Cervical Back Pain

Neck pain is quite literally that – a pain in the neck. A very common form of pain that most people experience at some point in their lives, neck pain can be caused from a variety of factors, can last for any amount of time, and can lead to additional uncomfortable symptoms in other parts of the body. If you’re dealing with neck pain and don’t know where to turn, the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas is here to help. Our expert team of pain management specialists is able to accurately diagnose and treat all forms of neck pain, with a goal to get all patients living pain free as quickly as possible. 

What is Neck Pain and What Does it Feel Like? 

Neck pain, also known as cervicalgia, is pain that is felt in or around the spine beneath the head. Top to bottom, the spine is made up of the cervical, thoracic, lumbar and pelvic regions, so neck pain refers to pain in the cervical part of the back. Issues in this cervical region of the back are believed to be the most common cause of neck pain. 

While neck pain is more common in women, people of all ages and genders could experience some form of neck pain in their life, with a range of symptoms. Age also increases the chances of experiencing neck pain. Overall, neck pain can seriously interfere with a person’s daily activities and overall quality of life. 

Neck pain can be axial, meaning that it is mostly felt in the neck, or radicular, which is pain that radiates to other parts of the body such as the arms and shoulders. Pain can be considered acute, lasting days to several weeks, or can be chronic, lasting months or even up to a year. It has also been found that once neck pain occurs, the chances of experiencing neck pain again in the future increases. 

While neck pain varies from person to person, most people describe neck pain as: 

• Headaches

• Persistent ache in and around the neck

• Stabbing and throbbing pain

• Shooting pain that moved to the shoulders and arms

• Restricted or limited range of motion

• Pain, weakness or sensory changes in their upper back, shoulders, arms and head

• Difficulty with balance and coordination

Why Does Neck Pain Happen?

The anatomy of the cervical spine is the main reason why neck pain is so common. The cervical spine has many important functions (as one could imagine!) that help to provide support for the head, give the head and neck the ability to move, and protect the spinal cord emerging from the brain. 

Structurally, the cervical spine consists not only of seven vertebrae, but also muscles, ligaments, joints, and nerves. Separating each individual vertebrae are discs that cushion the space and minimize impact on the cervical spinal, helping to absorb shock. 

The top two cervical vertebrae, the atlas and the axis, are responsible for the majority of the head’s range of rotational motion. They also support the head, connect the head to the spine, and help with balance and coordination for the rest of the body. 

Ligaments also help to give the cervical spine strength and mobility, and there are many muscles in the neck area that help with movement as well. There are also spinal nerves that exit the spine in the cervical area, which supply the structures of the neck, muscles and upper extremities with nerves. 

Together, this complex system provides for the head’s ability to move and rotate, helping the body to balance, providing coordination, as well as helping to support the neck altogether. Due to the fact that the neck is the most flexible portion of the spine, it is the most vulnerable to injury, overuse and wear and tear. Any damage or injury can lead to soreness, inflammation, pain, and stiffness in not only the neck but also the shoulders and upper back.

What Causes Neck Pain?

There are many different causes of both acute and chronic neck pain. This is why it’s so important to seek help from a pain management specialist who is trained at both properly diagnosing and treating the root cause of pain. Most often causes of pain include: 

• Muscle strain and misuse/overuse: strenuous lifting, poor sleep position, sitting with poor posture for extensive periods of time, and excessive use can all cause muscle strain and nerve irritation

• Whiplash: most often occurring in rear-end car crashes, whiplash is hypertension of the neck that causes damage to muscles in the neck as well as the ligaments and spinal bones due to the unusual and sudden whipping motion

• Degenerative disc disease: discs between the vertebrae can thin over time, causing pain from bone on bone friction; can collapse backward from a traumatic incident or decay with age, causing nerve irritation or spinal cord compression

• Nerve injury or compression: nerves that are compressed or inflamed, especially these nerves that provide sensory information to the head and face, can cause weakness, pain and loss of feeling

• Medical conditions: cervical spondylosis (neck arthritis), osteoporosis (thinning of bones) and spinal stenosis (thinning of the spinal column) can all cause cramping and shooting pain in the neck, back and shoulder area. While rare, cancers, tumors and infections can also cause neck pain. 

• While less common, neck pain can be due to vertebral compression fractures, spinal cord disorders, tumors, and infection.

Is Neck Pain an Emergency?

While most neck pain is not serious and can improve with conservative treatments, including pain medicine, exercise and stress management, there are some instances where neck pain can be a reason to seek immediate medical attention. These include: 

• Sudden blindness

• Altered level of consciousness in conjunction with neck pain

• Paralysis

• Bowel/bladder changes

• Changes in vision/hearing/taste

• Severe vomiting

• Unexplainable weight changes

• Fever

• Weakness

If you experience any of the above conditions, call your pain management specialist or medical provider right away. This could be the sign of a more serious condition that needs to be treated as soon as possible. 

How Can I Treat My Neck Pain? 

The best way to treat your neck pain is to seek help from a pain management specialist and get a thorough and proper diagnosis. The California Pain Consultants team will perform a complete examination and utilize X-ray, MRI and CT scan options to find the cause of the pain that will help to determine the best course of treatment. There have been great advancements in pain management in recent years, especially with minimally-invasive options. Most patients have found long-term relief by using a combination of treatments, such as steroid injections and physical therapy, for example. 

Possible therapy and minimally-invasive treatment options include:

• Lifestyle changes: a quick and simple solution could be to try a better or different pillow for sleeping, as well as focusing on a healthy diet to minimize any nutritional deficiencies that could contribute to neck pain. Beginning an exercise regimen that includes movements to strengthen the neck muscles, improve flexibility and range of motion, and release endorphins, which are the body’s natural pain relievers. 

• Physical therapy: a great option for increasing mobility and range of motion

• Alternative therapies: acupuncture is a great way to not only release endorphins but can also help you relax, decreasing stress, muscular spasm and tension (all three of which negatively affect the body and make handling daily obstacles more difficult). Massages are also a great way to reduce stress and relieve the pain associated with muscle spasms, as are chiropractic manipulations that help to realign (or properly align) the spine. 

• Biofeedback training: this non-invasive technique helps patients learn how to identify symptoms that are triggered by their emotions so they may learn how to completely prevent the occurrence of such symptoms. Regulating blood pressure, temperature and heart rate helps patients decrease the level to which stress can influence their pain intensity.

• Additional options also include occipital nerve blocks and stimulation, steroid injections, trigger point injections, cervical medial branch blocks, cervical spinal cord stimulation (SCS), as well as radiofrequency ablation. As a last resort, your specialist might recommend neck surgery. 

• Transcutaneous electrical nerve stimulation (TENS): this therapy uses electrical impulses applied to the skin above the area of pain that block pain transmission to the brain

• Neck pain medications: Non-steroidal anti-inflammatory drugs (NSAIDs), pain relievers and muscle relaxers can all help to provide pain relief

• Cervical epidural steroid injections: delivered through the skin into a targeted location (usually the space between spinal bones), these injections contain a mixture of a steroid and an anesthetic that helps to provide pain relief and reduce inflammation 

• Occipital nerve blocks: this injection of an anesthetic and corticosteroid targets the occipital nerves located at the back of the head with a goal to reduce pain and inflammation. Nerve blocks are also used as a diagnostic tool wherein if the patient feels pain relief then they might be a great candidate for other treatment options

• Occipital nerve stimulation: this technique uses an electrical stimulation (versus medication) to inhibit pain transmission, providing pain relief

• Trigger point injections: an effective treatment for muscle spasms, a mixture of a steroid and anesthetic is injected into the trigger point, or where the spasm was thought to originate, calming muscles and decreasing pain

• Cervical medial branch blocks: this treatment involves injecting medication into targeted nerves with the intention of completely disrupting nerve signals and blocking the transmission of the pain response on a more long-term basis than injections

• Radiofrequency ablation: if medial branch blocks proved effective for pain relief, radiofrequency ablation is a great next option for even more long-term relief. The targeted nerves are ablated or destroyed, eliminating the pain sensation from reaching the brain. 

• Cervical lysis of adhesions: also known as Racz procedure, this technique removes excess scar tissue in the epidural space that could be the cause of neck pain 

• Infusion techniques: a small catheter is placed in the epidural space or directly next to the affected nerves, and medicine is given periodically through the catheter over periods of time. Because the nerves are continually medicated and therefore blocked, pain relief can be very long-lasting. 

• Cervical spinal cord stimulation (SCS): tiny electrodes are placed in the epidural space close to the spinal cord and release a small electrical current that prohibits the feeling of pain from being sent to the brain. This is a great option for treating chronic neck pain as well as migraine pain. 

• Neck surgery: there are some instances where neck surgery is the best option for patients who are experiencing chronic neck pain. This is usually used as a last resort and after all other methods and therapies have been exhausted. 

It’s important to note that neck pain can be caused by both medical factors as well as emotional stressors. So in addition to focusing on the physical event that you believe might be the main cause of your neck pain, it’s also important to focus on your psyche. Depression, anxiety and stress all help to make chronic pain syndromes worse, and it’s often a vicious cycle where the patient is in pain, is upset and depressed about the pain and lack of sleep, missing work, etc., the pain gets worse, the depression gets worse, and so on. Your pain management specialist is trained to treat the entire patient, and not just the muscle spasm or broken bone, so it’s important to find a pain management specialist you trust and who is an expert in the field. 

There is no reason anyone needs to suffer through chronic neck pain. The best way to treat neck pain in the cervical area of your back is to seek help from the California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas. Our team of dedicated medical professionals have all the state-of-the-art tools and advanced treatment methods available to treat your specific cause of pain. If you have more questions and would like treatment options explained in more detail, please make an appointment today.