Dr Me­lanie:

Neck pain

Woman's Weekly (UK) - - Contents -

Two-thirds of us suf­fer at some time, but most episodes are pre­ventable

Our necks con­tain seven bony ver­te­brae which gently curve for­wards and sup­port our heads. They’re linked to each other, the skull, and the lower spine by shock­ab­sorb­ing jelly-like discs, com­plex tiny joints, strong gristly lig­a­ments and pow­er­ful mus­cles that pro­vide sta­bil­ity while al­low­ing us to bend and turn our heads. The spinal cord runs down a bony tun­nel and sends out nerves be­neath each ver­te­bra – these re­lay our brains’ in­struc­tions to our mus­cles, and bring back in­for­ma­tion about touch, pain, po­si­tion and other sen­sa­tions.

The causes

Our heads weigh around 10lb but look­ing down at our mo­biles can quadru­ple the strain on our necks. And poor pos­ture, car­ry­ing heavy weights, sleep­ing badly, twists, turns or sud­den jerks (whiplash) can strain or sprain soft tis­sues, pro­duc­ing a dull ache, stiff­ness, and/or ag­o­nis­ing pain when we move – spasm from an acute wry neck (tor­ti­col­lis) may tem­po­rar­ily twist it to one side. Most non-spe­cific neck pains only last a few days or weeks, but around 10% may be­come chronic, de­pend­ing on what the un­der­ly­ing cause is.

Neck pain of­ten spreads to the shoul­ders, up­per back or over the top of the head. Con­stant or wors­en­ing pain may mean a trapped nerve – es­pe­cially if it goes down the arm and is linked to fin­ger tin­gling, numb­ness or weak­ness. Pain can also be caused by bony conditions, in­clud­ing cer­vi­cal spondy­lo­sis (arthri­tis of the neck),

bone-thin­ning os­teo­poro­sis, and, rarely can­cer; or be ‘re­ferred’ – eg from a chest or heart prob­lem.

The tests

Seek med­i­cal ad­vice if pain lasts more than a few days or is linked to trapped-nerve symp­toms, night pain, weight loss or sweats – ur­gently if it fol­lows se­vere trauma, you have os­teo­poro­sis, or your legs/arms/blad­der or bowel con­trol are af­fected. You may need an X-ray to look for bony dam­age or an MR scan to ex­am­ine the nerves, discs and other soft tis­sues. You may also need blood tests or checks on other body ar­eas.

The treat­ment

Sim­ple neck strain can be treated with painkillers and heat (eg hot-wa­ter bot­tle). Try to iden­tify the cause and avoid driv­ing or lift­ing un­til your neck eas­ily moves. As soon as you can, gently move your neck (visit nhs.uk for ex­er­cises). Your GP may re­fer you for phys­io­ther­apy, and surgery is oc­ca­sion­ally needed for slipped discs or trapped nerves. Some peo­ple find acupunc­ture or chiropractic help­ful – choose a qual­i­fied prac­ti­tioner.

Neck pain of­ten spreads to the shoul­ders, up­per back or over the top of the head

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