The neck is the part of the body, on many terrestrial or
secondarily aquatic vertebrates, that distinguishes the head from the torso or
trunk. The Latin term signifying "of the neck" is cervical. Anatomy
of the human neck Bony anatomy:
The Cervical Spine
The cervical portion of the human spine comprises seven bony segments,
typically referred to as C-1 to C-7, with cartilaginous discs between each
vertebral body. The neck supports the weight of the head and protects the
nerves that carry sensory and motor information from the brain down to the rest
of the body. In addition, the neck is highly flexible and allows the head to
turn and flex in all directions. From top to bottom the cervical spine is
gently curved in convex-forward fashion. It is the least marked of all the
curves of the column. Soft tissue anatomy In the middle line below the chin can
be felt the body of the hyoid bone, just below which is the prominence of the
thyroid cartilage called "Adam's apple", better marked in men than in
Causes of Neck Pain
Neck pain can result from a variety of causes, ranging from over use injuries
and whiplash to diseases such as rheumatoid arthritis and meningitis.
Muscle strains. Overuse, such as too many hours hunched over a
steering wheel, often triggers muscle strains. Neck muscles, particularly those
in the back of the neck, become fatigues and eventually strained. When
you overuse your neck muscles repeatedly, chronic pain can develop. Even
such minor things as reading in bed or gritting your teeth can strain neck
Worn joints. Just like all other joints in your body, your neck
joints tend to experience wear and tear with age, which can cause
osteoarthritis in your neck.
Nerve compression. A variety or problems in your neck's vertebrae
can reduce the amount of space available for nerves to branch out from the
spinal cord. Examples include:
- Stiffened disks. As
you age, the cushioning disks between your vertebrae become dry and stiff,
narrowing the space in your spinal column where the nerves exit.
- Herniated disks.
This occurs when the inner gel-like material of a disk protrudes through
the disk's tougher outer covering. The protrusion can press on nerves
exiting the spinal column, causing arm pain or weakness, or on the spinal
- Bone spurs.
Arthritic joints in your neck can develop bony growths that may press on
Injuries. Rear-end collisions often result in whiplash injuries,
which occur when the head is jerked forward and then backward, stretching the
soft tissues of the neck beyond their limits.
Diseases. Neck pain can sometimes be caused by diseases, such as:
- Rheumatoid arthritis. After the joints in the hands and
the feet, the joints in the neck are the next most commonly affected by
- Meningitis. This infectious disease causes the
lining of the brain and spinal cord to swell. One of the most common
symptoms of meningitis is neck pain and stiffness.
- Cancer. Rarely, neck pain can be caused by cancerous tumors
in the spine. The cancer may have traveled to the spine from other parts
of your body.
Risk factors include:
- Age. The neck is often affected by the wear and tear
variety of arthritis (osteoarthritis), which becomes more common with age.
- Occupation. Your risk of neck pain may be
higher if your job requires your neck to be held in one position for
prolonged periods of time. Examples include driving and computer
Tests and Diagnosis
- X-rays. X-rays can reveal areas in your neck where your
nerves or spinal cord may be pinched by bone spurs or a bulging disk. But
many people, especially those over 60, have these findings and don't
experience any neck pain.
- Computerized tomography (CT). CT scans combine X-ray images
taken from many different directions to produce detailed images of bones
and soft tissues, including the spinal cord and the nerves coming from the
- Magnetic resonance imaging (MRI). MRIs utilize radio waves and a
strong magnetic field to create especially detailed images of bones and
soft tissues, including the spinal cord and the nerves coming from the
Nerve tests. If you doctor suspects that your neck pain may be
related to a pinched nerve, he or she may suggest electromyography (EMG). This
test involves inserting very fine needles through your skin into a muscle to
determine whether specific nerves are functioning properly.
- Blood tests. Blood tests can sometimes provide
evidence of inflammatory or infectious conditions that may be causing your
- Spinal tap (lumbar puncture). During a spinal tap, a needle is
carefully inserted into your spine to obtain a sample of the fluid that
surrounds your brain and spinal cord. This test can reveal evidence
The most common types of neck pain usually respond well to home care. If neck
persists, your doctor may recommend other treatments.
- Pain medications. Your doctor may prescribe stronger
pain medicine than what you can obtain over-the-counter. Opiod
analgesics are sometimes used briefly to treat acute neck pain.
Muscle relaxants, tramadol (Ultram) or tricyclic antidepressant
medications used for pain alsdo may be prescribed.
- Injections of medication. Injections of medications may help
relieve neck pain. Your doctor may inject corticosteriod medications
near the nerve roots, into the small facet joints in the bones of the
cervical spine, or into the muscles in your neck to help with pain.
Numbing medications, such as lidocaine, also can be injected to relieve
your neck pain.
- Neck exercises and
Your doctor may recommend that you work with a physical therapist to lean
neck exercises and stretches. A physical therapist can guide you through
these exercises and stretches so that you can do them on your own at home.
Exercises may improve pain by restoring muscle function, optimizing
posture to prevent overload of muscles, and increasing the strength and
endurance of your neck muscles.
- Traction. Traction uses
weights and pulleys to gently stretch your neck and keep it immobilized.
This therapy, under supervision of a medical professional and physical
therapist, may provide relatively fast relief of some neck pain,
especially pain related to nerve root irritation.
A soft collar that supports your neck may help relieve pain by taking
pressure off the structures in your neck. If used for more than two weeks,
however, a collar may do more harm than good.
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