Friday, June 18, 2010

Neck Pain

Neck pain may begin in any of the structures in the neck. These include muscles and nerves as well as spinal vertebrae and the cushioning disks in between. Neck pain may also come from regions near the neck, like the shoulder, jaw, head, and upper arms.

When your neck is sore, you may have difficulty moving it, especially to one side. Many people describe this as having a stiff neck.

If neck pain involves nerves (for example, significant muscle spasm pinching on a nerve or a slipped disk pressing on a nerve), you may feel numbness, tingling, or weakness in your arm, hand, or elsewhere.

Causes

A common cause of neck pain is muscle strain or tension. Usually, everyday activities are to blame. Such activities include bending over a desk for hours, having poor posture while watching TV or reading, placing your computer monitor too high or too low, sleeping in an uncomfortable position, or twisting and turning the neck in a jarring manner while exercising.

Traumatic accidents or falls can cause severe neck injuries like vertebral fractures, whiplash, blood vessel injury, and even paralysis.

Other causes include:

* Other medical conditions, such as fibromyalgia
* Cervical arthritis or spondylosis
* Ruptured disk
* Small fractures to the spine from osteoporosis
* Spinal stenosis (narrowing of the spinal canal)
* Infection of the spine (osteomyelitis, diskitis, abscess)
* Cancer that involves the spine

Home Care

For minor, common causes of neck pain:

* Take over-the-counter pain relievers such as ibuprofen (Advil, Motrin IB) or acetaminophen (Tylenol).
* Apply heat or ice to the painful area. One good method is to use ice for the first 48 - 72 hours, then use heat after that. Heat may be applied with hot showers, hot compresses, or a heating pad. Be careful not to fall asleep with a heating pad on.
* Stop normal physical activity for the first few days. This helps calm your symptoms and reduce inflammation.
* Perform slow range-of-motion exercises -- up and down, side to side, and from ear to ear -- to gently stretch the neck muscles.
* Have a partner gently massage the sore or painful areas.
* Try sleeping on a firm mattress without a pillow or with a special neck pillow.
* Use a soft neck collar for a short period of time to relieve discomfort.

You may want to reduce your activity only for the first couple of days. Then slowly resume your usual activities. Do not perform activities that involve heavy lifting or twisting of your back or neck for the first 6 weeks after the pain begins. After 2 - 3 weeks, slowly resume exercise. A physical therapist can help you decide when to begin stretching and strengthening exercises and how to do them.

Avoid the following exercises during your initial recovery, unless your doctor or physical therapist says it is okay:

* Jogging
* Football
* Golf
* Ballet
* Weight lifting
* Leg lifts when lying on your stomach
* Sit-ups with straight legs (rather than bent knees)

When to Contact a Medical Professional

Seek immediate medical help if you have a fever and headache, and your neck is so stiff that you cannot touch your chin to your chest. This may be meningitis. Call your local emergency number (such as 911) or get to a hospital.

Call your health care provider if:

* Symptoms do not go away in 1 week with self care
* You have numbness, tingling, or weakness in your arm or hand
* Your neck pain was caused by a fall, blow, or injury -- if you cannot move your arm or hand, have someone call 911
* You have swollen glands or a lump in your neck
* Your pain does not go away with regular doses of over-the-counter pain medication
* You have difficulty swallowing or breathing along with the neck pain
* You have pain that gets worse when you lie down or wakes you up at night
* You have such severe pain that you cannot get comfortable
* You lose control over urine or stool (incontinence)

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