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Medical Information
>> Types of Traffic Accident Injuries >> Neck
Pain
The neck (cervical spine) is composed of vertebrae
which begin in the upper torso and end at the base of the
skull. The bony vertebrae along with the ligaments (like thick
rubber bands) provide stability to the spine. The muscles
allow for support and motion. The neck has a significant amount
of motion and supports the weight of the head. However, because
it is less protected than the rest of the spine, the neck
can be vulnerable to injury and disorders that produce pain
and restrict motion. For many people, neck pain is a temporary
condition that disappears with time. Others need medical diagnosis
and treatment to relieve their symptoms.
What causes neck pain?
Neck pain may result from abnormalities in the soft tissues
- the muscles, ligaments, and nerves - as well as in bones
and joints of the spine. The most common causes of neck pain
are soft tissue abnormalities due to injury or prolonged wear
and tear. In rare cases, infection or tumors may cause neck
pain. In some people, neck problems may be the source of pain
in the upper back, shoulders or arms.
Degenerative and inflammatory diseases
- Degenerative diseases that cause neck pain include osteoarthritis
and rheumatoid arthritis. Osteoarthritis usually occurs in
older people as a result of wear of the joints between the
bones in the neck. Rheumatoid arthritis can cause destruction
of the joints of the neck. Both of these major types of arthritis
can cause stiffness and pain.
Cervical disk degeneration also can
cause neck pain. The disk acts as a shock absorber
between the bones in the neck. In cervical disk degeneration
(typically age 40 onwards), the normal gelatin-like center
of the disk degenerates and the space between the vertebrae
narrows. As the disk space narrows, added stress is applied
to the joints of the spine causing further wear and degenerative
disease. The cervical disk may also protrude and cause pressure
on the spinal cord or nerve roots when the rim of the disk
weakens. This is known as a herniated cervical disk.
Injury - Because the neck is
so flexible and because it supports the head, it is extremely
vulnerable to injury. Motor vehicle or diving accidents, contact
sports, and falls may result in neck injury. The regular use
of safety belts in motor vehicles can help to prevent or minimize
injury. A "rear end" automobile collision may result
in hyperextension, a backward motion of the neck beyond normal
limits, or hyperflexion, a forward motion of the neck beyond
normal limits. Most common injuries are to the soft tissues,
i.e., muscles and ligaments. Severe injury with fracture or
dislocation of the neck may damage the spinal cord and cause
paralysis (quadriplegia).
Much less common causes of neck pain include
tumors, infections, or congenital abnormalities of the vertebrae.
When should you seek medical care?
If severe neck pain occurs following an injury (motor
vehicle accident, diving accident, fall), a trained professional,
such as a paramedic, should immobilize the patient to avoid
the risk of further injury and possible paralysis. Medical
care should be sought immediately. Immediate medical care
should also be sought when an injury causes pain in the neck
that radiates down the arms and legs. Radiating pain or numbness
in your arms or legs causing weakness in the arms or legs
without significant neck pain should also be evaluated.
If there has not been an injury, you should
seek medical care when neck pain is:
- continuous and persistent
- severe
- accompanied by pain that radiates down the
arms or legs
- accompanied by headaches, numbness,
tingling, or weakness
Who can treat neck pain?
Many patients seek orthopaedic care for neck pain, because
orthopaedists are specifically trained in the workings of
the musculoskeletal system, including the diagnosis, treatment,
and prevention of problems involving the muscles, bones, joints,
ligaments and tendons. While some orthopaedists confine their
practices to specific areas of the musculoskeletal system,
most treat a wide variety of diseases, injuries and other
conditions, including neck pain.
Diagnosing neck pain:
Determining the source of the pain is essential to recommend
the right method of treatment and rehabilitation.Therefore
a comprehensive examination is required to determine the cause
of neck pain.
Your orthopaedist will take a complete history
of the difficulties you are having with your neck. He or she
may ask you about other illnesses, any injury that occurred
to your neck and any complaints you have associated with neck
pain. Previous treatment for your neck condition will also
be noted.
Next, your orthopaedist will perform a physical
examination. This examination may include evaluation of neck
motion, neck tenderness, and the function of the nerves and
muscles in your arms and legs.
X-ray studies often will be done to allow your
orthopaedist to look closely at the bones in your neck. These
simple diagnostic techniques often help orthopaedists to determine
the cause of neck pain and to prescribe effective treatment.
Patients who require further evaluation may
undergo one or more of the following examinations:
- MRI (magnetic resonance imaging). This non
X-ray study allows an evaluation of the spinal cord and
nerve roots.
- CT (computed tomography). This specialized
X-ray study allows careful evaluation of the bone and spinal
canal.
- Myelogram (injection of a dye or contrast
material into the spinal canal). This specific X-ray study
also allows careful evaluation of the spinal canal and nerve
roots.
- EMG (electromyogram). This test evaluates
nerve and muscle function.
Your orthopaedist may supplement your evaluation
with blood tests, and, if necessary, will consult with other
medical specialists.
Treatment:
How neck pain is treated depends on what the diagnosis reveals.
However, most patients are treated successfully with rest,
medication, immobilization, physical therapy, exercise, activity
modifications or a combination of these methods.
For example, if pain is caused by inflammation
as a result of stretching muscles and ligaments beyond their
limits, your orthopaedist may prescribe rest and a neck collar
for a specified period of time, as well as medication to reduce
inflammation. If medication is prescribed to reduce pain,
it should be used only as directed and should not be taken
for extended periods of time. In addition, remember that if
your orthopaedist prescribes rest, it is vital that you follow
instructions carefully.
When neck pain persists or is chronic, your
orthopaedist may recommend a rehabilitation program that includes
an exercise program and various types of physical therapy
to help you relieve your pain and prevent it from coming back.
Very few patients require surgery to relieve
neck pain. For the vast majority of patients, a combination
of rest, medication and physical therapy will relieve neck
pain. Surgery may be necessary to reduce pressure on the spinal
cord or a nerve root when pain is caused by a herniated disk
or bony narrowing of the spinal canal. Surgery may also be
required following an injury, to stabilize the neck and minimize
the possibility of paralysis such as when a fracture results
in instability of the neck.
Your orthopaedist is a medical doctor with
extensive training in the diagnosis and nonsurgical and surgical
treatment of the musculoskeletal system, including bones,
joints, ligaments, tendons, muscles and nerves.
This information has been prepared by
the American
Academy of Orthopaedic Surgeons and is intended
to contain current information on the subject from recognized
authorities. However, it does not represent official policy
of the Academy and its text should not be construed as excluding
other acceptable viewpoints.
If believe you have neck pain as a result
of a traffic accident, it is important to visit a qualified
doctor to evaluate your injuries. Trying to "heal yourself"
could cause your body more harm.
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