Neck Pain

Spine and Orthopaedic Centre Spine Specialist

Stop your Neck Pain today. Effective Treatment, Non Surgery. Discuss with our Spine Specialist for the Diagnosis, Treatment and Prognosis of your Neck Pain. Call us +65 97731458 to schedule for an appointment.

What is Neck Pain?

Our neck (cervical spine) is made up of vertebrae that extend from the skull to the upper torso. Cervical discs absorb shock between the bones. The bones, ligaments, and muscles of your neck support your head and allow for motion. Any abnormalities, inflammation, or injury can cause neck pain or stiffness.

Many people experience neck pain or stiffness in the neck occasionally. In many cases, it is due to poor posture, normal wear and tear, or overuse. Sometimes, neck pain is caused by injury from a fall, contact sports, or whiplash.

Most of the time, neck pain is not a serious condition and can be relieved within a few days. In some cases, neck pain can indicate serious injury or illness and require a doctor’s care. If neck pain continues more than a week, is severe, or is accompanied by other symptoms, seek medical attention immediately.

Neck Pain

 

Causes of Neck Pain or Stiff Neck?

Neck pain or stiffness can happen for a variety of reasons.

– Muscle Tendon and Strain

This is usually due to activities and behaviors such as:

  • poor posture
  • working at a desk for too long without changing position
  • sleeping with your neck in a bad position
  • jerking the neck during exercise

– Due to Injury

The neck is particularly vulnerable to injury, especially in falls, car accidents, and sports, where the muscles and ligaments of the neck are forced to move outside their normal range. If the neck is dislocated or fractured, the spinal cord may also be damaged. Neck injury caused by a sudden jerking of the head is commonly called “whiplash.”

– Due to Diseases and Conditions

Arthritis causes pain, swelling of the joints, and bone spurs. When these occur in the neck area, neck pain can result.

Osteoporosis weakens bones and can result in small fractures.

Fibromyalgia is a condition that causes muscle pain throughout the body.

As you age, the cervical disks can degenerate (spondylosis), narrowing the space between the vertebrae and adding stress to the joints. When a disk protrudes, it may add pressure to the spinal cord or nerve roots. This is called a herniated cervical disk, also known as a ruptured disk or slipped disk.

Spinal stenosis occurs when the spinal column narrows and causes pressure on the spinal cord. This can be due to long-term inflammation caused by arthritis or other reasons.

Meningitis is an inflammation of the thin tissue that surrounds the brain and spinal cord. Stiff neck is usually accompanied by fever and severe headache. Meningitis can be deadly and is a medical emergency. If you have symptoms of meningitis, seek help immediately.

In rare instances, neck stiffness or pain is caused by congenital abnormalities, in addition to infections, abscesses, tumors, or cancer of the spine.

When to seek Medical Care for your Neck Pain?

If symptoms persist for more than a week, consult with a Spine Specialist. You should also see a doctor if you have:

  • severe neck pain without apparent cause
  • a lump in your neck
  • fever
  • headache
  • swollen glands
  • nausea and vomiting
  • trouble swallowing or breathing
  • weakness
  • numbness and tingling
  • pain that radiates down your arms or legs
  • inability to move your arms or hands
  • inability to touch your chin to your chest
  • bladder or bowel dysfunction

If you’ve been in an accident or fall and your neck hurts, seek medical care immediately.

How Neck Pain is Treated?

Our Specialist will perform a physical exam and take your complete medical history. Be prepared to provide specifics about your symptoms, prescription and over-the-counter medications and supplements, and recent injuries or accidents, even if they don’t seem related.

Treatment for neck pain will depend on the diagnosis. Tests to determine the cause of neck pain may include:

  • blood tests
  • X-rays
  • computed tomography (CT) scan
  • magnetic resonance imaging (MRI)
  • electromyography (EMG – a test that checks the health of muscles and the nerves that control muscles)
  • lumbar puncture (spinal tap)

Depending on the results of these tests, treatment for neck pain may include:

The treatment of neck pain depends on its precise cause. Treatment options include rest, heat/ice applications, traction, soft collar, traction, physical therapy (ultrasound, massage, manipulation), local injections, topical anesthetic creams, topical pain patches, muscle relaxants, analgesics, and surgical procedures.

Stop your Neck Pain today. Effective Treatment, Non Surgery. Discuss with our Spine Specialist for the Diagnosis, Treatment and Prognosis of your Neck Pain. Call us +65 97731458 to schedule for an appointment.

Cervical Radiculopahy

Spine and Orthopaedic Centre Spine Specialist
What is Cervical Radiculopathy?

Cervical Radiculopathy is the clinical description of pain and neurological symptoms resulting from any type of condition that irritates a nerve in the cervical spine (neck).

Cervical nerves exit the cervical spine (neck) at each level, C1 – C7. Nerves in the neck exit above the designated vertebral level at all levels except the last one (C8 exits below the C7 vertebra), and then branch out to supply muscles that enable the shoulders, arms, hands and fingers to function. They also carry sensory fibers to the skin and muscles that provide sensation.

When any nerve root in the cervical spine is irritated through compression or inflammation, the symptoms can radiate along that nerve’s pathway into the arm and hand.

The patient’s specific cervical radiculopathy symptoms will depend primarily on which nerve is affected. The symptoms may also be referred to as radicular pain.

Causes of Cervical Radiculopathy

Any condition that injures or somehow irritates the cervical nerve can cause cervical radiculopathy. The most common causes include:

  • Cervical Herniated Disc. If the inner material of the cervical disc herniates, or leaks out, and inflames and/or impinges on the adjacent nerve, it can cause a cervical radiculopathy.
  • Cervical Spinal Stenosis. As part of the degenerative process of the cervical spine, changes in the spinal joints can lead to tightening of the space for the spinal canal.
  • Cervical Degenerative Disc Disease. When the cervical spine degenerates over time, it can result in degenerated discs and a pinched nerve.

Infrequently, cervical radiculopathy can be caused by other conditions, such as a tumor, fracture or sarcoidosis, which can compress or cause damage to the cervical nerve roots.

Cervical Radiculopathy Symptoms

Patients with cervical radiculopathy typically feel pain, weakness or numbness in the areas served by the damaged nerve. Pain can be in one area only, like the shoulder, or progress along the entire arm.

The type of pain also can vary. Some patients describe dull, all over pain; others describe the pain as severe burning or sharp. Patients may feel tingling, “pins and needles,” or numbness.

Certain neck movements, like bending the neck back, side to side, or rotating it, may increase the pain. Some patients report that pain decreases when they place a hand behind their head; the movement may be relieving the pressure and traction on the nerve root which then lessens their symptoms.

Types of Cervical Radiculopathy

Cervical radiculopathy symptoms differ depending on which nerve is affected. For example, if the nerve root that runs above the C6 vertebra is affected, a physician will use the term “C6 radiculopathy”.

While any patient’s specific symptoms can vary widely, the following are common descriptions for the types and symptoms of cervical radiculopathy:

  • C5 radiculopathy can cause pain and/or weakness in the shoulders and upper arms. Especially may cause discomfort around the shoulder blades. It rarely causes numbness or tingling.
  • C6 radiculopathy (one of the most common), causes pain and/or weakness along the length of the arm, including the biceps (the muscles in front of the upper arms), wrists, and the thumb and index finger.1
  • C7 radiculopathy (the most common) causes pain and/or weakness from the neck to the hand and can include the triceps (the muscles on the back of the upper arms) and the middle finger.2
  • C8 radiculopathy causes pain from the neck to the hand. Patients may experience weakness in hand grip, and pain and numbness can radiate along the inner side of the arm, ring, and little fingers.

Cervical Radiculopathy Treatment

There is a wide range of treatment options available for cervical radiculopathy, and the treatment will depend mainly on the underlying cause of the patient’s symptoms as well as the severity of symptoms

Cervical Spondylosis

Spine and Orthopaedic Centre Spine Specialist
What is Cervical Spondylosis?

Cervical Spondylosis is a general term for age-related wear and tear affecting the spinal disks in your neck. As the disks dehydrate and shrink, bone spurs and other signs of osteoarthritis develop.

Cervical spondylosis is very common and worsens with age. There also appears to be a genetic component involved because some families will have more of these changes over time, while other families will develop less.

More than 90 percent of people older than age 65 have evidence of cervical spondylosis and osteoarthritis that can be seen on neck X-rays. Most of these people experience no symptoms from these problems. When symptoms do occur, nonsurgical treatments often are effective.

Symptoms of Cervical Spondylosis

In most cases, cervical spondylosis causes no symptoms. When symptoms do occur, they typically affect only the neck — causing pain and stiffness.

Sometimes, cervical spondylosis results in a narrowing of the space needed by the spinal cord and the nerve roots that originate at the spinal cord and pass through the spine to the rest of your body. If the spinal cord or nerve roots become pinched, you may experience:

  • Tingling, numbness and weakness in your arms, hands, legs or feet
  • Lack of coordination and difficulty walking
  • Loss of bladder or bowel control

When to see a Spine Specialist?

Seek medical attention if you notice sudden onset of numbness or weakness, or loss of bladder or bowel control.

Causes of Cervical Spondylosis

As you age, the bones and cartilage that make up your backbone and neck gradually develop wear and tear. These changes may include:

  • Dehydrated disks. Disks act like cushions between the vertebrae of your spine. By the age of 40, most people’s spinal disks begin drying out and shrinking, which allows more bone-on-bone contact between the vertebrae.
  • Herniated disks. Age also affects the exterior of your spinal disks. Cracks often appear, leading to bulging or herniated disks — which sometimes can press on the spinal cord and nerve roots.
  • Bone spurs. Disk degeneration often results in the spine producing extra amounts of bone, sometimes called bone spurs, in a misguided effort to shore up the spine’s strength. These bone spurs can sometimes pinch the spinal cord and nerve roots.
  • Stiff ligaments. Ligaments are cords of tissue that connect bone to bone. Increasing age can make spinal ligaments stiffen and calcify, making your neck less flexible.

Risk Factors of Cervical Spondylosis

Risk factors for cervical spondylosis include:

  • Age. Cervical spondylosis is a normal part of aging. Spinal disks tend to dehydrate and shrink with the passing years.
  • Occupation. Certain jobs may place extra stress on your neck. This may include repetitive neck motions, awkward positioning or a lot of overhead work.
  • Neck injuries. Previous neck injuries appear to increase the risk of cervical spondylosis.
  • Genetic factors. Some families will have more of these changes over time, while other families will develop less.

Complication of Cervical Spondylosis

If your spinal cord or nerve roots become severely compressed as a result of cervical spondylosis, the damage can be permanent.

Diagnosis of Cervical Spondylosis

During the exam, our spine specialist will check the range of motion in your neck. To find out if there’s pressure on your spinal nerves or spinal cord, our spine specialist will test your reflexes and check the strength of your muscles. He may want to watch you walk to see if spinal compression is affecting your gait.

Imaging Tests

A variety of imaging tests can provide details to guide diagnosis and treatment. Examples include:

  • Neck X-ray. An X-ray may show abnormalities, such as bone spurs, that indicate cervical spondylosis. It is ordered primarily as a screening test to look for rare, serious causes for neck pain and stiffness such as tumors, infections or fractures.
  • Computerized tomography (CT scan). This test takes X-rays from many different directions and then combines them into a cross-sectional view of the structures in your neck. It can provide much finer details than a plain X-ray, particularly of the bones.
  • Magnetic resonance imaging (MRI). MRI uses a magnetic field and radio waves and can produce detailed, cross-sectional images of both bone and soft tissues. This can help pinpoint areas where nerves may be getting pinched.
  • Myelogram. This test involves generating images using X-rays or CT scans after dye is injected into the spinal canal. The dye makes areas of your spine more visible.

Nerve Function Tests

In some cases, it may be helpful to determine if nerve signals are traveling properly to your muscles. Nerve function tests include:

  • Electromyogram (EMG). This test measures the electrical activity in your nerves as they transmit messages to your muscles when the muscles are contracting and when they’re at rest. The purpose of an EMG is to assess the health of your muscles and the nerves that control them.
  • Nerve conduction study. For this test, electrodes are attached to your skin above the nerve to be studied. A small shock is passed through the nerve to measure the strength and speed of nerve signals.

Treatment of Cervical Spondylosis

Treatment for cervical spondylosis depends on the severity of your signs and symptoms. The goal of treatment is to relieve pain, help you maintain your usual activities as much as possible, and prevent permanent injury to the spinal cord and nerves.

Medications

If over-the-counter pain relievers don’t help, our spine specialist might suggest:

  • Muscle relaxants. Drugs may help if you’re having muscle spasms in your neck.
  • Anti-seizure drugs. Some types of pregabalin (Lyrica), work well to dull the pain of damaged nerves.
  • Narcotics. Some prescription pain relievers contain narcotics, such as hydrocodone (Vicodin, Lortab, others) or oxycodone
  • Anti-inflammatory injections. In some cases, injecting anti-inflammatory medicine into the area affected by cervical spondylosis may help.

Therapy

A physical therapist can teach you exercises to help stretch and strengthen the muscles in your neck and shoulders. Some people with cervical spondylosis may benefit from the use of traction, which can help provide more space within the spine if nerve roots are being pinched.

Surgery

If conservative treatment fails or if your neurological signs and symptoms such as weakness in your arms or legs are getting worse, you may need surgery to create more room for your spinal cord and nerve roots. This may involve removing a herniated disk or bone spurs, or it could require the removal of part of a vertebra.