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How to Determine when a Pain in the Neck is More than That

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Have you ever been shopping, tried to grab something just out of reach on an upper shelf, and felt an immediate strain in your neck? Or did you ever wake up in the morning and for some unknown reason have a painful, stiff neck that left you barely able to move your head? If you answered yes, then you are certainly not alone, as neck pain or discomfort is a very common reason for people to seek medical care. Most neck pain is caused by muscle strain or tension, and although some individuals experience this chronically, it is usually not serious. A first step is to identify what activities may be contributing to this neck pain, such as poor posture, work environment, sleeping in an uncomfortable position, or specific sports/exercise.

While most cases do not have serious medical implications, neck pain could be the sign of an underlying condition or problem that requires medical attention, according to the American Association of Neurological Surgeons. Neck pain may be caused by disc degeneration, narrowing of the spinal canal, arthritis, and, in rare cases, cancer or meningitis. For serious neck problems, a primary care physician and often a specialist, such as a neurosurgeon, should be consulted to make an accurate diagnosis and prescribe treatment.

Age, injury, poor posture, or diseases such as arthritis can lead to degeneration of the bones or joints of the cervical spine, causing disc herniation or bone spurs to form. Sudden severe injury to the neck may also contribute to disc herniation, whiplash, blood vessel destruction, vertebral injury, and, in extreme cases, permanent paralysis. Herniated discs or bone spurs may narrow the canal through which the spinal cord runs or narrow the small openings through which spinal nerve roots exit. Pressure on a nerve root from a herniated disc or bone spur may cause pain in the arm and neck, numbness or weakness in the arm, or tingling in the fingers or hand.

Cervical stenosis occurs when the spinal canal narrows and compresses the spinal cord and is most frequently caused by aging. The discs in the spine that separate and cushion vertebrae may dry out. As a result, the space between the vertebrae shrinks, and the discs lose their ability to act as shock absorbers. At the same time, the bones and ligaments that make up the spine become less pliable and thicken. These changes result in a narrowing of the spinal canal. In addition, the degenerative changes associated with cervical stenosis can affect the vertebrae by contributing to the growth of bone spurs that compress the nerve roots. Symptoms include neck pain, numbness and weakness in both hands, unsteady gait when walking, and muscle spasms in the legs. Mild stenosis can be treated conservatively for extended periods of time as long as the symptoms are restricted to neck pain. Severe stenosis requires referral to a neurosurgeon.

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Updated on: 12/10/09
It is important for patients to realize that both neurosurgeons and orthopedic surgeons perform spine surgery. Today, there is an emerging field of "spine surgery" that incorporates both specialties. - SpineUniverse Editorial Commentary
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