Neck Pain: Where Does It Come From?

Neck pain can arise from a number of different issues in the neck or shoulder region. Quite often, pain is generated from the small joints in the back of the vertebra, called facets. Pain can also arise from disc-related conditions where the liquid-like center part of the disc works its way out through cracks and tears in the thicker outer part of the disc. Pressure on nerves produce numbness and/or weakness in the arm. It is possible to “sprain” the neck in car accidents, sports injuries, or from slips and falls. Here, ligaments tear and lose stability resulting in excessive sliding back and forth during neck movements. When muscles are injured, these injuries are called “strains” and pain can occur wherever the muscle is torn. There is also "referred" pain. Here, the injury is a distance away from where the pain is felt. A classic referred pain pattern is shoulder blade pain, when a disc in the neck herniates. Let’s take a closer look at two conditions we often diagnose and treat as chiropractors:

Spinal Stenosis: This occurs when the canals in the spine narrow to the point of pinching the spinal cord in the trefoil shaped central canal (called “central stenosis”) or when the nerve roots get pinched in the lateral recesses (called lateral recess stenosis). This can be caused by arthritis in the facet joints, disc bulging or herniations, thickening of ligaments, shifting of one vertebra over another, aging, heredity (being born with a narrowed canal), and/or from tumors. Usually, combinations of several of the above occur simultaneously. Symptoms can include pain in one or both arms, but it’s more dangerous when leg pain, numbness, or weakness occur (called myelopathy). Rarely, loss of bowel or bladder control can occur. It's then considered a “medical emergency” and requires prompt surgery.

Cervical Disc Herniation: As previously stated, the liquid-like center of the disc can work its way through cracks and tears in the outer layer of the disc and can press on a nerve resulting in numbness, pain, and/or weakness in the arm. The classic presentation is the patient finding relief by holding the arm over the head, as this puts slack in the nerve and it hurts less in this position. The position of the head also makes a difference as looking up usually hurts more and can increase the arm pain/numbness; while looking down reduces the symptoms. We will carefully test your upper extremity neurological functions (reflexes, muscle strength, and sensation, as each nerve performs a different function in the arm), and we can tell you which nerve is pinched after a careful examination. These conditions can lead to surgery, so the sooner you address it, the better.

The good news is that chiropractic care can manage both spinal stenosis and cervical disc herniations BEFORE they reach the point of requiring surgery. So, make chiropractic your FIRST choice when neck pain occurs!

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