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Understanding the Causes, Diagnosis and Treatments of Neck Pain

Neck Pain Treatment in San Antonio

Approximately 15% of pain reported by adults in the United States is neck pain. Drug treatment for this debilitating problem also accounts for a large percentage of the pain medications being used on a daily basis.
The role of the neck is important — it supports the head and allows it to pivot freely. It also provides protection for vital nerves. When the neck is compromised, so, too, can the entire body be at risk for injury?
The human neck spans from the base of the skull to the top of the shoulders, making up the uppermost part of the spine. This area is known as the cervical region of the spine. It is comprised of seven bones known as vertebrae. Each of these bones stacks on top of the other, with a cushioning disc between each one. This “stacking” creates a supportive structure and provides protection to the spinal cord, which runs through the center of the spine in a space known as the spinal canal. Wrapped around the outside of these vertebrae are muscles and other connective tissues. Neck pain can originate from the nerves within the spinal column or the muscles or tissues surrounding the spine.

The Most Common Causes of Neck Pain

The neck, despite its tough construction, is still susceptible to injury and disease. Neck pain stems from a number of causes, including damage to the bones, muscles, discs, and nerves.

Common Neck Ache

Although not a definitive condition, once in a while neck pain can be experienced due to muscle spasms, muscle strains or a “crick” (a minor nerve impingement). This can happen for a number of reasons — stress, illness (such as the flu), sleeping in an awkward position or TMJ (temporomandibular joint dysfunction). If the symptoms persist, it is recommended that a physical exam is performed to rule out a more serious cause for the discomfort.

Degenerative Disc Disease (DDD)

A fairly common cause of chronic neck pain, degenerative disc disease is essentially a term used to define the symptoms associated with the stress and consequent damage to the disc. The symptoms of this condition include an unrelenting, low-grade pain that can also be accompanied by radicular pain (shooting or stabbing pain in the legs or arms), weakness and numbness or loss of sensation in one or more extremities. At times the pain can increase to fairly intense levels. In the worst-case scenario, the damaged disc can slip into the spinal canal, putting pressure on the spinal cord and nerves, leading to severe symptoms such as numbness, tingling, pain, bowel and bladder control problems, and even paralysis.

Herniated Disc

A disc herniation can occur anywhere within the spine but is particularly painful when it occurs in the neck. When a disc “herniates” the tough outer layer breaks open and the gel-like material inside pushes out, often placing pressure on the spinal cord or nerve roots. Much like degenerative disc disease, a herniated disc can cause pain, tingling in the extremities, numbness and other symptoms.

Cervical Fracture

Cervical fractures occur when the neck is subjected to trauma, such as a fall or accident, or when a tumor or bone disease compromises the structure. Cervical fractures can range in severity, from a hairline crack that doesn’t cause much noticeable discomfort to a markedly painful and immobilizing break.

Bone Tumor

In instances when a bone tumor is growing in a cervical vertebra it can erode the bone, causing the spinal cord and nerves to become caught or pinched. This leads to the same types of symptoms seen with all of the conditions above. Additionally, even if not destroying the bone tissue, a tumor can grow inside of the spinal canal (the channel that runs through the middle of the spine where the spinal cord resides), and once large enough, will press against the spinal cord, causing pain and other symptoms.

Diagnostics and Treatment for Neck Pain

Diagnosing neck pain can start with a visit to the primary care physician. He or she can perform a basic neurological exam and assess the range of motion and other factors. If it is thought that the pain is stemming from a simple pulled muscle or strain, the first and most conservative approach may be anti-inflammatory medications and rest. If the pain does not subside in a reasonable amount of time, further diagnostics may be required.

X-Rays

X-rays are a standard diagnostic tool when assessing neck pain. X-rays use highly-defined beams of energy to penetrate tissue and create an “impression” of the bones and other structures in the neck. This allows a two-dimensional image to be taken of the vertebrae in the neck. Fractures, tumors and other anomalies can often be spotted on x-rays and help determine a course of treatment or whether additional diagnostics will be required.

MRI (Magnetic Resonance Imaging)

An MRI uses high-powered magnets and computers to give doctors a comprehensive look at soft tissues in the neck. This diagnostic technique is often used in cases where muscles and ligaments may be damaged or a tumor may be present. It can also provide a clear picture of the inside of the spinal canal to help rule out non-muscle or bone-related issues.

CT Scan (Computer-aided Tomography)

Through the use of multi-angled x-rays and specialized computer software that puts them all together, a three-dimensional image is created, allowing doctors to fully view a patient’s neck. CT scans are the gold standard for fracture identification and assessment.

Treating Neck Pain

There are numerous treatments used for neck pain, each targeting a specific cause. Pain medication and rest are often the first options tried, unless a marked injury or other orthopedic issue is present. When the latter is the case, the following treatments are the most common “go-to’s” for neck pain treatment.

Microdiscectomy

This surgical procedure uses specialized instruments to carefully remove the portion of the damaged disc that is placing pressure on the spinal cord.

Fusion Surgery

In cases where one or more vertebrae are structurally compromised, a fusion surgery may be performed. This surgery essentially uses a bone graft to create a supportive “bridge-like” structure between the vertebrae, increasing strength and stability in that portion of the neck.

Laminectomy

In instances when the spinal cord is being severely impinged by a damaged vertebra (such as in the case of injuries like a hangman’s fracture), a laminectomy is performed. This surgery removes a small portion of the vertebra so that the spinal cord can move freely within the spinal canal.
Injections

Corticosteroid injections are useful in treating inflammatory issues that may be causing a patient’s neck pain. Freeing yourself of your neck pain should be a priority. Not sure where to start? Give us a call today at (210)614-6432 to schedule a consult with one of our experienced and compassionate surgeons.

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