Neck Pain Management
Neck pain is synonymous with computer use due to poor posture and ergonomic at work, prolonged screen time. It is relieved by treating muscular triggers and cervical disc and facet issues, if present. Neck pain comes with a wide variety of symptoms and causes. You can have an attack of acute neck pain that’s brought on by a simple movement or you can suffer from chronic neck pain and have a serious condition that builds and grows in intensity over time.
Signs and symptoms of Neck pain:
- Neck pain can be localized to the neck or radiating to the shoulder, arm, forearm and hand.
- There could be signs of tingling, numbness or weakness in the hand. This indicates some component of entrapment of nerve root by the disc or the deep cervical muscles.
- Aggravation of pains with neck movements can occur in some patients and there can be restriction of neck movements due to pain and stiffness.
- Severe spasms of the deep neck muscles can compress the blood vessels supplying the brain. Some patients complain of “brain fog” along with neck pain.
- whiplash injury- neck pain due to excessive stretching or tear of the neck muscles or due to facet joint injury.
Regular exercise is very important for neck muscle health because neck muscles are naturally vulnerable to develop problems. This is because there is a tremendous amount of mobility available at neck nearly 80° movement in the forward, backward side bends, side-to-side rotation and also a gliding movement of the head from side to side over the first vertebra of neck. More importantly all these movements are done while the muscles are carrying the weight of the head (1/8 body weight) for about 16 hours in a day. For young professionals who sit in front of the computer for 8-10 hours a day. It is important to maintain ergonomic posture while working with optimum height of the screen and the keyboard.
Causes of Neck Pain:
- Muscle related problems
- Irritation and wear and tear of joints in the spine called facet joints. It could be age related degeneration or could be because of whiplash injury.
- Intervertebral disc pressing on the nerve roots due to disc prolapse, most commonly at C5-6 or C6-7. This leads to radicular pain to the hand with tingling, numbness.
- As a part of shoulder problems and headaches migraine.
- As a part of neuralgia of trigeminal and glossopharyngeal nerves
- As a part of generalized diseases like rheumatoid arthritis, seronegative and seropositive arthropathies (ankylosing spondylitis), Fibromyalgia etc
- Cancer metastases
- Diseases like tuberculosis
- Specific conditions with muscle related pains :
- Wry neck
- Levator scapulae syndrome
- Repetitive strain injury
Treatment for Neck Pain
- Medications are the first line of treatment for managing neck pains but they are not a definite solution to the problem
- Physiotherapy and exercises of the neck can be used for treatment in mild cases. They are also important in prevention of recurrence of pains after treatment.
- Deficiency corrections of vitamin B12 and D3 is essential to support the ongoing treatment
- USGDN is used as the treatment for most cases of neck pain to relieve the muscle spasm in the neck muscles.
- Botox injections can be used in severe cases of neck pain where USGDN can be very painful or more time consuming.
- Interlaminar epidural injections are performed in case of nerve compression seen due to disc prolapse leading to radicular pain going to the arm, forearm and hand with symptoms of tingling, numbness, weakness of muscles.
- RF ablation of nerves to the facets is done to denervate the facet joints that are the pain genrators in certain cases.
- Pulsed RF treatments of C1, C2 and C3 for various neck pains that are recalcitrant and cannot be treated with only muscle treatment like botox or USGDN.
