There are many sensitive nerves and bone joints in the neck that can make people concerned when it comes to pain. How concerned should you really be, though? In this article, experienced consultant neurosurgeon and spinal surgeon Mr Jonathan Bull delves into neck pain, explaining when it requires professional attention and how it can be treated.
What are the most common causes of neck pain?
The most common cause of neck pain is usually muscular in nature that often comes from repetitive sort of straining of the neck muscles. This may well be typically associated with office workers where they will sit in a certain position to look at the computer screen and it may not be at the correct height or eye level, the keyboard maybe not be in the correct position and they end up straining or bending the head repeatedly, causing the muscles to become irritated and tired. Eventually, this becomes painful and then may limit the degree of movement in the neck.
It can also be due to normal processes such as wear and tear, change, and some degeneration in the joints and on the discs in the neck. These will cause some pain and then stiffness, and it becomes a vicious cycle where the joints are rotated, the muscles become stiff, and the range of movement becomes limited. Less commonly, you may have possible compression, say on the nerve that leads to the neck, which may give you pain down into your arm and into your hand or your shoulder for example. Usually, that is managed with conservative measures but it will usually be self-limiting.
Is there any way to prevent neck pain?
Common interventions with regard to avoiding developing neck pain or if it's happened in the past, would be looking at the ergonomic setup you have. Normally this is in your office or your working environment, potentially considering things such as:
- standing desks
- trying to break up the period of time you spend sitting doing one activity or the other
- trying to get up every half hour or hour and walk around the office
- maybe do some neck stretches (which may also include productivity)
- making sure that you're in a comfortable position working on your laptop
- the setup is not ideal, for example most people sit on the sofa or a comfortable chair with the neck craned forward
They are mostly simple interventions and involve probably a degree of common sense.
How can I relieve minor neck pain?
Having considered the ergonomic adaptations and trying to break up periods of inactivity or sitting or standing, stretching exercises which can be looked up online are very helpful. Often, if you go to see a physiotherapist, they will advise you over certain exercises and stretches you can undertake independently. Doing those regularly, perhaps two or three times a day, will be most helpful. Most people will start off doing them several times a day and then the frequency will diminish as the pain gets better, but then it gives them a toolbox of exercises that they can use if the pain number occurs to prevent it becoming more severe. As well, simple stretching exercises, and even activities such as yoga and Pilates, are very helpful as they improve core muscle strength and improve flexibility.
Should I be worried about pain in my neck?
Most neck pain is musculoskeletal in nature, is self-limiting, and isn't the cause for major concern. It can be irritating and affect your concentration, and sometimes the neck pain can cause headaches at the back of the head. Again, there typically won't be a sinister cause for it and it should be alleviated by stretching exercises and simple analgesia. When the pain is associated with for example symptoms down into the arm or into the hand, then that may require at least a consideration of seeing your physiotherapist or your GP.
As it’s usually self-limiting, it very infrequently requires anything to be done about it. Although, it may well be that you have some irritation upon the nerve roots (a disc putting pressure on from the nerve roots) which may manifest itself with ulnar sensation like pins and needles, weakness, or sometimes quite severe pain. That situation may require you to be referred on to see a spinal surgeon where you most likely will have an examination and then an MRI scan to determine if there's an obvious cause for it. Normally, it's also managed conservatively with physio exercise, stretching, and possibly stronger analgesia.
How is neck pain treated?
Most neck pain is self-limiting. You can manage it with physio interventions, so neck stretches and exercise such as yoga, Pilates, and very simple analgesia escalating up to some stronger medication before having nerve-related pain down into the arm and the hand. Less commonly, you may try an injection of local aesthetic and steroid under sedation using an X-ray guidance technique which may be helpful for arm pain or even sometimes neck pain.
Very rarely, if there's a persistence of compression of a nerve root or compression of the spinal cord, then you might end up needing an operation; but that's the much less common option. This option usually would be after a lengthy period of conservative management, for example if you had weakness in your arm that was persistently getting worse or pain that simply wasn't being treated with analgesia so it was refractory to all the treatments you tried, then you might consider surgery.
If you are having persistent neck pain or would like to have more information, you can go to Mr Bull’s profile and book a consultation.