by scientific  literature as an effective treatment aimed to improve function, increase neck mobility, reduce pain and disability levels.

Avoid heavy weightlifting exercises in order to preserve disc height. If you’re not sure how to modify your routine, it's a good idea to discuss your exercises routine with your physiotherapist in order to maximize safety and minimize your pain.

Osteoarthritis

Osteoarthritis is normally an age-related condition where the degenerative wear and tear of the intervertebral discs and joint cartilage occurs. The most common symptoms of neck arthritis are pain in the neck and upper shoulders and stiffness with movement.  Headaches can also be associated with neck osteoarthritis.

Age related changes in your joint structures can narrow the openings where spinal nerves exit, causing them to be pinched. If that happens, the pain can extend down the arm into the hand and fingers and numbness and/or pins and needles can occur.  Pain from osteoarthritis is often felt locally in your neck when turning your head to check your blindspot while driving, or looking up to reach into a cupboard. Stretche

Evidence-based management includes patient education about posture, lifestyle modification, weight reduction and exercise. Stretches to loosen short muscles at the back of your neck and areas of poor posture through the shoulders and upper back are can help to reduce pain and increase your movement. Additionally, manual therapy by a physiotherapist with experience in assessing and treating neck pain can help with neck pain, mobility deficits, headaches and nerve irritation due to arthritis.

Herniated Disc

A Herniated disc is a deformation of the disc structure, where gel-like centre of the disc (nucleus) bulges out from its fibrous barrier (annulus). Symptoms can include neck, shoulder, arm pain as well as numbness and/or tingling and/or weakness of the arm and hand.

It's important to manage your herniated disc with appropriate rehabilitation. Your physiotherapist can provide you with valuable information on how to optimize healing, avoid further damage and injury recurrence. They can perform conservative pain management techniques, help you restore mobility, strength and normalize nerve symptoms, is they are present

Disc symptoms can be interrupting to your function and they can be confusing, even scary. It's important to have a proper assessment to ensure that treatment prescribed is helpful and safe for you.

Neck fractures

Neck fractures can present differently from one case to another, from a simple break like any other bone in the body to a very severe injury, if the spinal cord gets damaged.  All broken necks should be treated as a medical emergency since fractures can have very serious consequences.

A broken neck is often extremely painful and the movement of your head may be largely limited or completely impossible due to muscle spasm. Depending on the presence and the level of damage to the patient’s spinal cord, it can affect your ability to move or feel your arms and legs.

Neck fractures are usually a result of trauma, such as a fall, a direct blow or a car accident. The recovery time depends on the seriousness of the injury sustained, and it can vary greatly; from a few weeks to irreversible, if your spinal cord has been damaged.