Neck pain: Doctors reveal types, causes, symptoms, treatments, preventive tips | Health


Neck pain is a very common musculoskeletal disorder affecting approximately one in every three people at least once a year. It can be mild or severe and may spread across our shoulders, arms and may also lead to headaches. Neck pain or discomfort is a multifactorial disease and it may result in decreased productivity and efficiency but a healthy lifestyle consisting of regular physical exercise, a balanced diet and a good work-life balance may keep the neck pain at bay.

Types:

In an interview with HT Lifestyle, Dr Jagjit Singh, Senior Orthopaedic Consultant at Mata Chanan Devi Hospital in Delhi’s Janakpuri, shared that neck pain can be of different types. Some of the common types include:

1. Occipital Neuralgia – It is a type of headache in which the upper neck, the back of the head, and the area behind the ears are painful. The occipital nerves, which pass through the scalp, can become inflamed, or injured, which causes occipital neuralgia.

2. Cervical Radiculopathy – It is sometimes known as a pinched nerve, which usually develops from a disk herniation in the neck. This may result in excruciating pain in neck, shoulder, arm and fingers. This is one of the most painful neck conditions, and thankfully has a good prognosis too.

3. Facet Arthropathy – The term implies arthritis of the small vertebral joints of neck, and it is a well known cause of neck pain. It may be caused by conditions such as ageing or rheumatoid arthritis.

4. Myofascial Pain Syndrome – Myofascial pain syndrome is a chronic pain condition that affects neck muscles and fascia. The lower and upper back, the neck, the shoulders, and the chest are among the body parts where Myofascial pain syndrome can manifest. This may be brought on by the repetitive motions people perform at work, stress-related muscle tension, injuries to the muscles, poor posture, or muscle group inactivity.

5. Cervical Spondylosis – Age-related wear and tear in the cervical spine causing neck discomfort and stiffness is referred to as cervical spondylosis.

6. Whiplash Neck Sprain – This is due to a rapid trauma to your neck, caused by an accident, car crash, etc.

7. Fibromyalgia – It is characterised by widespread musculoskeletal pain that may be associated with a disturbance of sleep, memory, and mood. Most people experience severe pain and stiffness in the neck and back.

Causes:

Dr Vivek Loomba, Pain Management Physician at The Indian Spinal Injuries Centre in New Delhi’s Vasant Kunj, pointed out some common causes that result in neck pain:

1. Physical strain – This is the most common cause of neck pain, resulting from overuse of neck muscles in activities like heavy physical workouts, weight lifting, carrying heavy bags on the shoulder, driving/travelling long distances etc. All such activities may cause neck pain secondary to a sprained neck ligament or muscles. Occasionally it may result in a disk herniation, which may cause neck pain radiating down the arm.

2. Posture – Poor posture is one of the leading causes of neck pain. Prolonged sittings with arched backs and forward bending necks while using smartphones and laptops (text neck syndrome) results in increased stress on the cervical spine, thus causing cervical degeneration, stiffness and pain. Dr Loomba says that there has been a steady increase of school-going kids coming to his clinic with these symptoms. The pandemic has only worsened the problem, he believes.

3. Whiplash injury – Sudden jerky neck movement in vehicular accidents can result in whiplash injury, leading to neck pain.

4. Arthritis – The arthritis of the vertebral joints of the neck may result in neck pain.

5. Miscellaneous – Neck pain may result from other causes like anxiety, depression, infection, tumour etc.

Symptoms:

Dr Jagjit Singh revealed that neck pain can take many different forms, from a dull, irritable ache to a scorching, incapacitating nerve pain that may spread down the shoulder and into the arm. Dr Singh emphasised that since treatment depends on the aetiology of the disease, it is vital to establish the correct diagnosis before any treatment is initiated.

Neck Pain may result in various other symptoms, like:

1. Headache

2. Lack of sleep

3. Neck stiffness/fatigue

4. Disturbed sleep pattern

5. Numbness or tingling in arms or fingers

6. Pain or Weakness that goes down to the Arm

7. Occasional loss of bowel or bladder control

Management of neck pain:

The vast majority of neck pain issues go away on their own in a few days but if you experience severe pain, persistent discomfort or neck pain that interferes with your everyday activities, you should seek medical attention for further evaluation and treatment, as per Dr Singh. Explaining it further, he said that a pain management physician or an orthopaedic doctor can help you by addressing your issue and by suggesting one or a combination of therapies.

Most neck pains are benign and don’t require surgery. Depending on the cause and severity of the neck discomfort, there are many treatments available.

Treatment:

Multimodal approach to the treatment of neck pain has proven to provide the best outcomes. According to Dr Vivek Loomba, the most common treatments for neck pain include:

1. Prescribed Medications – Various medications include acetaminophen (crocin), Non-steroidal anti-inflammatory medications (NSAIDs) like ibuprofen, muscle relaxants like myoril, and weak opioids like tramadol.

2. Physiotherapy – It is one of the most common treatments for chronic neck pain. The primary focus of physical therapy is to stretch and strengthen muscles and tendons in the neck.

3. Hot Fomentation – Applying heat to the affected area may result in good relief of symptoms.

4. Injections – The other alternative for treating neck pain involves minor procedures. These include occipital nerve block, facet joint injections, epidural injections or trigger point injections. In addition, radiofrequency ablation of the facet joints and of the occipital nerves can be performed for long lasting relief. These procedures have proven to provide pain relief in chronic neck pain patients.

5. Surgery – Most patients with neck pain respond well to conservative and non-surgical treatment. In rare cases, surgery is the only option. The patients presenting after neck trauma, like from road traffic accidents may be at risk of paralysis if urgent surgical exploration is not performed. Similarly, disk herniation patients may develop weakness of the upper limb that warrants urgent surgery. Patients and their families should remember that urgent surgery may be life saving in such instances, and any delay in decision making may result in dreadful and in some cases, potentially fatal outcomes.

Preventive tips:

According to Dr Jagjit Singh, subtle lifestyle modifications can go a long way in preventing conditions like neck pain. These include:

1. Ergonomics – Maintain right body posture. With the appropriate posture, the bones and joints are in alignment, thus preventing muscle strain and the subsequent pain.

2. A healthy lifestyle with 10 to 15 minutes of neck exercises daily and regular neck stretches while using a computer or the phone may prevent neck pains.

3. Avoid lifting heavy objects as that may strain your neck.

4. Use a seat belt as that may provide some protection in the event of road traffic accidents.

5. Seek help – Please see your pain physician or the orthopaedic doctor if you develop persistent neck pain. Self medication may delay proper treatment, thus worsening the problem.

Neck pain may result from a variety of causative factors and if you experience neck pain, you should consult your healthcare provider sooner rather than later. Most neck pains may resolve on their own with rest and activity alteration but occasional neck pains may be associated with a more serious pathology and may need specialised management.