Many of us have experienced severe Neck Pain or Cervicalgia at some point in our lives. It can be caused due to a variety of reasons such as not sleeping in a correct position, being in an accident leading to whiplash injury or twisting the neck during strenuous physical activity. Severe neck pain can also lead to headaches or dizziness. Symptoms may resolve in a few days or there may be persistent pain that limits everyday activities.
The cervical spine is a very intricate and flexible structure with the capability to support a head weighing 15 or more pounds while moving in several directions. Cervical spine has the maximum freedom of movement when compared to other parts of the spine. Cervical spine is capable of moving the head in many directions like 90 degrees of flexion (forward motion), 90 degrees of extension (backward motion), 180 degrees of rotation (side to side), and almost 120 degrees of tilt to either shoulder. Due to this combination of complexity and flexibility, the neck, or the cervical spine region, is more prone to pain and injury. Cervical spine is composed of 7 small vertebrae along with intervertebral discs to absorb shock, joints, the spinal cord, 8 nerve roots, vascular elements, 32 muscles, and ligaments. The nerve roots start from the spinal cord like tree branches through vertebral foramen. Each nerve root transmits nerve impulses or signals to and from the brain, shoulders, arms, and chest. A combination of 4 arteries and veins comprise of the vascular system that run through the neck to circulate blood between the brain and the heart. Joints, muscles, and ligaments enable movement and aid in stabilizing the cervical spine structure.
This is severe pain in the neck with stabbing, shooting pain referred into the shoulders and arms. Patients having the following symptoms should seek medical attention immediately: Progressive neurological deficit such as weakness in the arms or loss of feeling and coordination in the arms or legs may indicate nerve damage. Persistent or increasing pain accompanied by lack of appetite, unplanned weight loss, nausea and vomiting with fever/chills/shakes could be an indication of spinal tumor or infection.
Chronic neck pain is prolonged pain present for a long duration of time. It is accompanied by pain that radiates down the arms, and into the hands and fingers. Cervical herniated disc or foraminal stenosis pinching a nerve in the neck is the common cause. Treatment for cervical disc herniation depends on the duration of the pain, intensity of the pain and the extent to which the cervical nerve and/or spinal cord are affected. Usually, the symptoms are temporary and can be treated successfully with nonsurgical care such as medication, physical therapy, manipulations etc. If the pain persists beyond 6 to 12 weeks despite conservative treatments, then surgery is recommended.
Several structures are responsible for causing neck pain such as bones, nerves, discs, longitudinal ligaments, muscles, facet joints, and dura. All these structures cause pain when they are irritated or inflamed. The pain can be classified as nociceptive, neuropathic, or idiopathic in origin. Nociceptive pain is the most common type of pain. Acute pain is often of nociceptive origin, but when it becomes a chronic pain then the influence of psychologic and social factors becomes more apparent. The activation of peripheral primary afferent, gives rise to nociceptive sensation of pain. Impulses are conducted by a part of myelinated A-delta fibers and unmyelinated-C, which are produced by noxious stimuli and transmit sensations that are considered pain. Primary nociceptive afferents ascend contralaterally and stimulate spinothalamic and spinoreticular neurons in the dorsal horn of the spinal cord by mediating neurotransmitters, such as glutamate, aspartate, substance P, and calcitonin gene-related peptide. The axons transmit the stimulus to the brain travelling in 3 primary ascending tracts that project to the thalamus and the reticular formation. Damage or dysfunction of peripheral nerves or the central nervous system (CNS) causes neuropathic pain. Neurons may be sensitized to react to even an extremely slight stimulus that normally won't cause pain. Neuropathic pain often appears as chronic pain. Reorganization of central processing is thought to be related to this pain state. Infections such as herpes zoster, metabolic diseases like diabetes, and traumatic injuries to the spinal cord and strokes that involve ischemic damage to the ascending nociceptive pathways are the most common causes of neuropathic pain. The pain is termed as idiopathic when no damage in tissues or neurons can be found.
Treatment depends on the cause of the neck pain. Usually, neck pain originates from strain and can be treated non-surgically. This involves relieving neck pressure and muscle spasm. Other methods include:
Stand straight and move your head forward so that your chin touches the chest or comes as close as possible to the chest as shown in the video. Neck Flexion stretches the muscles of your neck at the back of the cervical spine and gives relief from the neck muscle tightness.
Stand straight and tilt your head back, not fast or forcefully, until your face looks directly at the ceiling. Neck extension movement stretches the front of your neck muscles. Don't continue this movement if you feels dizzy.
Stand straight and slowly turn your head to the right as much as you can, looking over the right shoulder. Hold the position at the end of the movement for 20 to 30 seconds. Repeat this exercise 5 times. Then, do the same exercise on the left side.
Keep your head straight and tilt your head down your right ear towards right shoulder, until you feel a slight stretch. Hold the position for 20 to 30 seconds. Do the same movement on your left side.