Neck Pain

Neck pain is less common than back pain and is significant problem in the elderly. It is more common in female than male. Most prolapse (70 %) affect the C6 disc, compressing the C7 root: 20 % affects C5.

Causes of Neck Pain:

a.      Mechanical:

·         Postural

·         Disc prolapse

·         Whiplash injury

·         Cervical spondylosis

b.      Inflammatory:

·         Rheumatoid arthritis

·         Spondylitis

·         Infection

·         Polymyalgia rheumatica

·         Juvenile idiopathic arthritis

c.       Metabolic bone diseases:

·         Osteoporosis

·         Paget’s disease

·         Osteomalacia

d.      Neoplasia:

·         Metastasis

·         Myeloma

e.       Referred pain:

·         Pharynx problems

·         Aortic aneurysm

·         Cervical lymph nodes

·         Myocardial infarction

·         Teeth pain

·         Angina pectoris

Sign and symptoms:

·         Pain: Pain is aggravated by turning head, up or down. The pain may radiate to the upper limb.

·         Limited cervical ROM

·         Stiffness of neck

·         Parasthesis due to Radicular pain

Investigations:

X – Ray:

o   To know osteophytes

o   Disc compression

MRI: Cervical spine

Treatment:

Non specific pain:

Analgesics

Physiotherapy

Cervical colar

Acute strain: (Musculo – tendinous)

Immobilization

Analgesic

Cervical colar

Physiotherapy

Herniated disc:

Cervical traction

Analgesic

Physiotherapy

Surgery

Arthritis:

DMARDs

Analgesics

Physiotherapy

Surgery