S C O L I O S I S I N L O N D O N
1/ Anatomy of the Neck
The neck contains the top end of the spinal column or spine, which supports the head and also protects the spinal cord. The spinal cord is the main nerve which runs from the brain, through the neck and down the back, and connects with nerves to the rest of the body.
The spine is made up of 33 bones called vertebrae stacked one on top of another to form a column.
The 7 bones in the neck are known as cervical vertebrae. Between the bones are intervertebral
discs. The sides of the bones are linked by facet joints. Many ligaments and muscles are attached to the spine and fan out from the neck to the shoulder blades and back. The muscles control movements of your head. The spine protects the spinal cord from outside damage while still allowing you to move head in any direction.
At the level of each disc, nerve roots branch out from the spinal cord, passing through an opening in the side of the spine. The nerve roots in the neck join to form the nerve trunks that run into the arms. Impulses travel along these nerves, sending sensations such as touch and pain to the brain and messages from the brain to the muscles.
2/ What causes neck pain?
Non-specific neck pain
Many people develop a stiff and painful neck for no obvious reason. It may happen after sitting in a draught or after a minor twisting injury, for example while gardening.
Having non-specific neck pain does not mean that your neck is damaged and often it happens in people whose necks would appear completely normal under an X-ray.
Is the most common type of the neck pain and often disappears after a few days.
This is form of osteoarthritis. With everyday use over many years the discs and the facet joints become worn. This wear varies from person to person. The discs become thinner and this causes the spaces between the vertebrae to become narrower. The abnormalities found in cervical spondylosis can be seen on X-rays.
When these changes do cause pain it may come either from the linings of worn joints or from stretched ligaments.
Occasionally bulging discs or osteophytes pinch the nerve roots and this causes pain and numbness that travels into the arm.
If the vertebral artery is pinched, this reduces the blood supply to the area of the brain that controls balance and this may lead to dizziness.
This type of injury often follows a rear-end collision in a car. In this type of collision, first the body is carried forward and the head flips backwards. Then, as the body stops, the head is thrown forwards.
Following a whiplash injury there is often a delay before the pain and stiffness start.
Most muscles of the body relax completely when they are not being used but some muscles have to work all the time in order to keep your body upright. Muscles all the back of your neck must always be tensed, otherwise your head would fall forwards when you are sitting or standing.
When these muscles work too hard it can cause neck pain and tension headaches.
3/ What are the symptoms of neck problems?
Dizziness and blackouts
Pain - you may feel pain in the middle of your neck or on one side or the other. The pain may travel to the shoulder and shoulder blades or to the upper chest.
Stiffness - this is common. You may find it painful to move and your muscles feel tight. Stiffness is often worse after long periods of rest or after sitting in one position for a long time.
Noisy joints - you may hear or feel clicking or grating as you move your head. This is caused by roughened bony surfaces moving agains each other or by ligaments rubbing agains bone.
Dizziness and blackouts - these can sometimes happen when bony changes in cervical spondylosis cause pinching of the vertebral artery. You may feel dizzy when looking up, or you may occasionally have blackouts.
Torticollis - sometimes if you have neck pain you may have muscle spasms that turn the head to one side. This is called torticollis. Although not very common, it is an unpleasant side-effect of neck pain.
Other symptoms - if you have long-lasting neck pain and stiffness, particularly if your sleep is disturbed, then you may feel excessively tired and this can cause depression.
Pain and stiffness can be caused by poor standing posture or by too soft a bed or the wrong thickness of pilow.
If your desk is too low, so that your head is bent forward for long periods, then the neck may be stretched and you may develop muscle pain.
Check your desk height and chair design at work and in the home - this is important to prevent problems.
Similarly, if you work at a computer screen it is important to have screen, desk and chair set at the correct heights.