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A Pain in the Neck

English: MRI scan of cervical disc herniation ...

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Neck pain occurs from the base of the head to the shoulders.  Like pain in other parts or your body, this pain can arise from accident, injury, or overuse.  Often people have pain without understanding why or how it started.  Osteoarthritis, whiplash, stenosis, and disc herniation can arise from worn or injured bones, muscles, or nerves.  Neck pain can also cause muscle tension headaches.

Osteoarthritis or OA is also known as degenerative joint disease.  It is the most common form of arthritis and is typically found in older adults, especially over the age of 50.  Cartilage acts as a shock absorber for the joints and OA is a breakdown of this cartilage.  With age weight bearing activities, injury, and stress may cause the cartilage to become less elastic and more susceptible to damage.

OA typically causes swelling of the joints which results in feelings of aching, soreness, and pain.  This usually occurs over a period of years and is not caused by one sudden event.

Whiplash is a common term that causes us all to think of car accidents.  This occurs when there is impact to the body and the head,  Our heads are 10% of our body weight, typically about the weight of a small bowling ball, and whiplash sends our heads flying back and forth on the top of our neck.  How’s that for a visual?  This can also occur from tripping, falling, or other types of accidents.  After this traumatic event your muscles, nerves, and joints may be overstretched.  Your body’s natural defense mechanism to any trauma is to protect the injured area.  This equates to swelling.  Again, people will have symptoms of aching, soreness, and pain.

Stenosis is also a process like OA that involves the bones, aging, and swelling.  It occurs when the foramen or little hole in the bone starts to fill up with extra bone.  Unfortunately little nerve roots that travel from your neck to your arm pass through these little foramen, so as they become smaller, the nerve becomes compromised.  This is usually more severe than OA as it involves the nerve and results in more intense, sharp pain.  The pain may be severe when you move your head in a specific direction to compromise the nerve then resolve when you are out of that position.  Stenosis usually progresses over years and can become quite severe requiring surgery.

Disc herniation is a condition when the disc material protrudes beyond the margin of the joint and can push posteriorly on the spinal cord or laterally on a nerve root producing pain, numbness, and or tingling into the arm.  This may occur over time from age, weight bearing, and normal wear and tear or be caused suddenly from trauma, accident, or injury.

Other than the major conditions listed above, many people have neck pain from normal activities of living: sitting in front of the computer for excessive periods of time, lifting, raking, shoveling, packing wood etc.  Many of us have muscle tension around the neck and shoulders that can range from a nagging ache to quite severe.  As always, try ice and  rest with first signs of pain or soreness, if symptoms don’t begin to improve within two weeks, you should seek treatment.  I have great success treating these conditions using joint and soft tissue mobilization.

Other Physical Therapists may treat these conditions with ultrasound and electric stimulation.  Chiropractic, acupuncture and massage are also useful treatment modalities for neck pain.

      Mary Boyd, MS, PT is the owner of Mountain View Physical Therapy and a member of the Sandpoint Wellness Council.  Please contact her at 290-5575 for questions regarding neck pain.

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