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Reviewing Causes and Treatment of Neck Pain

The cervical spine is often the cause of neck pain or discomfort in adults. Arthritis, pressure on the nerve roots, injury, or irritation to the neck muscles are common reasons for this type of pain. In this article, orthopedic surgeons review anatomy, causes of neck pain, and ways to treat it.

Understanding the way the cervical spine (bones, joints, nerves) is put together helps the doctor identify the underlying problem. For example half of all head rotation comes from the atlantoaxial joint (AO). The AO joint is made up of the first and second cervical vertebrae. A problem turning the head might point to this joint as the source of the problem.

There can be many different disorders and diseases that cause neck pain. The doctor takes a history and examines the patient, keeping in mind how the neck is put together and how it moves from an anatomical point of view.

These may include rheumatoid arthritis, polymyalgia rheumatica, or tumors. Cervical disc herniation from a prolapsed disc can put pressure on the spine or spinal nerve roots causing neck pain that goes down the arm. Other problems may stem from less obvious causes such as emotional and physical stress or poor sitting or sleeping postures.

Treatment usually starts conservatively with anti-inflammatory drugs. Physical therapy to restore normal motion, treat trigger points, and address any postural issues may be advised. The doctor may use one or two steroid injections into the joints. From time to time, a nerve block may be done.

If all treatment fails to bring relief from pain, surgery may be needed. Patients with severe arthritic changes, disc herniation, or instability are the most likely to benefit from surgery.

References: Kornelis A. Poelstra, MD, PhD, et al. Managing Neck Pain: Evaluation and Treatment Recommendations. In The Journal of Musculoskeletal Medicine. November 2006. Vol. 23. No. 11. Pp. 809-814.

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