NECK PAIN
WHAT IS IT?
Neck pain affects about 20% of the Australian population. It can range in intensity from a dull, constant ache to a sudden, sharp or shooting pain. Neck pain can start quickly as a result of an accident, muscle strain or whiplash, or can develop over time with age. Acute neck pain will typically settle spontaneously or resolve with modification of activities and instruction in appropriate exercising and self-management. However, neck pain that lasts three months or longer is considered chronic neck pain.
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NECK PAIN
WHAT CAUSES IT?
Common causes of neck pain include:
- Muscle strain – this may be caused by things such as poor posture (e.g., while using a computer or smartphone, slouching), poor neck support while sleeping, watching TV, sports or work activities, anxiety and stress.
- Cervical spondylosis – this is a type of arthritis of the neck and is related to aging. The intervertebral discs of the spine lose moisture and some of their cushioning effect with age. Your body might respond by creating bony growths known as bone spurs. The symptoms of bone spurs can include neck pain and stiffness. Some people may experience other symptoms, such as tingling or numbness in their arms and legs if bone spurs press against nerves.
- Slipped, herniated or bulging disc – this occurs when the tough outside layer of a disc tears or ruptures and the soft jelly-like inside bulges out and presses on the nerves in your spine.
- Whiplash – this is a form of neck sprain caused when the neck is suddenly whipped backwards and then forwards, stretching the neck muscles and ligaments more than usual. Whiplash commonly occurs following a car accident and the pain may come on days after the accident.
NECK PAIN
TREATMENT OPTIONS
Initial treatment options include:
- Medications, such as over-the-counter analgesics and anti-inflammatory drugs (Paracetamol or Ibuprofen)
- Physical therapy programs, which often have the objective of strengthening core muscles to support the low back and encourage proper positioning
A physiotherapist might recommend adjustments to your movement to avoid major flareups. Excessive resting or immobilization of the neck can sometimes actually aggravate the situation.
If you are not improving with over-the-counter or prescription medication, as well as physiotherapy, your healthcare professional might recommend epidural injections, nerve blocks or radiofrequency (RF) therapy:
- Epidural steroid injections are delivered to the outer space of the spinal canal known as the epidural space
- Nerve blocks involve the injection of an anaesthetic at a specific nerve root to temporarily “block” the pain generated from a specific nerve
- Radiofrequency (RF) therapy, which is a proven, low-risk treatment option. During the RF procedure, your doctor will place a thin needle at the site of your pain. This needle will deliver energy to those inflamed, pain-transmitting nerves to create a block, sometimes called a lesion. This disruption reduces the ability of the nerves to send pain signals to the brain.
More advanced care options include:
- Neuromodulation or spinal cord stimulation (SCS), which works to reduce pain by altering the pain signals as they travel up the spinal cord to the brain. A generator, similar to a cardiac pacemaker, sends electrical pulses to a thin wire called a lead. The lead is placed in the epidural space and delivers pulses to nerves along the spinal cord. The pulses modify the pain signals as they travel to different parts in the brain
- Spine surgery