Neck Pain

1.

Postural neck pain

Postural neck pain refers to pain in the neck and/or shoulders caused or exacerbated by postural habits such as holding the head / neck / shoulders in fixed protracted positions for long periods of time.

2.

Acute neck pain
(unknown cause)

If a sudden movement of the neck results in severe neck pain possibly accompanied by arm pain, muscle spasm and/or restricted movement of the neck then the problem resolves itself without intervention or identification of the structural cause e.g. via use of medical imaging techniques, the short-term (i.e. acute) neck pain may be described as of 'unknown cause'.

3.

Cervical spondylosis

Cervical spondylosis results from on-going 'wear and tear' of the cervical vertebrae and the intervertebral discs that separate them in the neck. This is sometimes considered a 'normal part of the ageing process' and can result in neck pain. The severity of symptoms can vary and might include:

• Neck pain that may extend to the shoulders and base of the skull, worsened by movement.
• Stiffness of the neck, especially on first waking after sleep/rest.
• Headaches extending from the back of the head (just above the neck) over the crown of the head to the forehead.
• Sensations of 'pins and needles' in part of an arm or hand - which can also indicate other conditions so must be described when reporting the problem to a qualified practitioner.

4.

Cervical myelopathy
(compression of spinal cord)

Cervical myelopathy is due to pressure on the spinal cord leading to dysfunction of the nerves below the area of pressure. It is therefore a condition of the nerves (spinal cord).

• Possible causes include developmental malformations of the cervical spine, degenerative changes in the cervical spine, a central cervical disc prolapse, tumours, infection/s, or complications arising from cervical spondylosis - see above (3.) in this list.
• Potential consequences can include balance difficulties, development of an unsteady (ataxic) walk/gait, numbness e.g. in the hands or feet together with increasing difficulty with certain actions such as writing or doing/undoing fastenings on clothing.
• Diagnosis typically involves assessment of the severity of the spinal cord damage and an MRI scan of the neck. X-rays of the cervical spine may be performed to assess any instability of the spine or kyphosis.

5.

Rheumatoid arthritis
(in the neck)

Rheumatoid arthritis is a chronic systemic inflammatory disease of the synovial lining of joints. In general this can result in joints becoming painful, swollen, and stiff.

Rheumatoid arthritis in the neck (cervical spine) often involves the atlantoaxial joint which is the articulation between C1 (the 'atlas' bone) and C2 (the 'axis' bone). Rheumatoid arthritis in the cervical spine, e.g. affecting the atlantoaxial joint, can result in instability of the joint(s) that may in turn lead to serious complications affecting e.g. spinal cord, nerves, and therefore also other parts of the body.

6.

Thoracic outlet syndrome - Rare

The thoracic outlet is the area between the rib cage and clavicle bone (which is also commonly referred to as the 'collar bone'). Thoracic outlet syndrome typically involves:

• pain in the neck and shoulder
• numbness and tingling of the fingers
• poor circulation in hands/forearms
• weak hand grips
  

In general, thoracic outlet syndrome can affects nerves, result in pressure on blood vessels, affecting circulation, and cause pain, tingling, swelling and / or weakness. Various different treatments may be recommended by physicians depending on the nature and severity of the case.

7.

Klippel-Feil Syndrome - Rare

Klippel-Feil Syndrome is a rare congenital abnormality in which the normal segmentation of the cervical vertebrae fails to occur during the early weeks of fetal development resulting in fusion of any two of the 7 cervical (neck) vertebrae. Normal / healthy cervical vertebrae C1-C7 separated by intervertebral discs are shown in the diagram at the top-right of this page.

Common indications of signs of Klippel-Feil Syndrome include an unusually short neck, low hairline at the back of the head, and restricted mobility of the upper spine. This may be associated with other skeletal abnormalities such as scoliosis (curvature of the spine), spina bifida, Sprengel's shoulder, cleft palate and other conditions of e.g. the brain and spinal cord, arms, legs, and fingers.

8.

Neoplasms in the neck area - Rare

'Neoplasms' is the medical term for abnormal new growths of tissues commonly referred to as 'tumours'. They can be either benign or malignant. Tumours originating in the cervical spine (neck bones) are rare. When tumours are found in this area they are often found to have originated elsewhere in the body and are therefore said to be 'secondary deposits'.

9.

Osteitis in the neck area - Rare

Osteitis is a word that means inflammation of bone.

Osteitis in the neck area (called 'cervical spine osteitis') is uncommon, but not unheard-of, in many developed countries.

Some studies have reported cases of osteitis following BCG vaccination given to protect against tuberculosis incl. e.g. reports from Finland (http://www.jstor.org/pss/30135813) and Iran (http://journals.tums.ac.ir/upload_files/pdf/359.pdf).