Neck pain overview
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Neck pain is a common problem, with two-thirds of the population having neck pain at some point in their lives. It is increasing in both intensity, frequency and severity of episodes. As people are increasingly sedentary, live fast-paced and hectic lives, they place more stress and strain on the upper back and neck regions of their spines.
The head is supported by the lower neck and upper back, and it is these areas that commonly cause neck pain. The top three joints in the neck allow for most movement of your neck and head. The lower joints in the neck and those of the upper back create a supportive structure for your head to sit on. If this support system is affected adversly, then the muscles in the area will tighten, leading to neck pain.
Neck pain may also arise from many other physical and emotional health issues.
Neck pain, although felt in the neck, can be caused by numerous other spinal issues. For example, neck pain may arise due to muscular tightness in both the neck and upper back. Joint disruption and ligamentous strain in the neck and upper back can create pain, as can sympathtetically mediated pain. Neck pain is a frequent cause ofcervicogenic headache orMigraine.
Natural History, Complications and Prognosis
About one-half of episodes resolve within one year. About 10% of cases become chronic.
The physician will examine the back and conduct neurologic tests to determine the cause of pain and appropriate treatment.
X-ray imaging includes conventional and enhanced methods that can help diagnose the cause and site of back pain. A conventional x-ray, often the first imaging technique used, looks for broken bones or an injured vertebra. A technician passes a concentrated beam of low-dose ionized radiation through the neck and takes pictures that, within minutes, clearly show the bony structure and any vertebral misalignment or fractures. Tissue masses such as injured muscles and ligaments or painful conditions such as a bulging disc are not visible on conventional x-rays. This fast, noninvasive, painless procedure is usually performed in a doctor’s office or at a clinic.
Computerized tomography (CT) is a quick and painless process used when disc rupture, spinal stenosis, or damage to vertebrae is suspected as a cause of neck pain. X-rays are passed through the body at various angles and are detected by a computerized scanner to produce two-dimensional slices (1 mm each) of internal structures of the neck. This diagnostic exam is generally conducted at an imaging center or hospital.
Magnetic resonance imaging (MRI) is used to evaluate the lumbar region for bone degeneration or injury or disease in tissues and nerves, muscles, ligaments, and blood vessels. MRI scanning equipment creates a magnetic field around the body strong enough to temporarily realign water molecules in the tissues. Radio waves are then passed through the body to detect the “relaxation” of the molecules back to a random alignment and trigger a resonance signal at different angles within the body. A computer processes this resonance into either a three-dimensional picture or a two-dimensional “slice” of the tissue being scanned, and differentiates between bone, soft tissues and fluid-filled spaces by their water content and structural properties. This noninvasive procedure is often used to identify a condition requiring prompt surgical treatment.
Diagnostic musculoskeletal ultrasound imaging, also called ultrasound scanning or sonography, uses high-frequency sound waves to obtain images inside the body. The sound wave echoes are recorded and displayed as a real-time visual image. Ultrasound imaging can show tears in ligaments, muscles, tendons, and other soft tissue masses in the back.