Causes, Diagnosis, and Treatment of Chronic Neck Pain

A pain in the neck – a quiet literal condition. Neck pain is one of the most common complaints and aches that doctors hear. Fortunately, neck pain is rarely the sign of a more complicated condition. 

Your neck supports the weight of your head and is flexible, making it prone to injuries and conditions that limit movement. 

Causes of Neck Pain

• Muscle Strains: straining your muscles can occur if you spend a lot of time looking down at a computer or hunched over a desk at work. Things that you may not associate with straining muscles such as reading or even grinding your teeth can cause strain to your neck muscles. 
• Injuries: Car accidents, especially read-end collisions that result in whiplash, can be particularly damaging to the soft tissues of the neck. Falls that jar your neck can also strain your neck muscles and joints. 
• Joint Wear-and-Tear: Like any other joint in your body, neck joints experience normal wear-and-tear. Conditions like osteoarthritis can affect your neck joints and cause the cartilage that cushions your bones to wear down. 

Those are just a few of the main causes of neck pain. Any damage to the nerves in your neck, such as a nerve compression, can cause pain and reduce motion in your neck. 

How to Diagnose Neck Pain

Your doctor will do an examination to determine the severity of your neck pain and to determine your ability to move your neck. Your doctor may also beck for any numbness, tenderness, or areas where your muscles may be more tense than usual. 

Depending on the general prognosis after the initial evaluation, your doctor may refer you to get tests done that are better suited to determine the source of the pain. For example, you may be sent to get imaging done, such as an X-Ray, MRI, or CT scan. Theses tests are able to show the doctor where there may be a pinched nerve, or internal damage to the structure of your neck.

Other diagnostic tests include:

• Blood tests to see if there is an underlying condition that could potentially cause muscle inflammation or infection
• If your pain is suspected to be caused by a pinched nerve, your doctor may recommend an EMG (electromyography) to determine whether specific nerves are functioning properly. 

Treatment Options

Treatment for neck pain determines on the location and severity of the pain and root cause. It can be debilitating and painful, however, surgery is not the recommended course of action.

Conservative (Non-Surgical) Treatments

Conservative treatments may relieve pain for six to eight weeks. 

• Physical Therapy: Physical therapy teaches your body the correct alignment and strengthening exercises to help ease the pain and prevent further pain or injury. Physical therapists use various methods like heat and cold therapy and electrical stimulation to relax muscle tension and strains that cause pain. 
• Traction: This method uses weights, an air bladder, or pulleys to stretch your neck. This can help relieve pain related to nerve root irritation and damage. 
• Neck Brace: Wearing a soft collar brace may help reduce pain by taking pressure off the structures in your neck. This should only be done short term, or it may cause more harm than good. 

Surgical Treatments

If conservative treatments prove to be ineffective, there are surgical treatments available. Steroid injections, like corticosteroid medications, are injected into the facet joints of the cervical spine in your neck to ease and reduce pain. Numbing agents are also used to reduce pain. Surgery is rarely necessary for this type of pain, although it can be used to relieve nerve root or compression pain. 

Resources: 

Expert Pain Care

https://www.mayoclinic.org/diseases-conditions/neck-pain/diagnosis-treatment/drc-20375587

https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Neck-Pain 

https://www.physio-pedia.com/Chronic_neck_pain