Neck Pain is Nothing to Shrug About

Thousands of Americans suffer from episodes of acute or persistent neck pain each year as a result of injury, strain, overuse or aging. However, a pain in the neck should not be ignored and left undiagnosed and untreated. Problems in the cervical spine, the first seven bones (vertebrae) in the neck running from the base of the brain to just past the shoulder blades, require assessment and treatment to prevent further, more permanent, damage.

"The cervical spine is where the spinal cord lives," said Volker K.H. Sonntag, MD, a member of the American Association of Neurological Surgeons Board of Directors and a neurosurgeon practicing in Arizona. "The spinal cord is the most delicate tissue in the entire body. Even minor damage to the spinal cord cannot be repaired. Unlike low back pain, in which waiting to seek treatment may prolong the pain but usually doesn't cause any further damage, untreated spinal cord compression can lead to irreversible damage."

Two Types of Neck Pain
There are two distinct types of cervical neck pain. The first type often involves a dull pain in the neck that radiates down the shoulders and arms. Patients may also notice weakness in specific muscles in the arms.

A herniated (bulging) disc in the spine pinching a nerve root in the neck often causes this type of neck pain. Discs are found between each vertebra, or bone, in the spinal column. They serve as "shock absorbers" within the spine and have a gel-like center that makes them flexible, allowing the spine to bend and move. However, because the discs are soft they can also bulge and become misshapen. When this occurs, they can place pressure on the spinal cord or irritate one of the nerves leading from the spinal cord out to the arms and upper torso. If the bulge becomes severe, the disc may herniate and push into the spinal canal. The result can be weakness, tingling, clumsiness and numbness in the arm and hands. Bulging discs can be caused by injuries like whiplash, stress on the spine by overuse, or by arthritis/degeneration in the spine.

The second type of neck pain often isn't experienced as 'pain' by patients at all. It usually involves numbness or weakness in the arms or legs, difficulty walking, loss of pain or temperature sensation in the hands and arms, poor balance and stiffness in the neck. In this case, there is pressure directly on the spinal cord. Because this type of "pain" is not felt in the neck itself, it is easily misdiagnosed.

"We usually see patients with neck pain in one of three different scenarios," Dr. Sonntag said. "One, they've been in some sort of accident and have suffered a whiplash-type injury. Two, they have a chronic injury caused by overuse, most likely caused by working at a computer for endless hours. Or they've experienced one of the first two scenarios in the past and now have arthritis or a tissue degeneration problem."

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