Neck (Cervical) Pain

The neck is the most mobile part of the spine, helping to keep our head in a supported position and allowing us to move in many directions. It has a complex joint structure that is responsible for protecting various vascular and nerve structures going from the skull to the body, and also includes the spinal cord. For this reason, it is in a position vulnerable to trauma.

Neck pain affects people of all ages and genders and constitutes a general public health problem. One in every three people experience neck pain at some point in their lives, and these are mostly mild. Chronic neck pain occurs in a very rare patient population. Although it is less common in children, the frequency of neck pain increases with age and is more common in people who use desks and computers. Cervical pain may also occur as a result of blunt trauma to the neck.

What are the factors that cause neck pain?

Since the anatomical structure of the neck is very mobile, it consists of 7 vertebrae and discs. Discs are structures located between the cervical vertebrae and provide a kind of support. His duty is; It is to distribute the load on the vertebrae evenly and to keep the friction force between the vertebrae at a minimum level. Since the nerves going to the trunk and shoulders pass between the neck vertebrae, numbness and tingling sensations may be experienced in the hands and legs during neck pain.

Neck pain may occur as a result of connective tissue deformation in the muscle structures that make up the neck. Making sudden and wrong movements may cause pain as a result of damage to these muscle structures. Jumping from a high place or trauma, calcification in the joints in the neck area, discs that serve as pillows bulging outwards, some rheumatic diseases, narrowing or hernia in the spinal canal and psychosomatic factors can cause various neck pains.

Mechanical Neck Pain

Epidemiologically, it is the most common type of neck pain. It mostly occurs as a result of trauma to the neck area and injuries resulting from misuse of the muscles in the neck area. The most common cause is anatomical poor posture. It is especially common in people who work at a desk or in front of a computer all day long. Mechanical neck pain can radiate to the back, shoulders or arms as a type of referred pain. Often no pathological cause underlying the pain can be found.

Neck Pain Due to Spine Diseases: It is less common than mechanical neck pain. Among the causes;

Cervical disc herniation (cervical disc herniation)
Degeneration/wear and tear in the cervical vertebrae (Cervical Spondylosis)
Spinal cord involvement due to narrowing in the cervical spinal canal (Cervical Spondylotic Myelopathy)

General Approach to Neck Pain Types

Among the musculoskeletal system complaints expressed by patients in the spinal canal, neck pain comes first after a herniated disc. When you go to the doctor with a complaint of neck pain, the doctor will take a detailed anamnesis from you. He or she will question one by one your occupational status, your past trauma history, any previous surgery, your genetic factors, and whether there are any other symptoms accompanying the pain. Among the complaints we have mentioned, such as excessive weight loss in the last month, persistent vomiting, and worsening neck pain day by day, which we call alert findings, the cause of neck pain should be investigated immediately. You may experience mechanical neck pain without any underlying pathology, or you may be faced with pain caused by malignancy.

Mechanical causes of neck pain include: Conditions such as degeneration of the discs between the vertebrae, muscle-related deformations, facet joint wounds, vertebral fractures, spondylosis, spondylolisthesis, and postlaminectomy syndrome may occur. Approximately 80-90% of neck pain is mechanically caused. Neurogenic neck pain may also be caused by conditions such as disc herniation, spinal stenosis, osteophytic nerve root compression, failed neck surgery syndrome, infection (herpes zoster), and nerve root irritation. Non-mechanical pathologies include conditions such as malignancy, spondylodiscitis, osteomyelitis, inflammatory spondyloarthropathies, ankylosing spondylitis, and Paget’s disease. Fibromyalgia and gastrointestinal causes can also cause neck pain.

After taking a detailed history from patients presenting with neck pain, we can make the diagnosis using radiological imaging methods and laboratory tests. It is extremely important for the treatment of neck pain to then evaluate and apply the appropriate treatment method to the patient.