Neck pain is a common condition that has considerable impact on individuals and their families, communities, health-care systems, as well as businesses and employers. It is a very common condition and the estimated one year incidence of neck pain from available studies ranges between 10.4% and 21.3%.
This condition is becoming more and more commonly encountered in today’s society given that we now spend so much time hunched over computers, tablets and phones.
Neck pain can radiate into the arm, hand, up into the head, or out to the shoulders. It is categorized as chronic pain if lasts for more than three months at a stretch.
What are the common causes of Neck Pain?
The most frequent causes of neck pain include the following:
Repetitive Motion/Poor Posture – Constantly sitting at a desk or computer in a poor position or leaning forward in a car while driving for hours at a time can lead to neck pain.
Muscle Strains – Repetitive motion, quick unexpected movements or even sleeping with the neck in a certain position can cause muscle strains throughout the neck and shoulders.
Age – As we age, cervical facet joints’ like any other joints, can suffer from wear. This can cause direct pain as well as a secondary pain in the muscles that lie over the inflamed joints, leading to neck pain, that can also be felt in the shoulders or back of the head (cervicogenic headache).
Compressed and Herniated Discs – Nerve compression caused by bulging intervertebral discs in the neck and back can lead to neck pain that may radiate into the arm or hand.
Injury - Rear-end collisions, most commonly resulting in whiplash injuries; stretch the neck muscles beyond their limits, causing pain. This can also happen with sports injuries.
Do I Need An Operation for my neck pain?
This is rare. For the vast majority of people with neck pain, the cause is as noted above. When you see a pain specialist for your neck pain, they will do a full assessment of your pain and advise you on treatment options, including, medications, physiotherapy and injections.
To help decide if you need further scans or if surgery is a possibility, they will ask you about the ‘red flags’. These are elements of your history, that suggest that you may need a scan (if not already done) and the advice of a spinal surgeon.
The red flags are
- Previous history malignancy
- Aged under 16 or over 50 with new onset pain
- Unexplained weight loss
- Longstanding steroid use
- Generalised neurological deficit
- Progressive spinal deformity
- Non-mechanical pain (Night pain, pain at rest)
- Fever/ rigors
- General malaise
What are my Treatment Options?
After doing a full assessment of your neck pain, your pain specialist will be able to tailor a treatment plan to suit your needs. This can include:
- Medications. These commonly include anti-inflammatory drugs, muscle relaxants, opioid based pain killers and specialist drugs for neuropathic (nerve) pain.
- Injections, including cervical facet joint injections, cervical median branch blocks, cervical epidural injections, occipital nerve blocks (for headache) and trigger point injections (for muscle pain) may be offered.
- Physiotherapy. This is often the most important part of treatment for neck pain. Medications and injections are usually offered to facilitate this therapy.