Neck Pain & Headaches
Neck Pain and Headaches:
In this computer and phone-dominant age, neck pain is a common reason people visit their doctor. Neck pain typically doesn’t start from a single injury. Instead, the problem usually develops over time from the stress and strain of daily activities. Eventually, the parts of the spine begin to degenerate and become a source of neck discomfort.
Why do I have neck pain?
There are many causes of neck pain. In many cases, a single event or injury, such as a car accident, can cause an acute injury. If you happen to work a desk job and sit or stand with poor posture, drive a car or truck for a living, spend most of your days moving your head in a certain motion at work, you can develop more chronic neck pain.
Below is a brief overview of some of the most common sources of neck pain.
Most neck problems happen after years of wear and tear on the parts of the cervical spine. At first, these small injuries are not painful. But over time, the wear and tear can add up, eventually causing neck pain.
Doctors sometimes call these degenerative changes in the spine spondylosis. Spondylosis can affect the bones and soft tissues of the spine. However, it is important to know that most problems with spondylosis are a normal part of aging.
Degenerative Disc Disease:
The normal aging process involves changes within the intervertebral discs. Repeated stresses and strains weaken the connective tissues that make up a disc. Over time, the nucleus in the center of the disc dries out. When this happens, it loses some of its ability to absorb shock. The annulus also weakens and develops small cracks and tears.
Often these changes are not painful. But larger tears that reach to the outer edge of the annulus can cause neck pain. The body tries to heal the cracks with scar tissue. But scar tissue is not as strong as the tissue it replaces. At some point the disc may finally lose its ability to absorb shock for the spine. Then forces from gravity and daily activities can take even more of a toll on the disc and other structures of the spine.
The nucleus may push through the weakened and torn annulus and into the spinal canal. This is called a herniated or ruptured disc. The disc material that squeezes out can press against the spinal nerves. The disc also emits enzymes and chemicals that produce inflammation. The combination of pressure on the nerves and inflammation caused by the chemicals released from the disc cause pain.
As the degeneration continues, bone spurs develop around the facet joints and around the disc. No one knows exactly why these bone spurs develop. Most doctors think that bone spurs are the body’s attempt to stop the extra motion between the spinal segment. These bone spurs can cause problems by pressing on the nerves of the spine where they pass through the neural foramina. This pressure around the irritated nerve roots can cause pain, numbness, and weakness in the neck, arms, and hands.
People with minor neck pain or stiffness are often told they have a muscle strain. However, unless there was a severe injury to the neck, the muscles probably haven’t been pulled or injured. Instead, the problem may be coming from irritation or injury in other spine tissues, such as the disc or ligaments. When this happens, the neck muscles may go into spasm to help support and protect the sore area.
Mechanical Neck Pain:
Mechanical neck pain is caused by wear and tear on the parts of the neck. It is similar in nature to a machine that begins to wear out. Mechanical pain usually starts from degenerative changes in the disc. As the disc starts to collapse, the space between the vertebrae narrows, and the facet joints may become inflamed. The pain is usually chronic. (Chronic pain builds over time and is long-lasting.) The pain is typically felt in the neck, but it may spread from the neck into the upper back or to the outside of the shoulder. Mechanical neck pain usually doesn’t cause weakness or numbness in the arm or hand, because the problem is not from pressure on the spinal nerves.
Radiculopathy (Pinched Nerve):
Pressure or irritation in the nerves of the cervical spine can affect the nerves’ electrical signals. The pressure or irritation can be felt as numbness on the skin, weakness in the muscles, or pain along the path of the nerve. Most people think of these symptoms as indications of a pinched nerve. Health care providers call this condition cervical radiculopathy.
Several conditions can cause radiculopathy. The most common are degeneration, disc herniation, and spinal instability.
The Neck Pain-Headache Connection:
There are a series of spinal nerves called the cervical plexus that branch off of the spinal cord into the neck. Like a tree branch, they form smaller branches that weave into your head, neck and shoulders. Often, tight muscles in the neck and shoulders can compress or irritate these nerves, thereby causing headaches that can radiate from the back of the neck towards the top of the head in a direction similar to a ram’s horns.
In addition, if you are lacking range of motion or flexibility in your neck, you tend to place greater tension in your shoulders, which can also lead to headaches. For many individuals, addressing your neck pain can often resolve these types of headaches for good.
How Physical Therapy Can Help Neck Pain and Headaches
As a musculoskeletal experts, Dr. Trinh can help improve your neck strength, flexibility and range of motion.
If it is a pinched nerve, Dr. Trinh will utilize a highly researched system called Mechanical Diagnosis and Treatment to assess your cervical spine movements and determine where the disc herniation is pushing on the nerve root. Treatment will involve a combination of manual therapy and specific exercises that will help push whatever is irritating the nerve away, thereby improving your mobility and reducing your pain. Most patients with a true radiculopathy have shown rapid resolution of pain within 4-6 visits. Most patients experience improvement in pain within the first visit.
Postural muscle re-training and education on how to prevent future recurrence are both an integral part of treatment.