NECK, SHOULDER & ARM PAIN
Most people will experience neck pain at some time in their life. The symptoms can range anywhere from being a nuisance to being severe and debilitating. Estimates state that during a given year between 12.1% and 71% of the general population will have an episode. Many with mild symptoms will self treat with over the counter remedies and ice or heat. When symptoms recur or become severe, the key to successful management is to identify what exactly is causing the symptoms so that the wide range of treatments available can be applied successfully and quickly, then implement a plan to strengthen and stabilize any weaknesses that contributed to its onset.
Causes of Neck Pain
While there are numerous conditions that result in pain in the neck and upper back, the most common causes are…..
Cervical disc disease: Sandwiched in between the 24 moveable bones of our spine are cushions called intervertebral discs. They are somewhat like jelly donuts with fibrous pastry on the outside called annulus fibrosus and a center filled with a jelly like substance called nucleus pulposus. As we go through life, bending lifting, twisting our necks, stopping short in our cars, playing sports, etc., the annulus acquires small tears. This is painful and in most cases produces some discomfort that is often self limiting. This is the common mild neck pain many people have that self resolves with home care. Over time the process tends to repeat itself, becoming more painful and lasting longer. As the condition recurs the nucleus can leak into the tears in the annulus. The nucleus is an irritant and causes inflammation so this hurts even more and tends to last longer. If the leakage becomes big enough to distort the outer margin of the disc, the disc will begin to protrude toward the nerves that run down the arm and cause arm pain, tingling, numbness, or sometimes weakness. Generally these bouts can resolve but more often need treatment from a professional. If the nucleus protrudes outside the annulus (disc herniation) and into the spinal canal where the spinal cord and nerves are, this is more serious and should always be examined and treated by a professional with experience in treating disc disease.
Somatic Dysfunction/Vertebral Subluxation Complex: The spinal column is designed to accomplish 2 major functions; protect the spinal cord and allow for movement of the head, neck, and torso in multiple directions. Over the course of the day, our spines accumulate the stresses and strains of daily activities and sometimes a spinal bone, called a vertebra can lock in an abnormal position, creating misalignment. This condition, called Somatic Dysfunction or Vertebral Subluxation Complex can put pressure on the spinal joints or the exiting spinal nerves and produce neck pain, upper back pain, arm pain and even headache. It often contributes to the initiation of disc disease as described above.
Myofascial Pain/Trigger Points: Tender and sore areas in muscles that hurt when pressure is applied are called tender points. When they persist and pain seems to refer outward from the sore area, we refer to them as trigger points. If trigger points persist we call the condition myofascial pain syndrome. Most people have experienced tender points form muscle strain. These often go away by themselves. Trigger points on the other hand are more painful and persistent. Many people unfortunately suffer with chronic myofascial pain syndrome. Symptoms typically occur after a muscle has been contracted repetitively. This can be caused by repetitive motions used in jobs or hobbies or by stress-related muscle tension.
Whiplash Injuries: Forceful forward, backward, and sideward movement of the neck resulting in sprain to the supporting ligaments and strain to the muscles as well as misalignment of the spinal bones (vertebra) is called whiplash. This can result from a car accident or simply flexing your head and neck forward and backward quickly while drying your hair. The movement creates overstretching of the soft tissues that surround and support the spine. Whiplash can be a causative factor for disc injury and nerve pressure as well. If not tended to professionally the condition and pain that it causes can become chronic.
Making the Pain Go Away: Treatment to resolve pain successfully is dependent upon an accurate diagnosis. This is accomplished by taking a thorough history, doing a complete examination, and utilizing any of a variety of diagnostic tools we have at our disposal. Once completed , the spectrum of treatment modalities available include medication, Osteopathic/Chiropractic manipulation, Physical Therapy, Injections, and Surgery.