Practical Practitioner
By: Pamela Egan, FNP-C CDE
Neck pain can be more than just a pain in the neck
Most neck pain is not serious and is usually the result of a strain or overload of the neck muscles. Neck pain that persists or worsens over time should be evaluated.
Your neck bones (vertebrae) are cushioned by cartilage (disks). After twisting your head and neck for 40 years or more, you’ll probably feel some wear and tear, such as stiffness and decreased flexibility. In fact, the majority of individuals 70 and older have some neck pain.
Osteoarthritis causes your disks to thin and lose their elasticity. As a result, bony outgrowths called spurs can form. These bone spurs often develop in spots where they limit your neck motion, resulting in stiffness and pain. Pain from osteoarthritis typically causes you to change your head and neck position and tense your muscles. This tension can lead to more pain by causing muscle spasms that restrict your neck movement.
Neck pain usually results from muscle strains or pinched nerves.
Muscle strains, overuse, such as too many hours hunched over a steering wheel, usually triggers muscle strains. Neck muscles, particularly those in the back of your neck, become fatigued and eventually strained. When you overuse your neck muscles repeatedly, chronic pain can develop. Muscle strains can also result from an injury.
Pinched nerves, long-term wear and tear and changes related to ordinary aging can result in pinched (impinged) nerves. As you age, your disks become dry, narrowing the spaces in your spinal column where the nerves come out. At any age, disks can herniate. This means the inner gelatinous material of a disk protrudes through the disk’s tough covering. Nearby nerves can be irritated.
Although most neck pain is not serious, it can sometimes signal a more significant condition. Neck pain can be referred, meaning an underlying problem elsewhere causes the neck pain. For example, shoulder injuries and pain can cause nearby muscles in your neck to tighten. Rheumatoid arthritis and related diseases also can cause referred pain.
Neck pain that occurs during eating may indicate problems with your esophagus-the tube that runs from your throat to your stomach. A heart problem can cause referred neck pain with or without chest pain. And neck pain that’s worse at night or accompanied by fever or weight loss may indicate a tumor or infection.
Muscle irritations are usually easy to self-diagnose. They usually get better on their own within a few days to a couple of weeks.
See your healthcare provider if the following signs and symptoms occur:
- Severe pain from an injury might indicate a fracture or an injury to a ligament.
Shooting pain to your shoulder, shoulder blades or down your arm, or numbness or tingling in your fingers may indicate nerve irritation.
Pain at night can signal a more serious disease or condition.
Changes in bowel or bladder patterns can be caused by nerve or spinal cord compression in your neck.
Neck pain associated with pressure or pain in your chest may be related to heart problems.
Most neck pain responds well to home care and doesn’t require medical treatment. Over-the-counter non-steroidal, anti-inflammatory drugs (NSAIDS), such as aspirin, ibuprofen (Advil and Motrin) or naproxen sodium (Aleve), may also help reduce inflammation and relieve pain.
Short-term immobilization, heat, cold or exercise may also help. My own remedy includes Knox Gelatin for joints, Glucosamine and Pycnogenol (antioxidant).
For pain that doesn’t get better with simple home care measures, your healthcare provider may recommend physical therapy, pain medications (NSAIDS) and other pain relievers, tricyclic antidepressants and anticonvulsant drugs, traction, transcutaneous electronic nerve stimulation (TENS), corticosteroid medications, chiropractic care or Surgery.
This article was originally published April 8, 2002 in The St. Tammany News.
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