Neck pain: causes, symptoms and treatment methods

What is neck pain?

Neck pain has become one of the major problems of modern society in recent years. Neck is part of the body that holds our brain and 5 sensory organs together and connects head to the trunk. The neck may be affected by many side effects associated with static position due to spinal extension and as an area that vitally important centers are connects and pass through. There are several ways to assess the cause of the neck pain.

Neck pain can be caused by many different diseases and neck tissue damage.  The causes of neck pain include degenerative disc disease, neck strain, neck trauma - whiplash, disk hernia or nerve compression. The swelling of the lymph nodes (glands) due to usual infectious disease, such as virus infection of the throat, can cause neck pain as well. Even in rare infectious diseases such as cervical tuberculosis, cervical vertebral bone infection (osteomyelitis and septic dyskitis) and meningitis (often accompanied by rigidity of the neck muscles), neck pain can be seen.  Also, neck pain can be caused by direct neck muscle damage, fibromyalgia, polymyalgia rheumatology, as well as sleeping in wrong position.  Neck pain is also called cervical pain.

Risk factors for neck pain include martial sports, traffic accidents, horse riding etc.

Causes of neck pain:

Straining and tension of the neck are the most common causes of neck pain and it takes several days and sometimes several weeks to ease. A neck strain occurs when neck muscle, ligaments or tendon irritating as a result of  excessive movement or excessive extensibility of the neck.

There are many factors that can cause neck pain. These factors can be combined under three headings:
Neck pains that are caused by non-spinal problems: There are some pains which affect the neck area but are not caused by spinal problems. The pains that compress certain thoracal muscles and nerves are called "thoracic outlet syndrome" and can occur for three different reasons.
 - Connection of first rib with cervical vertebrae
 - Compression of Scalenus Anticus
 - Compression of Pectoralis minior

2. Neck pains due to spinal problems: There are some subgroups.
 - Neck pains caused by trauma: Some traumas affecting the neck can be life threatening. We must not forget that our neck can easily be damaged due to little injuries that we face in our daily lives to more serious injuries.
A) Traffic accidents: Whiplash, which is dangerous for the neck, occurs during a traffic accident (when car damaged from the sides apart than front).  
B) Hyperflexion: during car accident neck and head are forced suddenly backward and forward with a great deal of force.  
C) Hyperextension: opposite state occurs when, car hits another car from behind.
D) Sport injuries:  Sharp, sudden movements of the neck, falls and etc.
E) Degeneration associated neck pain:  The most movable part of the neck is between 4th and 6th vertebrae. For this reason, in humans after 40 years of age, often degeneration occurs in this area. The amount of liquid contained in the discs decreases, and eventually the discs become dry and loss their elasticity. As a result, this reduces the ability of the disks to act as shock absorbers and eventually narrows the distance between vertebrae. Surely, as a result, the nerve roots passing through narrow and sensitive channels are being affected by different pressures from the deformed discs. In addition, the rest of the neck joints, like the other joints of our body, may be structurally disordered or degenerated which reminds calcification.
F) Occupational neck pain: Some of the occupational factors and wrong positioning of our neck can accelerate damaging process in the disks. Long distance truck drivers, painters who always work their heads up, and tilers working in sitting position are at risk.
G) Neck pain due to herniation and protrusion: Cervical herniation often occurs at the level of disks between 5th and 6th vertebrae. In such cases pain in the hands are inevitable.  Increased pain during coughing and tension, pain due to physical pressure from the top to the bottom of the head (Compression test), reduction of this pain on lifting the head upward by holding the lower jaw(distraction test) can be seen as characteristic signs.

Depending on the severity of herniation, loss of reflexes, numbness, muscle weakness and arm muscle wasting can be observed. With early diagnosis, it is possible to obtain successful results very quickly, without the need for surgery.

3. Pain referred to the neck: To feel the pain in the neck area, despite the actual cause being in different location of the body. This is called referred pain. These include: - Stress related pain;
 - Muscle related pain;
 - Bad (wrong) posture;
 - Related to eye disorders;
 - Rheumatism related;
 - Related to internal organs.

Diagnosis of neck pain

Early changes are better detected by computer tomography (CT) and magnetic resonance imaging (MRI) examinations. Often detailed patient’s history and good physical examination is enough. Direct x-ray imaging is sufficient for diagnosis in many patients. Magnetic resonance imaging (MRI) examinations and computer tomography (CT) may additionally be required depending on disease course (progression). EMG (Electromyography) examination for detecting nerve suppression and scintigraphy examination for tumor and pathological infections are more informative. 

Treatment methods

There are different treatment approaches depending on diagnosis and type of pain as acute, semi-acute and chronic.

Treatment with medication

Different medicines can be used during treatment. Duration of the therapy and thermedicine choice should be indicated by physician. The side effects of some medicines that can be recommended by one patient to another can be life-threatening. 

Physiotherapy for neck pain

Another effective method of treatment is physiotherapy. Aim is to reduce pain, relieve tension and restore the limited neck movement.

Surgical treatment for neck pain

Even if the results of MRI or CT, laboratory examinations and EMG results confirm a hernia, initially conservative methods of treatment should be considered. Neurological symptoms are very important. As these symptoms play an important role in selection of surgical therapy. The operation is performed by puncturing the anterior and lateral parts of the neck. Since the area of operation is considered vital, the operation should be performed in good conditions, with a special microscope and modern equipment. After the operation, rehabilitation programs should be appointed.

PROLOTHERAPY as a treatment of neck pain

Prolotherapy is a non-surgical therapy which is used efficiently in the treatment of degenerative disc disease. Prolotherapy is based on the self-renewal and recovery of the body-proliferation. Injection of hypertonic sugar solution in the damaged area of the spine (joints, ligaments and tissues), accelerates the healing process by restoring damaged tissues. As a result, the joints and ligaments heal and strengthen. Prolotherapy is a type of treatment which is an alternative to surgery. It’s a non surgical treatment of degenerative disc disease, disc bulging, protrusion, and hernia of the spine. Prolotherapy is even ideal treatment for the patients, who have undergone spinal surgery, but still have pains after the surgery.

The duration of treatment is 3-6 sessions depending on the severity of the disease. Each session lasts 25-40 minutes.

After the procedure, the patient can immediately return to normal life. Despite the fact that,  prolotherapy has been successfully used in the United States since 1940 and Turkey since 2008, in our country this method was first used by me in 2014.

Types of prolotherapy:
 - With hypertonic solution
 - With platelets-rich plasma
 - With stem cells

Prolotherapy therapy is not only applied to spine related diseases, but is also used in patients with knee, hip joint arthrosis, twists, muscle aches, fibromyalgia, carpal tunnel syndrome, Kubital syndrome, tennis elbow, pubis simphis pain and other diseases.

Do not make a decision on undergoing surgery without trying prolotherapy treatment first!