Aches and pains of the neck are frequent but tend not to be as debilitating as low back aches and pains. The episodes seem a little shorter, the treatment is a little easier, and for most of us, the demand on our neck is less than the demand on our low back.
The causes are very similar to low back pain. Little, trivial things such as twisting wrong at night, can precipitate an episode of neck pain. Again, fortunately, most episodes of neck pain resolve without the thought of surgical intervention.
The sources of neck pain can be the soft tissues such as muscles or ligaments or tendons. As we age there can be some degeneration of the disks and the facet joints and they can become easily irritated, or there could be something even a little bit more severe such as a whiplash type of situation that can really aggravate the soft tissues, the disks, and the facet joints.
Again, appropriate care is time and moderation. I may not recommend using a chiropractor quite as frequently in cervical spine problems as I do in lumbar spine problems. There may be slightly increased cost and risks with steroid injections in the cervical spine as compared to the lumbar spine. Passive modalities such as heat or ice tend to be a little more effective than they are in the low back.
With many episodes of neck pain, patients can experience concomitant shoulder problems. Many times the shoulder issues need to be dealt with as we treat the neck complaints. If the shoulder is the primary problem, injections or even a small arthroscopy may be indicated. Here at Iowa Spine Care we feel comfortable evaluating the shoulder, but I do not do elective shoulder surgery.
Some patients also experience burning pain down the arm with perhaps numbness and tingling in the fingers. Some patients have aggravation of the nerve in the neck which can intensify the neck pain, get pain down to the shoulder blade, and perhaps even cause symptoms down the arm. But, common problems such as carpal tunnel at the wrist or cubital tunnel at the elbow can mimic a pinched nerve, and so we ought to ask questions and proceed cautiously as we give care in this situation.
The vast majority of episodes of pain in the neck, shoulder, and arm can and should be treated with time, moderation of activities, and common sense active and passive modalities before any patient should explore surgical intervention.