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I hope that everyone has had a good start to the New Year. I want to thank all of you who sent in questions after the last article and I hope I answered them all. Most of the responses requested discussing neck pain, so here goes.

First let’s review the anatomy. Imagine trying to balance an 8 pound coconut (head) on the top of a broomstick (spine) and then walking around all day. Now add to that a long balloon in the middle of the broomstick filled with water (Spinal cord) that is not allowed to break. Oh, I forgot to mention the broomstick has to be flexible so it can bend in all directions but the coconut can’t fall off. So now you have an idea of what your neck does every second of every day even while asleep.

In order for the spine to be flexible but strong, the bones lay on top of cushions called discs, which for all intent and purposes, is structured like a jelly donut. As the bones come down along sides of the disc, they touch the bone below in what is called a facet joint. To stabilize all this is connective tissue that is strong but pliable (just like gristle in a tough cut of meat). To make all of this move the way we want it to are layers of muscles that pull in all directions.

So the two most common reasons for neck pain are related to “soft tissue” (muscles and connective tissue) and joint problems (facet and or disc problems). Now there are many other causes of neck pain that are not as common and are actually even dangerous. But a good 9 times out of 10 it will be in one of the above categories.

Facet and disc problems are mostly from what we as doctors call degenerative changes (ageing) but can also be caused by trauma to the neck. This is usually a more constant pain and doesn’t depend on the moment by moment movements that one does. It can cause pain that radiates down the arms when it gets bad enough to impinge on a nerve. It may respond to over the counter anti-inflammatory medication like Naproxen or Ibuprofen. But this is one to see your doctor about if it is getting worse or starting to go down your arm.

The most common pain in the neck (no! not that family member.) is from muscle and ligamentous strain. Even as you are reading this the muscles in the back of your neck are working to hold your head from falling forward. So if you kept your head in this position long enough you will feel soreness as you try to change position. If this went on too long then tomorrow you would wake up with soreness and even a headache. By the way, the way you sleep plays a very important role in how your neck feels the next day. Did you ever fall asleep on the arm of a couch and then have a tight neck for the rest of the day or even a week.  These strains and sprains respond to ice, anti-inflammatories, massage, moist heat, physical therapy and sometimes muscle relaxers. Also, reduce your stress (yes, easier said than done) but stress is one of the main reasons for soft tissue neck pain.

Other things to do to avoid neck pain are: keep your computer screens at eye level, never whip your head around to stretch the muscles always use smooth stretching movement in the direction opposite the tightness, and if you realize that your neck did a lot for you that day that it usually doesn’t do (like looking up a lot when you put the drapes up in the house) then use an ice pack for 20-30 minutes over the back of the neck to PREVENT the soreness the next day.   

 As always if things don’t get better in a reasonable amount of time seek medical help. I hope this helps some of you to understand better why neck pain is so common and why it happens so frequently.


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