Saving your neck

Does your neck feel stiff once in a while?

If you are like most people, then a pain in the neck is not an unusual feeling, occasionally. For after years of supporting a weight equivalent to that of a bowling ball, it’s small wonder your neck sometimes feel stiff and sore.

Neck pain is often caused by activities that are so familiar that they are easily ignored as risk factors. For example, a deceptively simple cause of neck pain is poor posture. Sitting hunched over a computer keyboard or driving a car with your neck inclined forward can put a strain on neck muscles, producing chronic muscular spasms and pain.

Other familiar factors that can cause or aggravate muscle strain are stress and tension. Some people react to emotional stress by unconsciously tightening the muscles in the neck and upper back. This can lead to a sore achy, stiff neck and even headaches.

This is not to say that all neck pain should be dismissed as resulting from spending too much time in front of the computer or in your car. Pain is nature’s way of telling us that something is wrong. It may be minor – or it may not. Here’s how to tell when to see the doctor.

The Anatomy Of The Neck

The neck is a series of intricate joints designed to allow liberal movements of the head, but it also serves as freeway for the central nervous system. The neck is supported by a complex structure of tendons, ligaments and muscles.

The neck’s seven bones (vertebrae) encase and protect the spinal cord and the nerves running from the base of the head to the tail of the spine. As these nerves descend, they exit on the anatomic equivalent of highway off-ramps.

Between the bones in your neck are fibrous elastic cartilage called discs. Discs act as "shock absorbers" to keep your neck flexible and cushion the hard vertebrae as you move. When discs begin to fail because of age or disease, their soft center can extrude beyond the vertebrae to press against a nerve. This is properly called a herniated or ruptured disc, but is sometimes referred to as a pinched nerve. Neck pain that migrates to arms or fingers provides an important clue as to where the pain is originating.

Arthritis can also cause pain in the fingers and arms when bony overgrowths on the spines press against nerves in the neck. Osteoarthritis, in fact, causes varying degrees of neck pain in about 85 percent of people older than 70.

Cervical spondylosis is a degenerative condition that may narrow the passages through which the nerves exit in the neck. This may compress the nerve roots, causing pain, numbness or weakness in the neck or arm. Neoplastic growth (cancer) is also a possibility, though rare.

When To See Your Doctor

Muscle strains are usually easy to self-diagnose. They typically come on after prolonged activity, a period of overuse or prolonged postures that put an excessive stress on the neck muscles. And they usually get better on their own within a few days to a couple of weeks. If you don’t see a trend toward improvement within a week or two, it’s time to see your doctor.

Also see your doctor if you have:

• Severe pain from an injury. If you’ve just had a head or neck trauma, such as a whiplash injury or blow to the head, see your doctor immediately. Severe pain over a bone might indicate a fracture or a significant injury to a ligament.

• Shooting pain. Pain radiating to your shoulder, shoulder blades or down your arm, or numbness or a tingling sensation in your fingers may indicate nerve irritation. Neck pain from nerve irritation can last from three to six months or longer. Because of the potential for serious effects from continued nerve irritation, see your doctor.

• Chronic pain that does not improve. Any long-term pain that doesn’t improve with simple self-help remedies requires evaluation.

• Pain at night. Pain at night that doesn’t respond to self-care measures can signal a more serious disease condition.

• Loss of strength. Weakness in an arm or leg, as evidenced by dropping things, leg stiffness and foot shuffling, requires immediate evaluation.

• Changes in bowel or bladder patterns. Significant nerve compression in your neck can cause changes in bowel and bladder habits, such as loss of control of bladder function, and should receive prompt evaluation.

• Neck pain associated with pressure or pain in the chest. This type of pain, or neck pain associated with exertion, may be related to heart problems and requires immediate evaluation.

Imaging techniques, such as X-rays, Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scans, can be used if a thorough exam doesn’t reveal the cause of the neck pain. These can show narrowing or compression of nerve roots and disc problems. Electromyography (EMG), a test that evaluates the electrical activity in nerve and muscle, may help determine whether there’s nerve damage, which nerves are involved, and the severity of the condition.

Finding Relief

Depending on the cause of your pain, treatment may involve rest, medications, physical therapy, exercise, immobilizing your neck or modifying your activities.

Make a conscious effort to maintain good posture. Relax the muscles involved and pay more attention to them. This should help break the vicious cycle of pain, muscle spasm, more pain and so on.

If the pain is related to emotional stress, try to deal with those issues. Create a pocket of time each day to do some kind of formal relaxation therapy. Tightening and relaxing your muscles from head to toe can relieve stress, as can 10 minutes of deep breathing, or doing a session of yoga or aerobic exercise.

It’s important to get a sound medical diagnosis from a physician before seeking any other type of help; for example, getting a massage or having manipulation done on your neck. And certainly, don’t allow your barber to twist and "crack" your neck. Without a diagnosis, these movements can be risky to dangerous, particularly if the pain originates from an alteration in the structure of the neck.

If the problem is, in fact, a biomechanical stress, a comprehensive, individualized treatment plan will usually include medications to reduce pain, inflammation and muscle spasms, physical therapy to restore normal biomechanics, and exercises to strengthen muscles, increase range of motion and improve flexibility.

The therapy may include traction, which stretches tight, overly tense muscles, and transcutaneous electrical nerve stimulation (TENS), which may help to relieve pain.

A cervical collar may be worn to immobilize the neck for the first few days after a strain. Local injections of trigger points or myofascial nodules may help. Surgery is definitely not something to rush into, but may be considered when conservative treatment doesn’t relieve arm pain or numbness involving nerve impingement. On rare occasions, surgery is done to relieve a compressed spinal cord.

Use Your Head

By and large, however, some simple precautions can help you save your neck. Don’t tuck the phone between your ear and shoulder when you talk. If you use your phone a lot, get a headset. If you drive long distances or work for long hours at your computer, take frequent breaks. Use good posture. Have your desk, chair and computer set at the proper height and distance. Deep breathing at your desk while extending your arms over your head can also help. Don’t sleep on your stomach, and use a pillow that supports the natural curve of your neck.

So hopefully, someday, when you say that you have a pain in the neck – you wouldn’t be referring really to your neck but to some other things like your strict boss who’s always looking over your shoulder, a nosey neighbor, or the BIR!