Causes of Neck Pain

Neck pain is a common problem that sooner or later makes life difficult for every adult. The good news is that it signals a serious problem in only a minority of cases. The pain may affect only the neck and shoulders but can also radiate into the arms. The sensation can be dull or even shock-like. Other symptoms — for example numbness or a feeling of muscle weakness — can help determine the underlying cause.

Causes of neck pain

Neck pain is one of the most common chronic conditions.

In the cervical section of the spine nerves, vessels, muscles and ligaments "share" a relatively narrow space, so even small impacts can cause significant complaints.

The causes of neck pain are varied, ranging from stress through spinal changes to injuries.

Predisposing factors can include depression, anxiety, prolonged overload, drafts and prolonged exposure to cold.

Forced posture

Shoulder pain is especially common among those whose work strains the shoulder girdle (hairdressers, beauticians, painters, dentists and their assistants, people working at computers). Poor posture alone can also lead to complaints.

Tech-back is a modern form of neck pain caused by poor posture and prolonged use of mobile phones and computers.

One-sided carrying

Neck pain can be caused by seemingly harmless habits, such as always carrying a backpack or bag on one shoulder only.

It may be surprising, but holding your mobile phone between your chin and shoulder during a long conversation can produce the same effect.

Poor sleeping position

Neck pain often develops during sleep. You may wake up with severe, one-sided neck pain that is worsened by turning your head. This is often due to sleeping with too many or too few pillows. A typical scenario is reading in bed and bunching your pillow into a lump under your head. If you fall asleep like that, some of your neck muscles become overstretched while others are compressed.

Muscle strain

Muscle strain generally results from sudden movement, exertion or a fall.

One form is whiplash injury. It is usually "acquired" in a car accident. Because of a rear-end collision the neck and head are forcefully whipped backward and then forward together with the body. It is similar to the tip of a whip accelerating and cracking.

A similar injury can occur in sports accidents, physical assault, or from a fall.

In most cases the complaints resolve within a few weeks (with physiotherapy and therapeutic exercise). In some people (especially those who do not follow the recommended treatments) the complaints become chronic and other long-term complications may develop.

Scoliosis

Scoliosis most often causes problems in the lower back and the neck. Due to the structural deformity, nerves exiting the spine on one side become compressed while the muscles on the opposite side become overstrained.

Spinal stenosis

The spinal cord runs through a "tunnel" formed by the vertebrae. In spinal stenosis this canal narrows because degenerative changes and bony overgrowth occur.

In severe cases surgery may be necessary to create space for the spinal cord and nerves. Mild spinal stenosis can be asymptomatic. Later on pain, tingling, numbness and muscle weakness may occur and may worsen over time.

Stress

Tight neck pain is very often simply caused by stress. You can "acquire" it at work, in your family, or even in the supermarket. A toxic relationship, a bullying colleague or boss, your child's school problems, or financial worries often first present as tightness or severe headache.

Cervical spondylosis

A general term for age-related wear affecting the cervical discs. As the discs dry out and shrink, signs of osteoarthritis (inflammation) develop, resulting in bone deposits at the margins of the vertebrae (bone spurs).

Very common and worsens with age. It affects more than 85% of people over 60 years old.

However, not everyone experiences symptoms. When symptoms do occur, they are usually effectively treated with physiotherapy.

Herniated disc (disc herniation)

Problems with the intervertebral discs in the cervical spine can cause neck pain.

The outer part of the disc is a tougher, rubbery, fibrous ring that surrounds a soft, jelly-like substance. A herniated disc occurs when the fibrous ring weakens or tears and some of the jelly-like material is pushed out through the defect.

The problem arises if the leaked material presses on or irritates a nerve root exiting between two adjacent vertebrae. Such a condition can develop anywhere along the spine. If it occurs in the cervical region, it can cause pain, numbness or muscle weakness in the neck, shoulder area and arms.

A herniated disc does not always cause symptoms. If the disc herniates in a direction where there is no nerve, there will be no complaints.

A herniated disc usually requires surgery only if it fully extrudes (not just bulges) and compresses the nerve, causing constant pain, sensory disturbances or motor impairment (paralysis).

In milder cases physiotherapy and strengthening of the spinal-supporting muscles help.

Fibromyalgia

More common in women than men. It is characterized by musculoskeletal pain accompanied by fatigue, sleep, memory and mood problems. Researchers believe that people with fibromyalgia process painful and non-painful signals abnormally in the brain and spinal cord, which makes the experience of pain much more severe than would be expected from the physical findings.

Symptoms are often triggered by emotional stress, physical exertion, injury or surgery. Sometimes they appear without any obvious trigger.

Muscle pains may be accompanied by tension-type headache, temporomandibular joint pain, irritable bowel syndrome, anxiety and depression.

Although there is no cure, various medications can help control the symptoms. Exercise, relaxation and a stress-reducing lifestyle are also beneficial.

Meningitis

Inflammation of the membranes (meninges) surrounding the brain and spinal cord. Typical signs and symptoms are headache, fever and a stiff neck.

It is mainly caused by viral infection, but bacterial, parasitic and fungal infections are also possible. Although some cases of meningitis may improve within a few weeks without treatment, in other cases it can be life-threatening. Therefore meningitis must always be taken seriously and requires emergency antibiotic treatment.

If you suspect meningitis, see a doctor immediately! Early treatment can prevent serious complications.

Osteoarthritis

The most common form of joint inflammation, affecting millions of people worldwide. The protective cartilage covering the ends of bones gradually breaks down. It can affect any joint, but most commonly the joints of the hands, knees, hips and spine.

Its symptoms are usually well managed, but the joint damage that has already occurred cannot be reversed. An active lifestyle, regular exercise, maintaining a healthy weight and certain physiotherapy treatments can slow the disease progression and help relieve pain and improve joint function.

Rheumatoid arthritis

A chronic inflammatory disease that can damage not only the joints but also various systems of the body, including the skin, eyes, lungs, heart and blood vessels. It is an autoimmune disease in which your immune system mistakenly attacks and damages your own tissues.

Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis causes painful swelling of the joints, which can eventually lead to bone loss and joint deformity.

Although newer medications have significantly improved treatment options, severe rheumatoid arthritis can still cause physical disability today.

Neck pain often accompanies the conditions listed above

When should you see a doctor?

Neck pain caused by muscle tension or strain usually resolves on its own within a few days and typically requires only conservative (non-surgical) treatment. Neck pain lasting longer than a few weeks generally responds to exercise, stretching, physiotherapy, massage and watchful waiting.

To relieve discomfort, try the following home remedies:

• Ice or heat: apply an ice pack to your neck for 15 minutes three times a day or more (even a bag of frozen peas will do). A hot shower or bath can help relax tense muscles.
• Stretching: stretch your neck muscles by gently turning your head from side to side and up and down.
• Massage: rubbing sore areas of the neck can help relieve muscle cramps.
• Improve your posture: practice good posture, especially if you sit at a computer all day. Keep your back supported and make sure your monitor is at eye level.

See a doctor if your neck pain

• worsens despite home remedies
• persists after several weeks of self-care
• radiates down your arms or legs
• is accompanied by headache, numbness or tingling

Seek emergency care immediately if the neck pain...

• develops after trauma (injury): for example a car accident, sports injury or a fall.
• is accompanied by muscle weakness: if your arm becomes weak along with neck pain, this may indicate a more serious problem.
• is accompanied by high fever: severe neck pain with high fever may be a sign of meningitis.

For non-emergency neck pain

Functional therapeutic exercise and therapeutic massage are recommended.

However, the greatest help can be provided by a muscle stimulator device. Just 15–20 minutes of treatment already relieves muscle tension and stiffness and reduces pain. Several days of use can achieve significant improvement in most of the cases mentioned, even in complaints caused by a herniated disc.