We understand your Neck.
Pain varies from person to person, and so does pain management. At TheraNow, we understand your neck and take a very personalized approach to manage your neck pain just with exercises and lifestyle modifications.
Our AI-powered exercise programs are tailored to your medical needs.
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All about neck
Neck pain is one of the five major musculoskeletal disorders amongst adults; with a world prevalence of 16% to 75%. Neck pain has a complex etiology. Common factors include:
- Individuality (BMI, age, pain/medical history, genome)
- Ergonomics (repetitive or strenuous physical activity, improper posture, or use of vibration or force)
- Behavioral (lifestyle, history of smoking)
- Psychosocial (stress, depression, anxiety, work culture)
- Neck pain is a major cause of morbidity and disability in everyday life and at work in many countries.
- By middle age, approximately 30% to 50% of people will have at least one episode of neck pain within a year.
- Around 2-11% of people report limited activities due to neck pain at any time.
- Neck pain annually affects more than 30% of adults in the US, and about 50% of people will have some continued chronic neck pain or frequent recurrence.
- Among adults, 20% to 70% will experience neck pain interfering with daily activities during their lifetime.
- Most patients treat neck pain with rest, immobilization, exercise and therapies.
Neck pain based on location
Axial Neck Pain
Mechanical/axial neck pain is the most common, focused on one part/region of the neck. It is typically dull, achy, or throbbing but may also be sharp/stinging.
Symptoms may increase with certain movements or poor posture. Usually caused by strains/sprains, however, may also be due to spinal degeneration, trauma, disc degeneration, facet joint dysfunction, or vertebral bone fracture.
Nerve root inflammation in the cervical spine causes radiating pain along the nerve, down into the shoulder, arm, and/or hand on one or both sides.
Pain can be searing or electric shock-like. The pain may increase with certain movements and posture. It is usually due to spinal degeneration, nerve root irritation by osteophytes or herniated disc.
It is a pain experienced in a location other than its source and not caused by nerve root irritation. Usually deep, achy, cramping and/or throbbing sensation.
The area of distribution is likely more diffuse than radiating pain. Pain can be referred to the neck in many ways, such as from the heart (during a heart attack) or the jaw (TMJ). Also, a neck pathology may cause referred pain like a headache, or shoulder/upper back pain.
The compressed spinal cord develops myelopathic pain.
Myelopathic pain may occur at the level of compression causing neck pain, however, symptoms are often far below the neck/compression site, such as in the legs and/or feet. This may lead to misdiagnosis and mismanagement.
Duration plays an important role
Duration of the condition has a vital role in understanding, diagnosing and treating the cause of neck pain.
Neck pain treatment may vary depending upon how long ago the pain started.
Acute neck pain (short-duration)
Usually starts as an immediate response to an acute injury from strain or sprain, motor vehicle accident or sports injury. Acute neck pain typically lasts for less than 4 weeks. The cause can be as common as sleeping with the neck in an awkward angle, poor posture while working on a laptop, or even texting on a mobile phone.
The pain is sharp + excruciating to dull + achy, starts suddenly and may be accompanied by stiffness that makes it difficult to rotate the head and/or look up or down.
Acute neck pain may serve as a protective mechanism and a natural phase of the inflammatory healing process. The pain motivates to rest and avoids further damage during healing.
Chronic neck pain (long-duration)
Chronic pain starts gradually, and may/may not have an identifiable cause. Pain is usually considered chronic if it has lasted at least 12 weeks.Pain lasting between 4 and 12 weeks may also be called subacute pain.
Chronic neck pain may be related to underlying conditions like degenerative disc disease or spondylosis or may develop without a known cause. In some cases, acute pain extends to chronic pain that persists long after the healing of the initial injury.
Chronic pain may be dull and achy, or sharp or searing, and may extend into the arm. It could be constant and unrelenting, or intermittent and progress gradually over time.
Activities of daily life are difficult with chronic pain and may also cause depression.
Anatomy of the neck
The neck comprises of bones (vertebral column), the spinal cord, discs, nerves, muscles, tendons, ligaments and other tissues.
- The vertebral column – The cervical spine consists of 7 vertebrae between the base of the skull and the thoracic spine (ribcage), with discs in between.
- The discs – Spongy cartilages located between the vertebrae, providing cushion.
- Nerves – Nerves arise from the spinal cord and go to different parts of the body. Any compression in the nerves may cause pain in the parts supplied by that nerve.
- Muscles – More than 20 muscles are connected in the neck. These muscles work together to help support the head’s upright position and facilitate movements of the head, neck, jaw, upper back, and shoulders.
- Tendons – Tendons are the connective tissues that attach the muscles to the bones.
- Ligaments – Ligaments help in holding the bones and skeletal structures together and in shape.
Treatment tailored for your neck
- Answer simple questions.
- Choose your plan.
- Exercise to recovery.
Know your neck more
The neck is a complex structure with components like muscles, spinal cord, discs, bones, ligaments, tendons, and nerves. Any of these can independently or collectively cause neck pain. Symptoms widely depend on the components/structures involved in the cause. Most of the causes can be completely treated with an appropriate diagnosis. Neck pain may also be linked to serious illnesses like heart conditions and cancers, including lung cancer that has spread to shoulders, neck and lower back. Chronic neck pain, often called a stiff neck, or an aching neck, or a crick in your neck, causes discomfort that lasts for days or weeks and can be linked to malignant tumors. Osteoarthritis may be present in up to half of all neck pain cases in individuals over 50. Men aged 55-65 with neck pain have a higher percentage of disc problems (40%) than women (28%). Common causes of neck pain include cervical dysfunction, muscle and tendon strains and sprains, osteoarthritis and herniated discs or degenerative disc disease
Most common causes of neck pain
Cervical spine dysfunction is a disorder or malalignment of the pain-sensitive facet joints (intervertebral joints between the seven vertebrae of the cervical spine). Disc disruption may also cause dysfunction. It may lead to secondary muscle spasm causing more stiffness and pain.
Everyday wear and tear due to activities requiring repetitive neck movements, bending or twisting of the neck over extended time may cause cervical dysfunction.
A single injury like a blow to the head or a sudden jerk/assault to the neck may also be a cause.
Strains and Sprains
The most common musculoskeletal cause of neck pain. Neck strain or pulled muscle occurs when one or more fibers of the muscles/tendons stretch too far and/or tears. Neck strain usually heals on its own (depending upon the size and location of the tear) within a few days or weeks. Pain caused may be mild and achy, or sharp and debilitating. Any injury to the ligaments of the neck is known as sprain and may cause similar symptoms.
Movement may worsen the pain in most cases and resting and icing the involved tissue may seem very effective.
Osteoarthritis or degenerative disc disease
Cervical spondylosis/osteoarthritis is a condition that involves changes to the bones, joints, and discs from normal wear-and-tear of aging. The cervical spine discs gradually break down with age, lose fluid, and become stiff. Usually seen in middle-aged and elderly people.
Degeneration of discs and other cartilages causes the formation of spurs (abnormal growths) called osteophytes on the bones, causing narrowing of the spinal column (cervical spinal stenosis) or may compress the exiting spinal nerves.
Cervical spondylosis causes neck pain and stiffness. Although rarely progressive, severe cases can be treated with corrective surgery.
Cervical disc herniation (disc bulging/ruptured disc) is a common disorder of the cervical spine that can lead to neck and/or arm pain. Herniated/displaced discs can compress nerves exiting the spine, the spinal cord or both.
The compression of the exiting nerve is knowns as radiculopathy. Compression of the spinal cord may cause more than one symptom and is called myelopathy. When spinal cord and exiting nerve(s) are affected, it is known as myeloradiculopathy.
Common complaint of people with neck pain.
Depression may be seen in people with chronic neck pain. Depression and pain can produce a vicious cycle causing more severe pain and depression.
Low Back Pain
People with neck pain often have correlated low back pain.
Neck Pain Management
Managing neck pain can be difficult due to the various causes. Each cause of neck pain requires different management; however, exercise and physical therapy may be commonly seen in all treatment protocols.
A personalized approach is very important. Identifying the cause carefully is the key.
Most common neck pain management techniques are –
- Oral treatments – OTC medications, prescription drugs, opioids, and supplements.
- Topical treatments – Topical medicines, heat/cold therapy.
- Physical Therapy – Movement and exercises.
- Lifestyle changes.
- Postural changes.
- Surgery including foraminotomy, laminectomy, fusion, discectomy, artificial disc replacement, and anterior cervical discectomy and fusion.
When to approach a doctor?
Neck pain doesn’t necessarily mean serious health condition and doesn’t require a doctor’s visit every time, especially when pain is caused due to sprains/strains. However, in some instances, an immediate doctor’s help is necessary.
Symptoms requiring immediate doctor’s help –
- Severe pain.
- Burning, numbness or tingling in the extremities
- Pain radiating to the extremities
- Headache or dizziness
Some people may be at risk –
- People with a recent history of major accidents and injuries
- People with cancer
- Long-term steroid or IV drug use
- People with weak immune system
Neck pain diagnosis
In severe neck pain cases, diagnosing the cause may be difficult. There are many methods/tools/studies available
that aid in the diagnosis.
Questionnaire & History Taking
Questions on how and when neck pain started, duration and nature of pain, location, aggravating and alleviating factors, and mechanism of the injury help a great deal in diagnosing neck pain.
Physical examination of the neck and other physical tests and reflex testing are necessary for appropriately diagnosing neck pain.
Radiology & Diagnostics
Symptoms may sometimes require thorough radiological tests like x-rays, MRIs, CTs, etc. Laboratory diagnostics may also prove helpful in some cases.
Neck pain can be prevented
Strong evidence proves that some neck pain causes can be prevented. Research shows that whiplash injuries from motor vehicle accidents can be reduced by up to 35% with cars having good head restraints and appropriate adjustments.
Maintaining proper posture and positioning
A good posture and proper positioning throughout activities, and improving ergonomics is the most helpful way to prevent the neck from musculoskeletal injuries and pain.
Neck muscles need a lot of strengthening when underused due to the nature of the job.
Stretching the neck muscles and exercising daily may prove very helpful.
Manage stress. Maintain an active, healthy lifestyle.