Pulled Muscle In Neck

The neck has an important function, it supports the weight of the head and its muscles enable movement of the head in every direction as well as movement of the neck, jaw and shoulders. This flexibility however, brings with it a higher susceptibility to injury – making neck pain a frequently cited complaint. The muscles of the neck also control flexion and extension of the head and neck, and throughout the day these muscles have to constantly adapt to the posture of the head, resulting in the exertion of extreme pressure.

The levator scapulae and the trapezius are the longest muscles in the neck and are therefore at an increased risk for strain, making them the most susceptible of the neck muscles, to wear and tear. However, whilst muscular strains are a common cause of neck pain, there are a number of other conditions which may result in painful symptoms in the neck and surrounding region, including but not limited to the following:

  • Nerve compression
  • Spinal stenosis
  • Fractured vertebrae
  • Degenerative spinal conditions – Spondylosis
  • Cancer
  • Infection

Common Causes of Muscular Strains in the Neck

Many patients suffering from neck pain self-diagnose the problem as a ‘pulled muscle’-a colloquial term. This essentially occurs when a muscle(s) is torn or overstretched, resulting in painful symptoms.

Injury

A muscle strain or tear may be the result of injury caused by a direct blow to the head or neck, a fall, or the result of a car accident such as in the case of whiplash, where the neck suffers from the impact of hyperflexion and hyperextension.

Poor Posture

text neckWhen the head is held for consistently long periods of time in a non-neutral position such as tilted at an angle, or held too far forward, this can result in neck pain. ‘Text neck’ is a classic example of neck pain as a result of a postural problem – the head remains tilted in a downwards position for extended periods of time. Holding a phone between the head and the shoulder may also cause neck pain.

Sleeping in an Awkward Position

An awkward sleeping position or an unsuitable pillow may put excessive strain on the neck causing painful symptoms.

Repetitive Strain Injury (RSI)

Although the neck is extremely strong and can manage a wide range of movements without suffering from adverse side effects, any movement outside of its normal range, when repeated can cause RSI.

Lifting Something Which Is Too Heavy

Incorrectly lifting heavy loads can have a negative impact on any part of the back including the neck.

Other Causes of Neck Pain

Nerve Compression

Cervical Radiculopathy is the medical term used to encompass a variety of medical conditions related to the compression or irritation of nerve roots exiting the spinal cord in the cervical region.  Nerve compression can result in painful symptoms which may vary in intensity from mild to severe. Pain may be referred to other areas, such as in the case of Brachialgia, characterised by shooting pains which travel down one of the arms, hands and shoulders depending on where the nerve compression occurs. Other symptoms may include sensations of numbness and pins and needles, as well as muscle weakness.

Spinal Stenosis

Spinal stenosis is the narrowing of the nerve pathways in the spinal cord, resulting in nerve compression of the spinal cord itself. It is usually the result of degenerative changes such as osteoarthritis and degenerative disc disease.  Pressure on the spinal cord can cause many symptoms including pain, numbness, pins and needles as well as weakness in the neck, arms and legs. It can also affect control over the bladder and bowels. Spinal cord compression requires immediate medical attention.

Fractured Vertebrae

A fracture in one or more of the seven vertebrae in the neck can cause anything from mild to debilitating symptoms. If the fracture causes injury to the spinal cord, permanent paralysis may occur.

Degenerative Cervical Spine Conditions

Osteoarthritis

The natural ageing process can lead to the degeneration of the cervical region – this may result in a breakdown of the protective cartilage of the joints and other soft tissue, as well as causing the intervertebral discs to dry out and shrink. In response to the degeneration of the cartilage and discs, the body may attempt to repair itself by producing more bone. The excessive bone is referred to as osteophytes or bone spurs, the bone itself is not painful, it can however cause painful symptoms if it encroaches on nerves exiting the spinal column. Osteophytes can also lead to stiffness of the neck and cause discomfort during movement leading to a decreased range of movement.

Cervical Disc Problems

The intervertebral discs act as shock absorbers, soaking up any jolts during daily activities, as well as separating the vertebrae. As we age, the gel like substance in the discs begins to dry out, causing the discs to lose height and elasticity, and also leaving them more prone to herniation. In the case of a herniated or bulging disc the inner gel like substance can in some cases seep out and compress any nearby nerve roots.

Spinal Stenosis

Spinal stenosis is the narrowing of the nerve pathways in the spinal cord, resulting in nerve compression of the spinal cord itself. It is usually the result of degenerative changes such as osteoarthritis and degenerative disc disease. Pressure on the spinal cord can cause many symptoms including pain, numbness, pins and needles and weakness in the neck, arms and legs. It can also affect control over the bladder and bowels. Spinal cord compression requires immediate medical attention.

Red Flags

Neck pain accompanied by other particular symptoms may be an indication of a more serious underlying problem such as severe nerve compression, musculoskeletal trauma, cancer, infection or a compromised immune system.

Pain in the neck and surrounding region with one or more of any of the following symptoms requires urgent medical attention:

  • Persistent high fever/chills/night sweats
  • Unexplained weight loss
  • Difficulty walking
  • Persistent sickness/vomiting
  • Loss of control of bodily functions such as bladder and or bowel
  • Numbness in the buttocks and legs
  • Lack of coordination

Treating Neck Pain

Medication

For short term management of mechanical neck related complaints, such as muscular strains, over the counter medication may suffice. The use of heat or ice packs, analgesics and NSAIDS can provide pain relief.

Stronger medication may be recommended by a physician in the case of severe pain. Opioids or particular anti-convulsants such as Gabapentin and Pregabalin, or tricyclic anti-depressants may on occasions be prescribed to alleviate nerve pain.

Physiotherapy

Offering numerous benefits, physiotherapy and massage techniques can help improve a patient’s strength and mobility as well as their general mood and sense of wellbeing.

Surgery

In some cases, surgery may be required, such as in the occurrence of severe nerve compression. However, spinal surgery carries with it a number of associated risks and does not guarantee a successful outcome.

Pain Management

A pain management program offers a comprehensive treatment program which incorporates a variety of different types of treatment -- it usually involves a multi-disciplinary team of health professionals such as physicians, physiotherapists, psychologists and other health professionals.

Pain management clinicians do not understand pain purely in biological terms i.e. physical symptoms, but rather adopt a biopsychosocial approach often described as ‘whole person care’. This determines an individual’s state of health by considering not only his/her biological symptoms but also their psychological health and socio-economic background.

Preventative Measures for Neck Pain

The chances of suffering from neck pain can be reduced by a few simple preventative measures:

  • Maintain correct posture throughout the day, both at work and at home
  • Avoid lifting heavy objects
  • Use only one pillow, and ensure this is not too high or too firm
  • Perform regular exercise and stretches, as this helps retain flexibility and is good for general health and wellbeing

Nerve Pain

nerve pain

Back Pain

back pain

Treatments

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