Introduction

When a person wakes up in the morning with a stiff and painful neck the tendency is to blame the condition on one’s pillow, bed, or sleep position during that night. Other times a person can move their neck suddenly and feel sharp pain thinking that something suddenly slipped out of position or is pinching a “nerve”. It is important to understand that most neck problems are seldom caused by a single incident but by the cumulative affect of improper sitting posture, poor work and living habits, lack of proper exercise and flexibility and other lifestyle-related factors. Of course some neck problems are due to traumatic events such as a whiplash accident, a fall or a sports injury.

Anatomy

To understand neck pain it is necessary to understand the anatomy of the spine. The spinal bones or vertebrae of the neck consist of posterior joints called facets that link vertebrae to one another and serve to guide the motion of the spine. The intervertebral discs connect the bodies of the vertebrae and are composed of a form of tough cartilage that encases a soft material in the centre called the nucleus. The primary function of the disc is a shock absorber and a spacer between the vertebrae. Ligaments are tough, non elastic bands that hold the bones together and muscles are the tissues that contract to move the body.

In a canal located between the body and the facets of the vertebrae is the spinal cord. The spinal nerves exit the spine between the vertebrae and provide the energy to make the muscles and other organs of the body function. The spinal nerves also carry impulses from the body to the brain regarding pain, touch, position, temperature as well as other senses. The nerves from the neck are responsible for the entire upper extremity including the shoulder, elbow and hand as well as structures of the head and neck. The neck has a natural forward curve viewed from the side that helps properly balance the weight of the head as well as to decrease stress.

Risk Factors for Neck Pain

More and more people are now making their living sitting at a desk. The use of computers have risen astronomically and many of us spend eight to ten hours a day slumped over the keyboard and staring at the monitor. When we sit with our head in a forward bent position, the posture that most desk workers assume, the ligaments that hold the facets together and the muscles in the neck are put under tremendous strain. In addition the normal forward curve of the neck becomes reversed causing more stress upon all the surrounding tissues of the neck. All of this can lead to spinal problems including disc herniation and subluxations, which are the main causes of spinal nerve irritation. Besides pain, spinal nerve irritation in the neck can cause symptoms including headaches, eye problems, giddiness, arm and hand pain paraesthesia, as well as shoulder pain.

Headaches

As mentioned above, headaches or migraines are frequently associated with disorders of the cervical spine. When the cervical vertebrae lose their normal position or motion, sensitive nerves and blood vessels that are associated with structures in the head are stretched or irritated thus producing symptoms from a dull ache to throbbing pain. In many cases the tight knots in the muscles of the neck called trigger points can also refer pain in to the head. Of course there are other factors associated with headaches including toxic fumes, certain foods and additives such as MSG, alcohol, caffeine and stress. However one must always look at the tissues and alignment neck when considering the cause of headaches and migraines. Chiropractic adjustments with postural exercises have proven to be very affective in the treatment of headaches.

Whiplash

Many people are involved in car accidents during their lifetime. By far the most common auto accident is when one car collides in to the rear-end of another car. During such an accident, the passenger in the front vehicle gets their head forcefully jerked backward and then forward causing injury to the structures of the back and front of the neck. This type of injury is often called a whiplash. Even at low speeds, the amount of force generated by such an accident is very strong and can cause trauma to the ligaments, muscles, facet joints, discs and the spinal nerves. Besides neck pain and immobility, symptoms such as headaches, nausea, vertigo, arm and shoulder pain, tingling in the hands and fingers and weakness of the arm and hand are associated with whiplash injury. It is very important to get immediate evaluation and x-rays to rule out the possibility of fracture. However in most cases, the injuries are usually to the soft tissues and joints. Proper management is essential to recover from the pain and symptoms of whiplash and to prevent future disability. Chiropractors are educated to understand whiplash injury and manage the case from beginning to end.