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Neckache What is neckache? Neckache refers to pain at the back of the neck. Depending on the cause, this pain may also affect the shoulders, head and arms. What causes neckache and who is at risk? Neckache is a common symptom and has a number of causes. The most common of which include tension headaches and migraine. Arthritis in the neck (cervical spondylosis) and trauma to the head and neck including whiplash injuries may also result in neckache. What are the common symptoms and complications of neckache?
Migraine and tension headaches Injuries and neckache Cervical spondylosis Usually the condition is chronic (long-term) but mild, but sometimes it can cause sudden neck pain. This is often caused by a rupture of a fibrous disc between the bones of the neck. The fragments of ruptured disc can bulge beyond their normal limits and compress the nerves in the neck or the spinal cord giving rise to shooting pains down the arms, weakness of the hand or arm or numbness of the arms. Occasionally, the condition can be severe and result in spinal cord compression leading to weakness of the legs and disturbances of bladder and bowel function. Other causes of neck pain Other forms of arthritis may affect the spine in the neck. Rheumatoid arthritis which would generally affect other joints in the body may also affect the spine. This results in pain stiffness and limitation of movement in the neck. Rheumatoid arthritis generally affects women more than men and usually begins in early adult to middle age years. A less common form of arthritis known as ankylosing spondylitis may affect the spine and also result in pain, stiffness and limitation of neck movement. It typically affects young men and involvement of joints other than the spine is less common. This condition may result in fusion (sticking together) of the bones in the neck and the rest of the spine severely limiting movement. Another uncommon cause of severe neck pain usually spreading up to the back of the head on only one side is a condition called occipital neuralgia. There may be tenderness in the back of the neck and a stabbing pain arising on one side of the neck usually shooting into one side of the head at the back. Neck pain also commonly results from poor posture. This is frequently as a result of an occupational habit and is common in office workers. How do doctors recognise neckache? X-rays of the neck help to distinguish between the various causes of neckache. If tingling or numbness is affecting the arms or hands, further investigations should be undertaken. These may include magnetic resonance imaging (MRI) of the neck to determine the extent of compression of nerves in the neck. Sometimes computer-assisted X-rays of the neck can provide more information about nerve compression in the neck. This technique is known as spiral CT. What is the treatment for neckache? Self-care action plan
Neckache from poor posture can often be corrected by taking advice on
chair height and posture while working. A physiotherapist or occupational
health practitioner will be able to advise you on how to improve your
posture, as well as showing you how to arrange your work environment to
avoid neck or spine problems. They can also give you good advice on lifting
and carrying techniques that do not place undue strain on the spine.  Medicines Anti-inflammatory medicines may result in relief of the neck pain due to any of the causes of arthritis affecting the neck. In occipital neuralgia, injections of local anaesthetic drugs and steroids around the affected nerve at the back of the neck often provides relief. In addition, local application of hot packs, painkillers and anti-inflammatory drugs such as aspirin and ibuprofen may provide relief. Occasionally, an anti-epileptic drug known as carbamazepine may be beneficial. Surgery Only a very small proportion of patients will require an operation to relieve symptoms and neck pain resulting from cervical spondylosis. These operations (known as laminectomy and foraminotomy) relieve the pressure on the nerves. Neckache alone is not usually sufficient grounds to perform surgery. Complementary therapy Manipulation of the neck either by a chiropractor or an osteopath can result in improvement of neck pain due to poor posture or if there has been injury to muscles or soft tissues in the neck. However, manipulation of the neck in an individual with cervical spondylosis or a ruptured disc may make the problem worse. The Alexander technique may be useful for individuals with a problem with posture, and relaxation techniques may be useful in relieving neck pain associated with stress, tension headaches and migraine. What is the outcome of neckache? This depends on the underlying condition. Neckache due to poor posture usually responds well to simple advice on chair height and avoidance of stooping. None of the causes of arthritis affecting the neck can be cured but hot packs, medicines and occasionally surgery can often result in considerable relief if symptoms.  Download Acrobat PDF version
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