Articles from prior issues of The Advocate

March/April 2000

Neck Pain When it’s serious, When it’s not

Your neck has been sore for a week. Have you just been spending too much time hunched over the sewing machine or workbench, or is something more serious going on? Neck pain has many causes. It’s rarely serious, and you can usually ease the pain with some simple home-care techniques. But neck pain can at times, be a symptom of a more serious problem. You should know the danger signals.

Proper alignment

Ideally, your head should rest on top, of your neck like a golf ball on a tee. Usually though, it doesn’t. You live in a forward-facing world. Your eyes, your ears - the way you perceive your environment- all are oriented facing forward. Whether, you are reading this article sitting at a desk, or even just walking, your head is usually tilted forward. And with the weight of your head more like that of a bowling ball than a golf ball, holding it forward, out of alignment puts a strain on your neck and upper back muscles. The result can be muscle fatigue and, all too often, an aching neck.

The usual suspects

Neck pain usually comes from:

Muscle sprains — These are usually triggered by overuse, such as too many hours leaning over a steering wheel. Neck muscles fatigue and become strained - particularly those in the back of your neck. When neck muscles are used a lot, chronic pain can develop. As muscles fatigue, neck bones and disks (the spongy cushions between vertebrae) bear an increased load. Over the long term, this can contribute to “pinched nerves” in the neck and also worsen symptoms of underlying osteoarthritis. Muscle strains can also result from an injury.

nPinched nerves - Long term wear and tear and changes due to aging can result in pinched (impinged) nerves. As you age, disks can become dry, narrowing the pathways in the spinal column where nerve roots come out. At any age, and often as a side effect of muscle strain and overload, disks can “herniate” – the inner gelatinous material of a disk protrudes through the disk’s tough covering. Nearby nerves can be irritated. Other tissues and bony growths can also press on nerves as nerves exit the spinal cord, causing pain.

More serious problems

Although most neck pain is not serious, it can sometimes signal a more significant condition. Neck pain can be “referred,” meaning that there’s an underlying problem elsewhere that’s causing the pain. For example, shoulder injuries and pain can cause nearby neck muscles to become tight. Other conditions that can cause referred neck pain include rheumatoid arthritis, and other related diseases. In addition, neck pain that occurs when you are eating may indicate problems with your esophagus, the tube that runs from your throat to your stomach. Throbbing neck pain or pain with or without chest pressure can be due to a cardiovascular or heart problem. And neck pain that’s worse at night or accompanied by a fever or weight loss may indicate a tumor or infection.

When to see the doctor

Medical treatment may be needed if symptoms do not resolve with in a few days to a couple of weeks and any of the following symptoms are present:

l Severe pain from an injury l Shooting pain l Chronic pain that doesn’t improve l Pain at night l Loss of strength l Changes in bowel or bladder patterns l Neck pain associated with pressure or pain in the chest

Treatments

Doctors may recommend:

l Corticosteriod medication l Tricyclic Antidepressants and anti convulsant drugs l Transcutaneous electric nerve stimulation (TENS) l Surgery, which is about 90 percent successful in relieving pain l Traction