The sources of neck pain are myriad and symptoms often overlap. It can be really hard to tell one source of pain from another. The pain sources often coexist as a problem in one area affects the other. Neck pain is becoming more and more common as a result of poor posture and lack of exercise. We divide causes of neck pain into conditions that affect the:
- Spinal Ligaments
- Disc
- Facet joints (neck joints)
- Myofascial pain (neck muscles)
- Nerves and Spinal Cord
- Structures outside the spine
1. Spinal Ligaments
There can be pain and stiffness of the neck after extension–flexion injury (usually from a frontal collision) which may occur immediately or after a few days; associated symptoms include headache, back pain, shoulder pain, giddiness, the sensation of “pins and needles”, tiredness and insomnia
2. Disc
Pain and stiffness of the neck limiting movement, with occasional numbness and shooting pain down the arms on one or both sides. Worse on coughing, sneezing and straining.
3. Facets (neck joints)
Pain and stiffness of the neck limiting movement; pain may be felt elsewhere over the shoulders, scapular, occiput and upper I know arm in what as “referred pain”
4. Myofascial pain (neck muscles)
There are specific points of pain and sensitivity over the neck and shoulder region also known as “trigger points”; pain is aching and may be accompanied by tingling or numbness. Sometimes patients can have generalised tenderness over the trapezius and neck
5. Nerves and Spinal Cord
Radiculopathy (nerve root) compression
There is shooting electric pain down one or both arms, along with numbness and sensations of “pins and needles”, and weakness of various muscles
Myelopathy (spinal cord) compression
The spinal cord is compressed from various causes leading to changes in bladder and bowel control, difficulty walking and coordinating, and weakness of the hands or legs
Ligament thickening
The posterior ligament that overlies the spinal cord behind becomes thick and hard and infused with calcium, leading to pressure on the nerves and the spinal cord with its attendant symptoms as stated above
Other Causes of Neck Pain:
Other causes that arises elsewhere but give rise to pain in the neck include:
- Heart attack or angina that radiates into the neck
- Infection of the spine, throat, and the meninges (covering of the brain)
- Cancer with metastasis or lung cancer
- Tension headache
- Muscle diseases which sometimes gives rise to spasms in the neck
- Pain in the shoulder from ligament tears or frozen shoulder
- Fibromyalgia and certain rheumatological conditions
- Abnormal arteries which may dissect or become inflamed
- Infection and inflammation of the biliary system (gallbladder/liver)
- Inflammation or narrowing of the oesophagus