Neck pain

Symptoms Of Neck Pain

A few of the symptoms associated with neck pain include:

1. Dizziness and unsteadiness

Dizziness and unsteadiness can be caused by inflammation or compression of the nerves in the neck. The most common cause of this is an injury after an accident, but it could also be due to repeated stress on the neck muscles.

2. Movement barrier

If you notice that you are unable to move your neck as per your normal requirement and there is a distinct stiffness, this is a movement barrier, a symptom of painful issues with your neck. 

3. Frequent headaches

In the neck, issues of muscle tightness can cause increased tension and lead to headaches on a regular basis.

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4. Pain in other areas

Any imbalance that puts additional strain on the network of nerves in the neck region, may result in shoulder, chest, arm, wrist, and hand discomfort.

Causes Of Neck Pain

• Muscle strain: Excessive use of the muscles in the neck, such as spending too much time crouched over a computer or smartphone, often results in muscular strains. Even activities, such as reading on the bed or grinding teeth, may cause the neck muscles to get strained.
• Worn joints: As with the rest of the body’s joints, even the neck joints deteriorate with age. Osteoarthritis deteriorates the cushioning (cartilage) between the bones (vertebrae). Following that, the body creates bone spurs that impair joint mobility, leading to discomfort, even in the neck.
• Compression of the nerves: Herniated discs or bone spurs in the neck vertebrae might compress the nerves that branch from the spinal cord.
• Injuries: Whiplash damage is often the outcome of rear-end vehicle crashes. Whiplash occurs when the head is jerked backward and then forward, straining the neck’s soft tissues. 
• Other diseases: Neck discomfort may be caused by numerous conditions including rheumatoid arthritis, meningitis, and cancer.

Risk Factors For Neck Pain

There are a number of factors that increase the risk of neck pain like a sedentary lifestyle, sitting in front of a computer for prolonged periods of time, and carrying heavy bags around. 

One risk factor that many people don't think about is the number of times they sleep on their stomachs. This increases the likelihood of experiencing neck pain due to poor posture and muscle imbalance between your head and torso.

Other risk factors include:

1. Age: The risk for neck pain increases with age. As you get older, your neck muscles tend to weaken. This makes it more difficult to support the head during rapid changes in posture or movement. 

2. Gender: Females are thought to be at a higher risk for getting neck pain. 

3. Excessive weight: Obesity is an important risk factor for developing neck pain because excess weight puts pressure on the spine and interferes with its normal function.

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4. Height: Taller people are more likely to suffer from neck pain than shorter people.

5. History of lower back pain: Neck and back pain can also be related because a problem in one area of the body can lead to changes in posture and movement that negatively affect the other area.

6. Accidents: Any injuries during contact sports, motor-vehicle accidents, horse riding, etc. are a risk factor for neck pain.

7. Occupation: People with desk jobs or manual labor jobs (construction workers, carpenters, etc. have a higher risk of developing neck pain. Studies show that dentists, nurses, office workers, and crane operators have been shown to have a higher prevalence of neck pain.

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8. Stress and anxiety: Stress is related to pain and disability and perceived as a risk factor for neck pain. Also, neck pain has been found to be comorbid with anxiety.

9. Depression: Mood disorders, especially depression, have been found to be related to chronic neck pain and disabilities.

Diagnosis Of Neck Pain

There are a lot of ways to diagnose issues affecting the neck. These include:

1. Complete medical history

A thorough medical history is the first step in diagnosing the specific cause of neck pain. It requires the doctor to ask about current symptoms, the patient’s occupation, and lifestyle. 

2. Physical examination

A key component of the clinical evaluation of neck pain is to identify serious pathology and non-musculoskeletal diseases that may be the source of pain and related symptoms. It consists of examining the patient’s posture, particularly the neck and shoulders, feeling along the neck’s soft tissue for signs of muscle spasms, tightness, or tenderness, checking the range of motion reflexes, muscle power, and any unusual sensations along the extremities.

3. Imaging tests

These tests may include:

• X-rays: X-rays are used to detect places where bone spurs or other degenerative changes might affect nerves or spinal cord.
• CT scan: CT scan combines X-ray images taken from many different angles to make a detailed cross-sectional view of the inside of the neck.
• MRI: This technique uses a strong magnetic field and radio waves to make detailed images of bones and soft tissues, such as the spinal cord and the nerves that come from the spinal cord. 
• Discography: A discogram might help the doctor to determine if a specific abnormal disk in the spine is causing back pain or neck pain. 

4. Other tests

• Electromyography (EMG): Electrodes are inserted into the muscle, or placed on the skin overlying a muscle or muscle group, and electrical activity and muscle response are recorded for pain.
• Nerve conduction studies (NCS): These measure how fast an electrical impulse moves through your nerve and can identify nerve damage. 
• Myelogram: This test uses a contrast dye and X-rays or computed tomography (CT) to look for problems in the spinal canal. 
• Selective nerve root block (SNRB): It is an injection used to identify the source of nerve pain in the neck and sometimes to also provide longer-term pain relief.

Prevention Of Neck Pain

Neck pain is a common problem. One of the most common causes of neck pain is poor posture. This leads to improper use of muscles in the neck and spine, which leads to chronic pain. 

Below are some preventive measures that can be taken to ensure proper posture in order to relieve neck pain:

1) Exercise regularly 

It is advisable to exercise regularly so that your body doesn’t stiffen up when you are inactive. Aim for a 30-minute cardio workout 5 times a week.

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2) Perform stretching exercises for the neck

Keep your neck muscles fit by performing short sets of stretching and strengthening exercises throughout the day. 

3) Maintain a healthy weight

Obesity or being overweight can predispose to neck pain. Hence, it is important to maintain the body mass index (BMI) between 19 and 24.

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4) Stay hydrated

Drink an adequate amount of water during the day. It helps to hydrate the discs between the vertebrae in the neck. These discs are mostly made up of water, so staying well hydrated will help keep your discs supple and strong. It is recommended to drink at least 8 large glasses of water per day unless advised otherwise by your doctor.

5) Maintain a good posture

Incorrect posture can cause neck pain by straining the muscles and ligaments that support the neck.

The head-and-shoulders-forward posture in which the neck slants forward, placing the head in front of the shoulders is the most common example of poor posture which adds to neck pain. This posture causes the upper back to slump forward as well, putting a strain on the entire spine.

6) Avoid straining the neck

• Do not try to lift by bending your back. Squat down and reach your load by bending your hips and knees and then straighten your legs. Keep your load near your body and then straighten your legs to lift. 

• People tend to carry their bags on one side resulting in uneven load. This leads to pain in the neck and shoulder area. Whenever you have to carry a bag, make sure that the shoulders are at the same level or else you can use a backpack which will distribute the load evenly.

7) Use electronic gadgets correctly

• Make sure that your mobile device is at your eye level while working. Avoid texting or looking down at your mobile device for a long duration of time.

• Use any type of hands-free device, such as a headset or earpiece in case you spend a lot of time on the phone.

• Put your phone out of reach when you sleep.

• Adjust the monitor/laptop height. Your vision should be directly in the top-third of your computer screen. If you find you have to look down, raise your monitor up.

• Laptops most often require you to angle your head downward to see the screen, so connecting your laptop to a separate monitor, or screen, can be beneficial.

8) Make safety a priority

• Always wear a seat belt while traveling in the car to prevent whiplash injury.

• Use proper sports equipment to protect the neck while playing sports, that can easily lead to neck injuries eg, football, basketball.

9) Wear a neck brace 

Neck brace can provide support to the neck and help to prevent any neck injury or pain. 

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Specialist To Visit

Doctors that can help in the diagnosis and treatment of neck pain include:

• General physicians

• Otolaryngologists

• Orthopaedists

• Neurologists

When to call your doctor?

Call your doctor immediately if your neck pain is accompanied by:

• Neck pain after having an accident.

• Numbness or tingling in the arms, shoulders, or legs.

• Weakness in legs or loss of coordination in arms or legs.

• Headache, dizziness, nausea, or vomiting.

• Loss of bowel or bladder control.

• Chills, fever, or unexplained weight loss.

• Pain does not come down with over-the-counter medications.

• Pain persists for more than a week.

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Treatment Of Neck Pain

There are different treatments which are as follows:

1. Pain relief medications

Various pain relief medications like nonsteroidal anti-inflammatory drugs (NSAIDs), are prescribed for management of neck pain. They should be used under medical supervision as self medicating is never a good idea. Some egs include:

• Paracetamol/ Acetaminophen

• Paracetamol/Acetaminophen + Tramadol

• Ibuprofen 

• Naproxen 

2. Physical therapy

Physical therapy is one of the most common treatments for managing long term neck pain. It can help in reducing stiffness as well as improving head and neck range of motion. It aids in strengthening the neck and its supporting musculature along with preventing pain from recurring.

3. Injections

In case of severe neck pain, a physician may inject a small amount of local anesthetic and/or medication to numb a joint and provide pain relief.

Injection of anti-inflammatory medicine like a corticosteroid might also be used around the nerves in the neck.

4. Surgery

Surgery is usually not indicated for neck pain, though it might be considered for alleviating nerves or spinal cord compression. Along with surgery, drugs like non-steroidal anti-inflammatory drugs [NSAIDs], opioids, benzodiazepines, gabapentin, neurontin, and cortisone injections are also used to boost the recovery process.

Home-Care For Neck Pain

Neck pain can be disturbing and might interfere with daily activities. Home care, a break from sports, gyming, or any other physical activity is recommended. At the early stage of any neck injury, a doctor must be consulted and heavy lifting must be avoided. Other tips that you can follow include:

1. Gently massage the affected areas

You can lower your shoulders and identify the sore spot and then gently massage your neck with essential oils for immediate relief. Essential oils like peppermint or lavender oil are known to be beneficial. 

2. Exercise daily 

Stretching is a great form of exercise that can be very helpful if you have a stiff neck. Moving your head gently will increase the blood flow in a particular area and reduce inflammation.

3. Adjust your sleep positions

Sleeping on your back is the best position for your neck. You can also sleep on your side, but never on your stomach. Choose a rounded pillow to support the natural curve of your neck, with a flatter pillow cushioning your head.

4. Apply hot or cold compresses

A hot or cold compression can help you to get quick relief from a stiff neck. It is recommended to use ice for the first 24 to 48 hours to reduce swelling, followed by heat to loosen muscles and improve stiffness.

5. Take hot showers

Warm water bath can help you relax and soothe the tightened muscles, and nothing is better than adding a little Epsom salt. The salt helps to reduce inflammation and improve blood flow.

6. Try apple cider vinegar 

Apple cider vinegar is an excellent home remedy to treat a stiff neck as it is loaded with antioxidants and anti-inflammatory agents. Just soak a napkin in some apple cider vinegar and apply it on your neck.

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Complications Of Neck Pain

Neck pain can cause a lot of discomfort and reduces mobility affecting the quality of life. Most common complications of neck pain are discussed below:

• Loss of productivity: Studies show that most workers with neck/shoulder symptoms or hand/arm symptoms experience productivity loss from a decreased performance at work and not from sickness absence.

• Nerve damage: Cervical radiculopathy, commonly called a "pinched nerve," occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord.

• Depression: Living with chronic back or neck pain can lead to depression, feelings of stress, anxiety, sadness, and other mental health-related symptoms.

• Weight gain: Having excessive weight gain can also lead to a bad posture where your head is slightly pushed forward and your back is curved. This puts more weight on the neck and shoulders, causing them to strain. 

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Alternative Therapies For Neck Pain

1. Ayurveda 

This contributes significantly to the management of neck discomfort by combining a corrected Ahar (diet), Vihar (exercise), and Aushadhi (medicines) program. Pranayama or breathing exercises are recommended. Ayurvedic concoctions made with Rasnairandadikashaya, YogarajaGuggulu, and Sahacharadi Kashaya are highly recommended.

2. Homeopathic medicine

Homeopathy has also been regarded as a safe approach to treating neck pain and muscle stiffness. It is devoid of extreme side effects while effectively treating the affected area. Medications such as Bryonia, Causticum, Cimicifuga, and Chelidonium Majus effectively treat stiff neck muscle pain and alleviate sore points.

3. Yoga

For ages, yoga has been known to provide effective and long-term relief to critical ailments, and therefore, the same stands true for neck pain. The following yoga poses can be tried.

• Ear-to-shoulder neck rolls

• Seated forward bend

• Crossbody shoulder stretch

• Two-footed pose, however, the poses are to be done as per expert guidance.

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4. Gua sha 

Gua sha typically involves having a trained practitioner use a spoon to apply short strokes down the skin of the painful area. It is from Chinese Traditional Medicine, and it’s applied to areas of the body where blood circulation is believed to be stagnant and blocking energy (called “qi”). While there is no scientific evidence for qi, people have reported neck pain relief from gua sha. 

Living With Neck Pain

Neck pain can cause serious problems like disability, challenges to daily movement and lack of balance in the body. It is often associated with headaches and shoulder pain, which can be challenging to deal with on a daily basis.

Here are some of the tips to manage living with neck pain:

• Maintain a good posture by choosing the right support chair for the neck

• Try water pillows, as they can adjust the firmness by increasing or reducing the amount of water inside

• Start physical therapy to understand how to reduce the risk of injury, learn exercises targeting the affected area, and identify incorrect postures

• Start swimming after consulting your doctor. It is a great low-impact exercise for many people who have neck or back pain

• Maintain a journal to record the intensity and duration of pain so that you can identify your triggers

• Be careful on how and how much of screen time you are indulging in

• Manage your stress by using relaxation techniques including yoga, meditation, exercise and running. Start with one and engage for at least half an hour every day in the morning.