Neck pain is caused by one or a combination of these three main causes…

Disc injury

This can be a disc herniation, rupture, buldge, or a simple irritation. If you have had an MRI, you might be familiar with these terms. All of these diagnoses cause inflammation in the neck that can put pressure on other structures that lead to pain. The most common of these areas are the spinal nerve roots or even the spinal cord. Most people get nervous or upset when they learn that they have some kind of disc injury, but as it turns out, most disc injuries are asymptomatic. This means that many people are walking around with one of the above versions of a disc injury and they don’t have any symptoms (pain).

People who have disc injuries…

Are typically age 40 and under

There are of course always exceptions but most people with disc injuries tend to be on the younger side. This is because as you age, you start to lose the water content of the disc and it becomes less likely for you to have a disc injury like a bulge or herniation.

Have pain that gets worse with looking down

Most people with a disc problem have an increase in pain in the neck or even down their arm when they look down or turn their head to one side. When you do these activities, pressure is put on the front of the disc and the material inside the disc pushes toward the back of that spinal segment which puts pressure on the nerves right behind the discs.

Typically have these signs and symptoms…

Neck pain that can go down to the shoulder, elbow or even all the way down to the hand
Have pain that is worse in the morning when the get up
Pain that gets worse at the end of the day
Complain of numbness and or tingling in the shoulder, arm or hand
Feel nervous to move your head in certain directions (usually twisting motions of the spine) for fear of increasing the pain.

Spinal Stenosis

Stenosis in the spine is defined by a narrowing of the holes created by the vertebra (segments of the spine stacking on top of one another) that the nerves travel through. These holes are called the vertebral foramen (the big hole that the spinal canal travels through) and the intervertebral foramen (the smaller holes that the spinal nerves travel through on each side of the spinal cord). As these holes get smaller, there is less room for the nerve to move through. This is an issue because it can restrict the motion of the nerves or even put pressure on the nerves causing pain, numbness tingling and or burning anywhere from the neck down to the hand. As we age, this is a natural process that most people know as being called arthritis.

People who have spinal stenosis….

Are usually over the age of 40

There are always exceptions to this rule, but most people with spinal stenosis are over the age of 40. As the spine ages, the water content of the disc lessens and the space between each vertebrae gets smaller. This is one of the reasons most people get a little shorter as they age. As the space gets smaller, there is less room for the nerves to travel through and thus there is an increase in the incidence of pain caused by this smaller space.

Have pain that gets worse with looking up or sitting for long periods of time

If you are over the age of 65 and you have neck pain that gets worse as you look up or sit for a period of time, there is a chance you have spinal stenosis. This is the tell tale sign that your neck pain is coming from a narrowing of the canals the nerves travel through them.

Typically have these signs and symptoms…

General pain/ soreness in the neck, usually stronger on one side.
Morning stiffness that feels better after you get up and get moving.
Pain that extends down from the neck into the shoulder, arm or even all the way down to the hand.
Numbness/tingling or even just pain and stiffness in the arms.
A feeling of general weakness or even a cramping sensation in the arms.

Muscle Weakness/Instability

Limited activity requirements for many jobs and a sedentary lifestyle lead to many people having neck pain. Oftentimes chairs in offices are not designed to aid you in keeping a good posture and poor desk setups can worsen these issues. Prolonged sitting contributes to a host of problems throughout the body and desk workers in particular have a high frequency of neck related disorders due to the slouched posture.

People who have weakness of muscles surrounding the neck….

Age can be anywhere from 9-90

Neck strength is one of the biggest predictors of future neck pain and the slouched position commonly seen when people are seated contributes to reduced activation and deconditioning of these stabilizer muscles. The muscles at the base of the skull also become shortened as an adaptation to this position and excessively tight.

Typically have these signs and symptoms…

Loss of range of motion when turning or tilting head
Sharp stabbing pain with normal movement
Feel like their neck is always tight despite stretching
Pain that can radiate down the arm due to tight muscles compressing the nerve roots
Possible headaches starting from the base of the skull