If you have suffered from a neck problem for three months or more, your pain will be described as “chronic”. The pain may be severe or mild, constant or intermittent; these factors will determine the degree to which it affects your life.

Neck Pain
Neck Pain

Causes

Precise causes of chronic neck pain are often difficult to determine. In more than 50 per cent of sufferers, it stems from the facet joints as a result of osteoarthritis, spondylosis, or a previous trauma such as a whiplash injury. If you have nerve-root pain, the most probable cause is a prolapsed disc. Less common causes of chronic neck pain include myofascial pain and, very rarely, cancer.

Symptoms

The symptoms of chronic neck pain are similar to  those of acute neck. Older people with degenerative changes in their neck may experience grinding or grating when moving, causing stiffness and aching. Recurrent episodes of more disabling pain can be triggered by trivial movements such as rotating your neck suddenly, jolting or jarring, and extending your neck or bending forwards for sustained periods of time. Numbness, pins and needles, and weakness in your hands may be a sign of cervical myelopathy – when the spinal cord in the neck is squeezed by degenerative changes in the bones and discs, leading to impairment of the nerves, affecting the arms and sometimes the legs – or spinal cord compression. Advanced cervical myelopathy may affect walking and gait. Chronic nerve-root pain may cause neuropathic features – when a nerve or nerves are damaged over a long period, leading to abnormal processing of pain – such as burning sensations. Mood and sleep patterns may become disturbed; the impact of the pain on your life can cause frustration and sometimes depression.

Risks and Complications

The physical risks of chronic neck pain are associated with the more serious conditions of major disc prolapse or cervical myelopathy leading to spinal cord compression. In rheumatoid disease, the neck can become unstable due to ligament damage. Other significant complications of chronic pain relate to its effect on your life, work, relationships, mood, and fitness.

Treatment for Facet Joint Pain

  • If your pain has been diagnosed as being caused by a facet joint problem, you should
    • take painkillers
    • start physiotherpy
  • If your pain is moderate to severe,and you have not improved with physiotherapy, you should see a specialist. The specialist may:
    • perform MRI and injections to the neck.
  • If the specialist decides that injections are not appropriate or are not working, he may:
    • suggest a functional rehabilitation programme
    • suggest an operation
  • If a more specific diagnosis leading to effective treatment has not been made
    • use medication wisely and appropriately.

Treatment for Myofascial Pain Syndrome

  • If your pain has been diagnosed as being caused by a myofascial problem, you should:
    • take painkillers
    • start physiotherpy
  • If you are still in pain, your doctor may refer you to a specialist, who may:
    • consider giving you a low dose of an antidepressant to relax your muscles and improve sleep quality.
    • identify trigger points. If these are found, he may use trigger-point injections.
  • If after several months you are still in pain, your specialist may:
    • suggest a functional rehabilitation programme.

Treatment for Disc-Related Pain

 

  • If your pain has been diagnosed as disc-related, you should:
    • take painkillers
    • start physiotherapy
  • If your pain is moderate or severe and it has not improved with physiotherapy, then you should see a specialist. He may:
    • perform MRI.
    • offer further treatment, such as prolotherapy.
  • If your spine has degenerated of the disc is badly damaged, your specialist may:
    • suggest surgery
  • If your specialist feels that treatment is not working,
    • a functional rehabilitation programme to improve the range of motion.
    • suggest surgery
  • If treatment has improved your symptoms, you should:
    • continue to practise good neck care

Call +65 64712674 for an appointment to treat Chronic Neck and Nerve Root Pain today. Same day appointment.

Acute neck and nerve-root pain describes several conditions that affect the cervical spine region, and can also cause head pain. In the long term, it is rarely as disabling as low-back pain, but the severity of acute nerve-root pain ca be just as bad as sciatica.

Neck Pain
Neck Pain

Causes

This pain can be caused by strain of the facet joints and ligaments, and disc herniation. Muscular pain is more of a chronic condition but can flare up. Your neck is also vulnerable to extend indirect trauma, as in whiplash syndrome. When acute neck pain arises spontaneously in young adults or adolescents it is called acute torticollis, or “wry neck”. Disc prolapse with nerve-root compression is the cause of the most severe pain.

Symptoms

You may feel sharp pain, centrally or to one side of the neck, with intense, dull aching that can spread further into the shoulder blade area and half-way down the thoracic spine. You may have stiffness due to your spine being trapped by a muscle spasm (known as “splinting”), and worse pain on certain movements such as bending forwards, backwards, sideways, or rotating. You may also find it hard to sit in a car or at a computer for long periods. The pain is often troublesome at night and lying down may make it worse. If a nerve is compressed or irritated, a sharp pain will radiate down your arm as far as your hand, accompanied by sensory disturbance such as pins and needles or numbness. If your motor nerve fibres have been damages, you may develop weakness in your upper arm/or forearm.

Risks and Complications

The risk of serious consequences of acute neck pain is extremely small. Most of the time the pain eases over a few weeks without specific treatment The main risk lies in too much rest, the fear of triggering pain through everyday movements, and the idea that more pain means further harm, as these can lead to loss of confidence and mobility. If you have developed pain after direct trauma such as a blow to the back of the neck, then you should obtain immediate medical advice.

Treatment for Cervical Disc Herniation

Herniated Disc

Seek Medical Attention

If you suspect your pain is caused by a cervical disc herniation, you should:

  • Relieve your pain by finding the least painful position.
  • Use ice pack for the first day of pain.
  • Take painkillers.
  • Try not to rest for more than 2-3 days.

If after 7-10 days and you are still feeling pain, you should:

  • Stay as active and mobile as you can, while being careful to avoid extreme movements of your neck.
  • Avoid prolonged reaching or working with your arms extended.
  • Ssee a doctor for stronger painkillers.

If after 2 – 4 weeks and you are still feeling pain, you should:

  • Consult a doctor for further examination and treatment.
  • See a specialist for an epidural steroid or nerve-root injection.

If after 6 – 8 weeks and you are still feeling pain, you should:

  • You may need to have an X-ray, MRI or blood test for further evaluation.

Treatment for Acute Torticollis

Seek Medical Attention

If you suspect your pain is caused by acute torticollis, you should:

  • Use ice packs and take some painkillers

If after 3 days and the pain increases, you should:

  • Avoid prolonged static positions

If after 7-10 days and the pain increases, you should:

  • Consult a doctor for further examination, advice, or treatment.

If after 6-8 weeks and the pain increases, you should:

  • You may need to have an X-ray, MRI or blood test for further evaluation.

Treatment for Whiplash

Whiplash Injury

If you suspect your pain is caused by whiplash, you should:

  • See a doctor to get your neck assessed to exclude more serious bone or nerve injury.

If after 7-10 days you are not able to resume normal activities, you should:

  • Consult a doctor for further examination, advice, or treatment.

If after 6-8 weeks you are not recovering as expected, you should:

  • See a specialist regarding the benefit from facet joint injections.
  • You may need to have an X-ray, MRI or blood test for further evaluation.

Call +65 64712674 for an appointment to treat Acute Neck and Nerve Root Pain today. Same day appointment.

A variety of conditions can cause pressure on one or more nerves as they leave your vertebral column in the middle and lower back. And, depending on the cause, the severity of symptoms, also known as “radiculopathies,” can vary.

Symptoms for Nerve Root Impingement

Pressure on the nerve roots often causes what is known as “radicular pain” – that is, pain that seems to come from some distance away from the site of the original problem. This is because the nerves that emerge from your spine form the link between your brain and you outlying tissues: if they are pinched or damaged, you’ll feel pain in the areas that they supply.

The symptoms of nerve root trouble in the middle and lower back can vary from back pain and numbness to nerve pain. Bending forward or sitting tends to relieve the pain of spinal stenosis because this flexed position enlarges the space available for the spinal cord or cauda equina, a bundle of nerves at the end of the cord. There may no symptoms until the condition has been present for some time. In other cases, there’s an immediate onset of pain.

What Causes Impingement on the Nerve Roots?

There are a number of ways a nerve root can become compressed in this area:

Spinal Stenosis

Spine Anatomy
Spine Anatomy

A narrowing of the canal and bony openings (foramina) through which the spinal cord travels and the nerve roots emerge, spinal stenosis can cause a number of nerve root problems in the lumbar spine. The lower part of the lumbar region is more often affected than the upper part.

Spinal stenosis is usually the result of the aging process, when osteoarthritis sets in and your discs become drier and shrink. The growth of bony projections – spurs, called osteophytes, that protrude into the canal and foramina can also contribute to nerve root problems.

Other causes of the spinal stenosis are a herniated or bulging disc, inflamed facet joints, a vertebra that has slipped forward (spondylolisthesis), trauma (such as road accident or fall from a ladder), scoliosis, bone disease, a tumour of the spine, or a congenital defect of the spine, such as a narrower that usual spinal column that has been present from birth.

Slipped Disc and Disc Bulges

Herniated Disc

Unfortunately poor movement patterns, such as bending with your back rather than your legs o pick up things, can damage the innermost rings of your vertebral discs. The damage gradually spreads to the outer rings, allowing the gel-like fluid in the center to leak out. If the outermost rings are still mainly intact, the fluid causes a bulge, which can press into the central spinal canal or into the space where the nerves leave your spine, and pinch them – causing, for example, problems such as sciatica. If all the rings are damaged, and the fluid seeps out of it, the disc ruptures and “slips” – what doctors call a “prolapse” or “herniation.”

Facet Joint Problems

These tiny joints are located at the back of the vertebrae. They are the joints at which the upper part of each vertebra joins the lower part of one above it, and the lower part joins the upper part of the one below. But if, for example, the lumbar spine loses stability, as a result, say, of poor lifting technique, the fibrous tissue surrounding the facet joints can thicken in an effort to regain stability and protect the area. This can not only pinch nerves as they leave the vertebral column, it can encourage the growth of bony spurs called osteophytes that will also pinch the nerves.

Proper Posture in Lifting Heavy Load

Figuring Out Nerve Root Impingement

Back pain should always be investigated by your doctor. In particular, if you experience bowel and bladder incontinence, severe numbness down the legs, muscle weakness, poor balance, or paralysis, seek immediate medical attention. Following a physical examination, and listening to an account of your symptoms, your doctor will probably be able to make a preliminary diagnosis. An X-ray, CT scan, or MRI of the spine may confirm the precise cause.

Fixing Nerve Root Impingement

Many cases of nerve root inflammation get better without treatment. If this doesn’t happen, the treatment options your doctor may consider include:

  • Physiotherapy
    This usually involves stretching and strengthening exercises. Posture and movement training are also likely to be included.
  • Medication
    NSAIDs, and injections may be helpful.
  • Surgery
    May be an option to relieve pressure on your spinal cord and/or nerve roots.

Call +6564712674 for an appointment to treat Nerve Root Impingement today. Same day appointment.