Introduction
Some medical conditions are so common that most people will suffer from them at a certain point in their lives. Neck pain is one of them and it is estimated that no less than 2 out of 3 people of the entire population will suffer from it at least once in their lives.
While neck pain is extremely common, you should know that the issue at hand is far more complex than this and that there is a lot to know about this type of pain.From nervous system issues to muscular issues, this condition can have a wide range of causes and each of them may need special treatment.Neck pain should not be underestimated, especially since it can turn into a chronic condition that will linger for an extended period of time.
This book is dedicated to those who want to find out more about neck pain, what it is, what its causes are and which are the main types of treatment applied in the case of those who suffer from it. Do read on if you want to find out all these things and to inform yourself properly.
Neck Pain: The Basics
Before you try to gain an understanding of what neck pain actually is, you should first learn about the structure of the human neck. Put very simply, the entire vertebral spine is made out of 33 vertebrae, out of which only 7 are part of the neck area.
Each of these vertebrae should be seen as a bony block and in between each of them you will find the discs which usually act as “cushions” between the bony structures when they move. In close proximity, you can find nerves that pass through the vertebrae, which are part of the central nervous system. As for the structure of the neck, you should also know that it includes skin, muscles, arteries, certain kinds of glands (such as the thyroid and the parathyroid ones), lymph nodes, the esophagus and the trachea. Knowing the parts that constitute your neck is important because any kind of medical issues that may be related to them will lead to neck pain in one way or another.
Furthermore, you should know the fact that neck pain is usually associated with other symptoms as well. For example, in some cases, headaches can appear together with the neck pain. In other cases, the symptoms that may appear include shoulder pain, facial pain, tingling and tenderness (especially when the pain is associated with the nerves that pass through the neck), pulsations, swishing sounds in the head, lightheadedness and the swallowing of the lymph node. Again, these symptoms may or may not appear and they are usually related to the exact cause that led to the patient to feel pain in the neck area.
The Main Types of Neck Pain and the Conditions Causing Them
There are two main types of neck pain: acute and chronic. Acute neck pain is not long-term, but it can be caused by various rather serious conditions as well. Chronic neck pain, on the other hand, can last for extended periods of time and it can have many causes as well.
In addition to these two main types of neck pain, you will also encounter classifications made according to the other symptoms associated with neck pain. For example, you may encounter cases where the neck pain irradiates towards the arm, cases where the neck pain is worse in the morning but where it gets better towards the night, and so on.
Although people do not necessarily associate neck pain that is caused by various types of activities and positions with serious medical conditions, you will later on learn that there are cases when even surgery may be required to alleviate the patient from the pain felt in the area of the neck.
Following, you will be presented with the main medical conditions that show neck pain as a primary symptom and with the causes that lead to their development. Read on if you want to understand more about the reason behind your neck pain.
Degenerative Disc Disease
One of the most common medical conditions that cause patients to feel neck pain is degenerative disc disease. As shown before, the discs that are found in between the vertebrae are actually cushions that prevent the vertebrae from being badly impacted due to movement. The degenerative disc disease affects precisely these parts of the neck and it is most often associated with getting older. That is so because the discs are formed out of a “jelly” ring and a central, softer part and both of these “materials” can wear out in time. As you get older, your vertebral spine discs may become slimmer, which makes the impact of the movement harsher on the neck.
Although advancing in age is the most commonly known cause for the development of the degenerative disc disease, there may be cases when trauma or injury can lead to the development of the same disease. In both of the cases though, the degeneration of the disc (medically known as “spondylosis”) can be easily detected with an MRI scan or with an X-ray test both of which will show whether or not the discs have worn out (and this is one of the main tests performed in the case of the patients who suffer from almost any kind of severe neck pain).
The main symptom of the degenerative disc disease is feeling pain in the area where the discs have worn out. According to which part of the vertebral spine has been affected, you will find various classifications:
The degenerative disc disease that appears in the neck area is referred to as “cervical disc disease”.
When it affects the mid-part of the back it is called “thoracic disc disease”.
When it affects the lower part of the back it is referred to as “lumbar disc disease” or “lumbago”.
In certain cases, some patients may develop osteoarthritis as well (when degeneration is present at the level of the discs and at the level of the joints between the vertebrae).
The diagnosis in the case of the neck pain starts with acknowledging the presence of the symptoms that characterize this medical condition. Further on, the medical professional may have to perform additional tests such as an electromyogram (EMG) or a nerve conduction velocity test (NCV). CAT and even MRI scanning can also be used in certain cases.
According to the severity of the condition in a patient, the doctors will determine what kind of treatment should be administered. In some cases, a non-surgical treatment may be the best choice and it can include non-steroidal anti-inflammatory drugs, steroids and muscle relaxers. Usually, the patient will be recommended with a series of techniques and practices that will help him/her manage his/her condition. For instance, doing special exercises under expert guidance can be recommended especially in order to strengthen the abdominal muscles. Also, lifting weights, wearing corsets or braces and following certain specialized more aggressive treatments (such as facet rhizotomy and intradiscal electrothermal annuloplasty) can be recommended when the patient’s state is more severe.
The surgical treatment applied in the case of those who suffer from the degenerative disc disease can come in two forms: stabilization surgery (or spinal fusion) and decompression surgery. In the case of the first of these, two vertebrae are fused together and this gives the patient’s vertebral spine more stability. This type of surgery is more frequently encountered in the case of those who suffer from the degenerative disc disease located in their lower back or in their neck (since these two are the most moveable parts of the human spine).
The second type of surgery, the decompression one, can also come in many forms. For instance, your doctor may decide to perform:
A facectomy (which basically means the surgeon will remove the facet joint),
Aforaminotomy (which means enlarging the opening between the vertebrae so that the nerve passing through it would not be so compressed),
A laminectomy (which involved removing the lamina – or at least part of it – to relieve the pressure),
Alaminotomy (which is similar to a laminectomy with the difference being that the opening created is larger).
Furthermore, other types of surgery procedures used to be performed as well, such as a discectomy (removing the disc or a part of it) or such as a corpectomy (which involved removing the vertebral bodies and the discs).
Stem cell therapy has also been researched and it has been shown to be potentially beneficial for those who suffer from the degenerative disc disease. Basically, this procedure involves the idea of the formation of new cartilage through the injection of a combination between hydrogel and several other substances.
Surgery will only be recommended in certain severe cases. Examples of situations where the patient may be recommended to undergo surgery include:
Feeling numbness and weakness in the leg as a result of the disc degeneration.
Strong back pain or leg pain that prevents the patient from doing everyday activities.
Standing and walking are very difficult for the patient.
The patient did not respond to physical therapy or medication.
Generally speaking, the outlook of suffering from the degenerative disc disease depends a lot on how severe the condition is in each of the cases encountered out there. Responding to medical treatment and non-surgical treatment can lead to a complete healing of the patient, while surgery may require physical therapy and an extended period of recovery time.
The degenerative disc disease cannot be prevented for some,but it does help to avoid injury of any kind. For those who already have this condition, avoiding stress and using the spinal cord too much is more than recommended, since any kind of pressure put on the spinal cord (neck, middle back or lower back) can make the situation worse.
Spinal Disc Herniation
Commonly known as a “slipped disc”, the spinal disc herniation can be a very serious medical condition. Basically, this condition affects the outer ring of the vertebrae, which leads to the bulging out of the soft portion found in the central part of the vertebrae.
Most often, it is believed that age degeneration is the main cause of the spinal disc herniation, but this condition can be caused by other things as well. Trauma, injuries resulted from lifting and straining can also be implicated in the development of this medical condition. People who work in jobs where they are required to constantly sit and squat are more at risk of developing a spinal disc herniation than other people.
Very often, a spinal disc herniation is the result of a former existing protrusion in the outer ring of the vertebrae and it is not to be mistaken with it. The difference between the two conditions is that in the case of the “protrusion”, the outer parts of the ring are completely intact and the disc only bulges when it is under pressure.
Some scientists out there believe that genetics do have a role to play in the development of spinal disc herniation as well (especially in the lumbar area). Apparently, mutations that appear in genes that deal with the regulation of the extracellular matrix can be responsible for the development of the disc herniation (and examples of such genes include MMP2 and THBS2).
The symptoms shown by patients with spinal disc herniation vary according to how severe their case is and to the area in which the disc has herniated. Most usually, feeling strong pain in the area of the disc is the first and most important symptom. Thus, if the spinal disc herniation has developed in the neck area, pain will appear in the neck and it can irradiate from there to the surrounding areas (shoulders, for example). The difference between the pain felt in the case of a herniated disc and the pain felt by a muscle spasm is the fact that in the first case the pain is continuous, rather than intermittent such as in the second case. In addition to pain, some of the patients out there experience other symptoms as well, such as:
Muscular weakness
Paralysis
Parasthesia
Numbness
Tingling
Affected reflexes
Also, you may want to know that the lumbar region is the most common area in which spinal disc herniation appears, but that the second most common area is the neck. Apparently, the thoracic area accounts for very few cases of herniation of the disc. Cervical disc herniation appears more commonly between the fifth and the sixth vertebrae and between the sixth and the seventh vertebrae and the symptoms usually can extend towards the following body parts:
Neck
Back of the skull
Shoulders
Shoulder girdles
Scapula
Arms
Hands
The diagnosis of the spinal disc herniation involves spotting the symptoms first and then trying to exclude other possible reasons for which the pain and the other symptoms have developed (such as tumors, degeneration, lesions and so on). The physical examination is an important part of the diagnosis process and it usually involves the “straight leg raise” test which can turn positive or negative, but it is to be kept in mind that this examination usually has a low specificity and that it can only be taken into consideration in order to rule out lumbar disc herniation.
In addition to this physical examination, the doctor will most likely have the patient undergo some imaging scans as well. X-rays are quite commonly used, but they are not always the best and most accurate examination. However, they help rule out tumors and other potential causes for the symptoms. Furthermore, CT scans, MRI scans, myelogram tests, electromyelogram tests and other imaging examinations can be performed and each of them can help with the diagnosis in one way or another.
The treatment can come both in non-surgical forms and in surgical forms as well. However, it is generally believed that almost three quarters of patients with a spinal disc herniation do respond well to non-surgical treatment within the first few months of treatment. Thus, in the first phase the doctor will prescribe the patient anti-inflammatory non-steroidal medication, but this is to be taken very cautiously because the treatment can be affected by underlying gastrointestinal toxicity and cardiovascular toxicity as well. Thus, an alternative to this type of medication can sometimes consist of cortisone injections with results being apparent between the first 2 and 6 weeks. This technique does not usually show any kind of risks, especially not when performed the right way.
The patient may have to undergo treatment for auxiliary symptoms and he/she may also have to go through rehabilitation and physical therapy. Anti-depressants and exercises are quite commonly prescribed and recommended.
As for the surgical options, they are rarely performed and only in those cases which are very severe. Laminectomy, chemonucleolysis, nucleoplasty and lumbar fusion are among the surgical interventions out there, but they are definitely not the only ones. Only medical professionals can determine exactly which option may be more suitable for their patients with spinal disc herniation.
It is important that the patient receives proper treatment for his/her herniation because there may be serious consequences to not doing it. Complications of this medical condition include the caudaequinasyndrome, chronic pain, permanent injury to the nerve and even worse, paralysis.
Undergoing rehabilitation is also extremely important. Some of the most commonly encountered rehabilitation techniques include the following:
Electrostimulation
Ultrasound therapy
Laser light stimulation
Hot/cold therapy
Weightlifting (but only under the close supervision of someone who knows how to work with people suffering or recovering from a spinal disc herniation)
Prevention is possible in the case of spinal disc herniation and it is mainly based on educating people into knowing exactly what it is that can lead to such a condition. Since a lot of people working in the manual labor sector develop this condition, they will be among the first ones to have to learn about biomechanics and about not lifting weights beyond their power. Exercising can be an important part of preventing the development of this condition since it can help with strengthening the back.
Whiplash
Again, this is probably one of the most common conditions that lead to the development of neck pain and it is sometimes considered to be even more common than the degenerative disc disease. However frequently encountered though, this particular medical condition is very often misunderstood, which in itself leads to inadequate treatment.
Basically, what the medical professionals may refer to as “whiplash” is nothing else than the neck pain that is resulted out of a rapid acceleration of the back-and-forth head movements. This type of injury is quite frequent in motor accidents (and this is one of the reasons that make the resulting pain as common as it is). In most cases, this type of injury appears when the patient was in a vehicle that was standing at the moment of the impact with another vehicle that was moving towards it.
In addition to neck pain, there are other symptoms associated with whiplash as well. For instance, some patients may experience:
Dizziness
Headaches
Shoulder pain
Stiffness felt both in the area of the neck and in that of the shoulder
Arm pain and weakness
Fatigue
Disturbances at the visual level
Back pain and so on.
Patients who suffer from the severe form of this medical condition do experience other symptoms as well. These symptoms are of a more psychological nature in general and they include:
Depression
Anxiety
Frustration
Anger
Stress
Post-traumatic stress syndrome
Sleep disturbances (such as insomnia, for example).
Having all these symptoms (or a large portion of them) for extended periods of time means that the patient will have to follow a treatment that may eventually cause addiction (such as in the case where the doctor administers powerful pain killers to relieve the patient from the symptoms felt).
As for the diagnosis in the case of those who suffer from whiplash, it can be easily done with the help of X-rays. As a matter of fact, even without the presence of any symptoms, a person who has been involved in an accident will have to be tested for serious injuries and if whiplash is diagnosed, the patient will be informed on his/her condition, on what it means and on which is the path to recovery.
The treatment applied in the case of those who suffer from whiplash depends on the symptoms they show. Generally speaking, medical professionals out there used to believe that isolating the movement in the cervical area with a soft collar helps. However, it has been proved that not allowing the neck to move at all can slow down the healing process and that when immobilization is combined with too much rest, there is a higher risk of developing chronic conditions such as:
Pain
Stiffness
Muscle atrophy
A decreased blood flow to the soft tissue in the injured area.
It is believed that early movement exercises and physical therapy can be much more effective and that they can help the patient recover faster.
If the patient also develops psychological symptoms such as those described earlier (depression, anger, and so on), the doctor will recommend therapy for the specific symptoms shown as well. The main target of the emotional treatment is teaching the patient more about his/her condition and making him/her understand that it can be healed. As a matter of fact, giving a patient the proper information lies at the very foundation of the treatment in the case of whiplash and it is generally considered to be extremely important for the entire healing process.
Whiplash can be prevented only by avoiding car accidents wherever possible and by making use of all safety measures. Modern seat belts and head restraints have made everything safer and they have decreased the chances of whiplash in the case of a car accident. Furthermore, airbags can also prove useful in preventing this condition and a large portion of the cars nowadays are equipped with them as well.
Although whiplash is not a life-threatening condition, the truth is that the costs of this condition in the economy of the United States can get quite high when it comes to the medical care associated with it and to other expenses (such as medical leave, litigation, and so on). Very often, people who suffer from this condition suffer from a certain degree of disability for an extended period of time. In some cases, there may appear complications that are associated with this medical condition and they are usually referred to as “whiplash associated disorders” (which usually means that the condition has become severe and chronic). Still, most of the patients that suffer from this condition do recover successfully within a fairly short period of time and they do not experience any chronic symptoms associated with the injury.
Swollen Lymph Nodes
Lymph nodes are small and round (or oval) structures found throughout the entire human body (the neck area included) and their main purpose is that of protecting the body against potential viruses. While some of these lymph nodes are found right under the skin and they can be felt even if they are small, others are found deep in the body and they cannot be palpable. As an important part of the immune system in the human body, these lymph nodes are connected to each other in a chain by the blood vessels. Each of the body’s lymph nodes is covered by a capsule which contains proteins and macrophages that will “capture” any kind of virus or microbe and it will destroy and remove it from the body.
There are many medical conditions that can lead to the inflammation of a lymph node. The most commonly encountered inflammations appear when the lymph node is active and it is fighting a particular virus or microbe that has entered the body. However, sometimes, cancer may be the cause of the lymph node inflammation.
Viruses, such as:
Chickenpox
Infectious mononucleosis
Herpes
Cold viruses
HIV
are among the primary causes for lymph node inflammation. Furthermore, certain bacteria can cause the inflammation as well (such as streptococcus, syphilis, chlamydia and cat scratch disease, for example). Parasites and fungal infections can also be behind this kind of inflammation (and some examples are toxoplasmosis and histoplasmosis).
When cancer is the main cause of the inflammation of a lymph node, the cancer will spread towards the nearest lymph node. For instance, the mammal cancer can spread towards the axilla lymph node, while lung cancer can spread towards the collar bone lymph node. Jawbone swollen lymph nodes are usually the result of a tooth infection or abscess, but in certain cases they may also show an underlying head cancer or neck cancer. Also, swollen nodes behind the ears are usually the result of an eye infection, while the presence of these nodes on the head is the result of common head skin conditions, such as dandruff. The collar bone swollen lymph nodes are generally believed to be abnormal and they can be the result of an infection or cancer in the area. However, sometimes, cancers that are located in completely different parts of the body are the ones who feed these lymph nodes (such as colon cancer, for example).
Leukemia and lymphoma are two of the cancers that may lead to the inflammation of the lymph nodes as well. It is generally believed that a non-moveable, hard and non-tender lymph node may be a sign of cancer.
In certain cases, a swollen lymph node is not at all a sign of an underlying disease, but a normality. For instance, a small swollen lymph node under the jaw bone in children and young adults can be quite frequently encountered and it is perfectly normal. Furthermore, small lymph nodes in the inguinal area in young people can also be normal and they are not a reason to worry (unless they are past the diameter of 2 centimeters).
In many cases, swollen lymph nodes are completely asymptomatic and patients do not feel anything. In other cases, this condition can be manifested through pain in the particular area where the inflammation is located (hence the neck pain if the swollen lymph node is located in this particular area of the patient’s body), through tenderness and even through disfiguration.
There is a list of symptoms that your doctor will also look for if you have reported a swollen lymph node, since these symptoms can be relevant for the right diagnosis. For instance, fever, night sweats and certain local infections that have already been spotted (such as a toothache or a sore throat, for example) may be signs of an underlying condition that has to be investigated.
In addition to checking for associated symptoms, your medical professional may also run a computed tomography scan if he/she considers that this is needed and he/she may also check for the possibility of having contracted a sexually transmitted disease. The doctor will also make sure to analyze your medical history and other factors and, if needed, he/she will need to make a biopsy of the lymph node.
The treatment for a swollen lymph node correlates with the underlying condition that led to this to begin with. Thus, if it is an infection that caused the inflammation, the condition will be treated according to the medical specialist’s advice. Also, you should know that it is extremely important to visit a doctor if you show any other symptoms associated with the swollen lymph node or if you have been checked for an infection and the lymph node persists.
Even if the swollen node is not the result of a very serious disease, there are some things not treating the node can lead to. Not treating a node that is the result of an infection may lead to abscesses that need local drainage. At the same time, there are cases when the size of the lymph node is very large and it compresses the body parts around it (for instance, a very large axilla lymph node can compress the blood vessels in the area, while a very large intestinal lymph node can compress the intestines themselves).
Osteomyelitis
Osteomyelitis is an infection of the bone that can appear at all ages: from infancy to adulthood. However, you should also know that the neck (and, in general, the entire vertebral spine) is rarely affected in the childhood by this infection and that this particular area is usually affected by osteomyelitis only in adult patients (together with the feet and the pelvis area). In the case of children, however, osteomyelitis affects the knees, the wrists, the hips and the shoulders. You should know that although the infection bears the same name, there are multiple types of bacteria causing this infection and that they target different age groups.
The development of osteomyelitis can be triggered by a series of things. One of the common situations is when the bacteria travel with the bloodstream towards the bones (from another infection in the human body). Quite frequently, patients develop this infection due to a previous infection that they may have had, such as pneumonia or urinary tract infection.
Another way in which osteomyelitis can develop in the human body is when the patient has an open wound over a bone. Also, if the patient has an open fracture, the bone that is punctured through the skin will be exposed to bacteria and it will be at risk of developing osteomyelitis. This situation is commonly encountered among those who suffer from diabetes, peripheral neuropathy and peripheral vascular disease.
Patients who are under medical treatment that may make their immune system weaker are also at risk of developing the same kind of bone infection. People with cancer, HIV, those who undergo hemodialysis, those who suffer from the sickle cell disease and the people who belong to the elderly age group are more at risk of developing osteomyelitis than other patients out there.
The range of symptoms experienced by patients with osteomyelitis can differ from children to adults and from one person to another. The main symptoms experienced by the patients are pain and tenderness in the area of the bone which was affected (neck pain in case one of the vertebrae of the neck has been affected). Children with severe forms of osteomyelitis can also develop inability in using that area and they may also show symptoms that include:
Fever
Chills
In some cases redness in the area that was affected
At the same time, adults can show these symptoms and others as well (including irritability, nausea and stiffness). Also, in their case the disease gradually developed and in the case of those who suffer from certain medical conditions such as diabetes or peripheral neuropathy, for example, there may be no pain at all.
The diagnosis can be made in the case of osteomyelitis and the doctor may perform a series of tests, such as those performed for a complete blood count, for blood cultures and for the C-reactive protein. In some cases, imaging examination may be required and in these cases the patient will have to go through an X-ray scan, through a computerized tomography scan, through an ultrasound scan or through basic bone scans. Further on, the medical professional may also need to perform a biopsy to see exactly what kind of bacteria has affected the bone and which will be the most adequate treatment that can be administered.
The treatment usually includes various types of antibiotics and patients are required to take them for periods that vary according to the severity of their condition. In most cases, patients with osteomyelitis have to undergo treatment for anything between 4 to 8 weeks. The area that has been affected by the infection may have to be isolated with the use of some sort of brace.
Surgery may be needed as well, but only in certain cases. For instance, if the patient shows an abscess, the area will have to be opened and it will have to be thoroughly cleaned. In the same way, if the tissue or the bones have been damaged by the spread of the infection, they will have to be removed (and, in the case of the damaged bones, they will be replaced by a graft).
Generally speaking, the prognosis for the patients who suffer from osteomyelitis is fairly good, especially if the disease is diagnosed in due time. However, if the diagnosis is delayed, the patient may have to suffer further complications and the bones and the tissues can get severely damaged (which, as shown above, can lead to the need to replace the bone).
Encephalitis and Meningitis
Both encephalitis and meningitis are serious inflammations that can be very dangerous for the patient who suffers from them. While encephalitis is the inflammation of the brain, meningitis is the inflammation of the membrane surrounding the brain and the spinal cord.
Encephalitis can have many variations and it can be caused both by viruses and by certain diseases that cause the inflammation of the brain. Most frequently, encephalitis is caused by infections and the infections are, in their own turn, caused by various viruses (and the most frequent virus that affects people this way is the herpes simplex virus, which mainly targets the infants, toddlers and the elderly). The viruses that lead to encephalitis can be contracted through breathing, through direct contact with an infested person’s skin and through certain insects’ bites.
Meningitis is quite similar to encephalitis when it comes to their causes. Same as encephalitis, it can be caused by various viruses out there and it can also be the result of certain diseases that lead to the inflammation of the tissue (without the presence of infection necessarily). Such diseases include systemic lupus and Behcet’s disease.
The symptoms and signs of both encephalitis and meningitis are quite similar as well. The main symptoms shown by patients with encephalitis are headaches and fever, but a list of other symptoms can appear as well. Some patients feel:
Nausea
They experience light sensitivity
Confusion
Irritability
And they may have a stiff neck.
In the worst cases symptoms such as the following will appear:
Loss of consciousness
Non-responsiveness (or poor responsiveness)
Dementia
Muscle weakness
Memory loss
The symptoms of meningitis are also focused on headaches and fever, but in the case of the patients who suffer from it, stiff neck is one of the most common symptoms (in the case of the adults and older children especially). Furthermore, nausea, vomiting, difficulty in walking, sleepiness and confusion may appear as well. As for cases involving infants, it is known that babies do not show very strong symptoms and that poor feeding, fever and irritability are among them.
Encephalomyelitis is the infection of both the brain and the spinal cord. This type of infection is generally caused by different viruses and the most common one is the herpes zoster virus. The patients who develop this type of infection usually show a combination of symptoms that are typical to both encephalitis and meningitis.
Patients become suspects of these infections when they show the main symptoms. Once a patient has become a suspect, the doctor will proceed with further examinations. He/she may have to run some blood tests to see if there are any bacteria present, he/ she may have to perform a brain scanning (CT or MRI) and he/she may have to perform a cerebrospinal fluid analysis. A lumbar puncture is one of the most common methods of collecting spinal fluid and it can confirm the original diagnosis.
The treatment of encephalitis and meningitis is mainly based on antibiotics and antiviral drugs. A doctor may have to administer anticonvulsant drugs (to prevent the patient from having seizures) and corticosteroids (to reduce the brain inflammation). Sedatives and other medication may have to be administered as well (to help the patient rest or to treat the main symptoms, such as fever, for example). Depending on the severity of the meningitis (and on its type), the patient may have to be hospitalized as well.
The prognosis in the case of both of these diseases can vary a lot, according to the severity of the case as well as according to the type of inflammation. Generally speaking, if the case is mild, there is a very big chance of complete recovery. In more severe cases, however, it can lead to impairment and even to death. Meningitis can be very dangerous because it can have repercussions on the neurological system of the patient, while encephalitis can be dangerous because it can influence the neurological symptoms and because in certain cases the acute phase can last for up to two weeks. The most important thing about treating both encephalitis and meningitis is making sure that the diagnosis is made as soon as possible and that the patient starts to be treated as soon as possible.It can be comforting to know that in most cases, people with very mild encephalitis or meningitis can make a full recovery, although the process may be slow.
Also, you should know that meningitis can be contagious, especially when it is caused by certain viruses out there. In most cases, the virus is contracted through direct exchange of throat secretions with a person that is already ill (such as through kissing, for example). In other cases though, people who have only had a prolonged contact with the patient can develop meningitis. For instance, in the case of the meningitis that has been caused by Neisseria Meningitidis, every person in the household of the patient is considered to be at a very high risk of contracting the disease. Also, people who will come into contact with a patient who suffers from this disease will have to take antibiotics and protect themselves (and this includes doctors as well).
Meningitis can be prevented through the usual ways in which viruses are repelled and avoided: washing hands, covering the mouth when coughing, and so on. Furthermore, vaccines are available in the case of certain viruses that can cause meningitis (such as in the case of Hib and in the case of the N meningitis virus). Very often, travelling abroad to countries where these viruses are common means that you will have to undergo immunizations and this may include these vaccines as well. Also, teens, pre-teens and college students are encouraged to take the vaccine as well, since they tend to live in a large environment and infestation with the virus can easily occur this way.
Arthritis
Arthritis is one of the most commonly encountered diseases out there and it primarily affects the elderly, but some forms of arthritis can affect children and teenagers as well. Basically, this disease of the bones is characterized by the inflammation of the joints that “tie” the bones between themselves. There are many forms of arthritis, but the most common one is osteoarthritis. While in general the degeneration of the joints is related to getting older, there are cases when arthritis is related to autoimmune diseases (and these are the cases where children and teenagers can be affected too).
The arthritis of the neck bones is called “cervical spondylosis” and it is estimated that it affects more than 85% out of all the people who are past the age of 60. However, cervical spondylosis does not usually affect the patients in a very harsh way and it does not become crippling or disabling for them.
Very commonly, cervical arthritis is linked to the degeneration of the discs (which was previously explained in this book). As people grow older, the amount of “watery” liquid between their vertebrae becomes considerably smaller than in the case of children and younger adults. In time, this makes the vertebrae collapse and settle. Together with this, the joints are affected as well and this is how cervical spondylosis develops. If the cartilage wears away completely, the patient’s body can respond to this by growing a new bone that will narrow down the space available for the nerves and this leads to a condition known as “stenosis”.
The main symptoms people with cervical arthritis show are the following:
Neck pain
Neck stiffness
Weakness and numbness in the arms (hands and fingers included)
Muscle spasms in the area of the neck and shoulders
Headaches
Popping sounds in the neck area
Loss of balance
Weakness in the arms and legs
Furthermore, you should also know that there is a series of risk factors when it comes to developing arthritis in general and these factors include the following:
Smoking
Genetics
Depression
Anxiety
Injuries
Trauma
Your occupation
The diagnosis process of the cervical arthritis begins with a series of questions regarding your neck pain. Your physician will most likely ask you when this pain started, how much it lasts, what is the occurrence rate of the pain, if the pain is getting worse or better under certain circumstances and if you have ever been treated for this pain.
In addition to the physical examination, further tests will most likely be required as well. X-rays will be the first examinations ordered in the case of neck pain in general, because they can show whether or not the discs have collapsed. In addition to this imaging test, the patient may also be required to get a magnetic resonance imaging test (MRI), a computed tomography (CT), a myelography or an electromyelography. At least one of these tests will be able to reveal whether or not the patient has cervical spondylosis.
The treatment in the case of the “neck arthritis” can be both non-surgical and surgical. The non-surgical treatment will usually include various medications such as acetaminophen (usually prescribed first in these cases), non-steroidal anti-inflammatory drugs and muscle relaxants.
In addition to medication, several other things may be recommended by your physician. These non-surgical treatments may or may not include the following:
Physical therapy (almost always recommended)
Steroid-based injections (usually prescribed when medication is not as efficient as it should be)
Soft collars (usually prescribed for shorter periods of time since long-term use can cause adverse effects such as weakening of the neck muscles)
Cervical epidural block
Cervical facet joint block
Ice-heat treatments, massages and other remedies
The surgical treatment applied in the case of those who suffer from cervical arthritis is quite uncommon and the doctor will recommend it only in those cases when none of the treatments described above has given results. Often, people who also show neurological symptoms (weakness, balance issues and so on) should be recommended with a solution involving surgery.
Pinched Nerves and Cervical Radiculopathy
Although “pinched nerves” is a medical condition that is common to various diseases and affections, it should be mentioned here because it can be one of the causes that lead to developing neck pain of various degrees of severity. Neck pain that develops due to pinched nerves is commonly connected to other medical conditions and diseases that have already been mentioned in the book (which is precisely why it has been left towards the end of the list of medical conditions that lead to pain in the neck area).
One of the categories of pinched nerves conditions is related to spinal disc herniation. As mentioned before, disc herniation usually develops with age due to the fact that the discs wear out. The herniation can appear on any of the parts of the disc, including the inner part that is close to the spinal canal (which, as also mentioned before, is where the spinal nerves pass through). When that happens, the nerve beside the herniated disc can be pressured and that leads to pain, numbness and weakness.
Another circumstance when a pinched nerve may be behind the neck pain of a patient is when a bone spur appears. As also shown before, there are cases when the degeneration of the bone part of the vertebrae can trigger an odd reaction in the body: that of growing another bone to support the vertebral spine (which is called a “spur”). When this happens, the spur can press against the nerves and lead to pain (which can appear in all the 3 main areas of the vertebral spine: the neck, the thoracic part and the lumbar part). Do bear in mind that this kind of pinched nerve is slightly different than stenosis. The main difference consists out of the fact that in the case of stenosis, the degeneration of the disc is already in a very advanced stage and it pressures the nerves because the spinal canal becomes smaller. Also, in the case of stenosis, the weakness, pain and tingling can extend to the arms and legs as well.
Cervical radiculopathy can be caused by anyof the threecases described here (pinched nerve due to cervical stenosis, due to degenerative disc disease or due to spinal disc herniation). Basically, radiculopathy appears when the root of the nerve that has been affected by one of these three conditions travels down the arm and hand. When this happens, the neck pain radiates towards the arm and the hand (and this has been described in the book under other medical conditions related to neck pain as well).
The symptoms of the cervical radiculopathy are feeling pain in one area or radiating towards the shoulder, towards the arms and towards the hands, as well as feeling numbness, tingling or weakness in the area.
There are four main types of cervical radiculopathy and they have been categorized this way according to the vertebra in which the issue occurs first. Thus, you may encounter the following:
C5 radiculopathy (which affects the shoulders and the upper arms)
C6 radiculopathy (which is the most common and which affects the arm and the middle and index fingers)
C7 radiculopathy (which affects the neck, the hand, the triceps and the middle finger)
C8 radiculopathy (which affects the hand grip, the inner part of the arm, the ring and the little finger as well)
The diagnosis process of the cervical radiculopathy is similar to those applied in the case of other neck pain sources as well. The doctor will first ask about the nature of the pain, family history and so on. Further on, an X-ray scan will be ordered and, if necessary, an MRI, a CT scan or an electromyogram (EMG) will be ordered as well.
The treatment in the case of a pinched nerve or in the case of the cervical radiculopathy depends a lot on the main cause that led to its development. Thus, radiculopathy that has been caused by cervical stenosis will be treated accordingly and it will be the same way with radiculopathy that has been caused by disc degeneration or by spinal disc herniation.
Generally speaking, the prognosis for those who suffer from cervical radiculopathy is quite good. Usually, non-surgical treatment gives results and even when surgery intervention is required, patients do not usually suffer from long-term adverse effects of the surgery. It is believed that the cervical radiculopathy can resolve in a period of time that is anything between 6 weeks and 3 months.
Fibromyalgia and the Myofascial Pain Syndrome
Although these two syndromes are very frequently encountered, the truth is that up to the moment medical researchers have not yet been able to clear things up about them. As a matter of fact, these syndromes are among the most common mysterious medical conditions out there and they affect a lot of people. Even so, they are frequently misdiagnosed and misunderstood and for a very long time they were not even considered to be stand-alone medical conditions.
Generally speaking, even some of the medical professionals out there mistake fibromyalgia for myofascial pain and the other way around. The fact that both of these syndromes are associated with a lot of medical issues and the fact that they are both similar makes it confusing for patients and doctors alike.
Fibromyalgia is generally characterized by chronic pain that is widespread (and this includes the neck area in a lot of cases). What makes this syndrome so mysterious is the fact that its causes are not only unknown, but harshly debated as well. While some medical researchers out there believe that fibromyalgia’s onset is related to an imbalance in the chemicals in the brain (which eventually makes the patient have a very sensitive reaction to pain, more recent studies sustain that some bacteria may be the cause for the development of this syndrome).
The main symptom of fibromyalgia is, as previously mentioned, chronic pain. However, in most cases patients accrue symptoms that can differ a lot from one person to another, that are overlapping with symptoms of other diseases and disorders and that are not even always considered to be proper symptoms but risk factors, underlying conditions and results of the fibromyalgia syndrome. The symptoms of fibromyalgia may or may not include the following:
Chronic pain
Fatigue
Tingling sensation of the skin
Sleeping issues (such as insomnia or the restless leg syndrome)
Muscle spasms
Weakness of the limbs
Palpitations
Lack of concentration
Issues related to memory
Inability to do more things at once
Impaired speed performance
Anxiety
Depression (fibromyalgia itself was considered to be just a form of depression until not so very long ago)
The large number of potential symptoms is one of the reasons why diagnosing fibromyalgia can be very difficult. Usually, one of the tests a doctor will perform will be that of trigger points. There are 18 total trigger points spread throughout the human body (one of which is located on the neck – which explains why neck pain is commonly encountered among patients with fibromyalgia). If the patient responds to 11 out of the 18 trigger points, he/she becomes a fibromyalgia suspected sufferer.
Several other syndromes and diseases are considered to be co-morbid with fibromyalgia. Many times, patients with fibromyalgia also develop thyroid issues, irritable bowel syndrome andmyofascial pain syndrome.
Very often,myofascial pain syndrome is even more misunderstood than fibromyalgia and patients are diagnosed and treated only for one of these conditions. As a matter of fact, the myofascial pain syndrome has started to be considered a disease (and not a syndrome) and many medical professionals out there prefer to refer to it as “chronic myofascial pain”.
In the case of those who develop the myofascial pain syndrome, the muscles and the connective tissues form trigger points that become painful. Do bear in mind the fact that these trigger points are not the same as those encountered in the case of fibromyalgia and that they can form due to trauma or injury as well.
There are a lot of things that make MPS and fibromyalgia different and one of them is their symptoms. Although symptoms commonly overlap when these two medical conditions are co-morbid, there are some symptoms that will be encountered in the case of fibromyalgia and not in the case of myofascial pain:
Fatigue
Confusion
Allergies
Sensitivities
Panic attacks
The treatment in both fibromyalgia and the myofascial pain syndrome differs a lot, from one person to another and it is prescribed according to the symptoms shown by each patient. Typical medication includes pain killers, steroids, vitamin supplements, sleeping pills and anti-depressants. In addition to medication though, patients will be recommended to undergo physical therapy and to try out other treatment methods as well (but only under the close supervision of a professional and only after checking with their doctor about it).
Neck Strain
Straining is probably the most common and the least serious cause that leads to neck pain. There are many things that can lead one to get a strain around the neck and they can include:
Sitting in an odd position for an extended period of time
Sleeping in an odd position
Driving for a longer period of time
Carrying a heavy object on one side of the body only
Neck strains do not generally need drugs to be treated and they can be successfully treated with a series of home remedies (such as cold/hot packs). When medication is needed, however, it will most likely be of the over-the-counter type (such as anti-inflammatory drugs, for example).
Although neck strains are not very serious and they can resolve without much hassle, they can be truly uncomfortable and painful. Do bear in mind that in certain cases you should definitely go visit your doctor about the neck pain because there may be other reasons behind it. Here are some examples of when to go visit a doctor:
If the pain lasts for more than 1 or 2 days
If the pain has irradiated towards the arm or shoulder
If you have a tingling sensation
If you have a feeling of numbness
If the pain and stiffness are severe
If you have been involved in any kind of trauma or accident that may have hurt your neck or any other part of your body
Neck Pain: Remedies, Exercising and Prevention
As you have read up to this moment, neck pain can be a sign of a serious underlying condition or it can be a simple strain. Whichever it is, it is highly important that you keep yourself informed at all times and that you know as much as possible about neck pain, its nature and how to fight it.
One thing to absolutely bear in mind when it comes to acquiring information about neck pain (or about any kind of medical problem, for that matter) is making sure that your sources are 100% reliable. If you don’t understand something or if you plan to pick up some sort of exercise program to help your neck, you should definitely talk to a professional first (and this could not be emphasized more).
Also, keep in mind that not all remedies and exercises work the same for everyone and that what may have been great for your best friend may not be as good for you. This stands true for exercises, remedies and medication alike and if you plan to take any kind of over-the-counter drugs to relieve yourself from pain, do make sure that they are right for you (ask your pharmacist about potential side effects or about medication and medical conditions that may interfere with the treatment). Usually, over-the-counter drugs are safe to be taken for limited periods of time, but you can never be too sure about this.
Neck Pain Remedies and Exercises
There are a lot of things that you can do for your neck pain before (and even after) you visit your doctor. Some of these methods are generally considered to be “traditional”, while other methods are considered to be “alternative” (and most of them are influenced by the Asian culture and practices).
Among the traditional neck pain remedies is applying hot and iced packs on the area that hurts. You can simply use a heating pad (on medium or low setting) and apply it to the neck for 15-20 minutes once every 2-hours or 3-hours. Also, you can take a hot shower or you can use single-use heat wraps (but do bear in mind the fact that these will only last up to 8 hours). Some people believe that applying ice packs is more beneficial and if you want to do that, you should do it for 10-15 minutes once in a 2-hours or 3-hours period of time. Also, you may want to know the fact that although this method is commonly known, the truth is that there is not much evidence that it is truly effective.
Massages are also helpful, but it may be better to get them from a professional. However, gently massaging the painful area can help with pain relief.
For more serious conditions, your doctor will most likely recommend physical therapy. Attending these sessions is extremely important and you should definitely do it.
Some people believe that Eastern practices such as acupuncture and Tai-Chi can help. If you do decide that these techniques are helpful, do make sure that you only practice them with a professional that actually knows how to deal with people who have your kind of medical issue. Do not force yourself into anything and do make sure that you do not strain your neck even more. Also, make sure that you check with your doctor before you attend any kind of such session.
Acupuncture and Tai-Chi (as well as other Eastern remedies) are considered to be helpful in relieving chronic pain. Many fibromyalgia and myofascial syndrome patients choose these therapies for their benefits, but there are people who suffer from other conditions who believe they can be beneficial for their symptoms.
Acupuncture uses very small needles that are inserted into special areas of the body and this is believed to help because it sends impulses into the nerves (and thus, it can relieve pain). As beneficial as this practice may be, it is always of the highest importance that you undergo this kind of therapy only under the close supervision of an authorized professional who actually knows what he/she is doing. Otherwise, you may cause yourself even more harm and that is definitely not something you want.
Tai-Chi is a Chinese practice that uses very small and slow movements to stretch the body and to help its energy centers heal anything that may be wrong with it. This makes it popular among people who suffer from various medical conditions and although it is considered to be fairly safe, you should never do this without consulting with a professional first. Under certain circumstances, even the smallest wrong movement can make your pain worse.
Exercising (of any kind) is important when it comes to recovery, but you should definitely make sure to take this as slow as possible. If your pain is very severe and if it is associated with other symptoms (tingling, numbness, etc.), you should definitely consult with your medical professional first.
One of the exercises you can try out for neck strain is to very gently bend it forwards and backwards. Do this very slowly because otherwise you will not be able to reap all the benefits of the exercises, but you can hurt your neck muscles even more.
Slow neck retractions, side bends and rotations work the same way and they are usual exercises you can do at home as well. Another exercise you can try out is pulling your shoulder blades backwards and stretching the arms forwards after that. This exercise is especially good if your neck pain is situated on the lower end of the neck and if your shoulder blades show pain symptoms as well.
There may be many other exercises that help with relieving patients from pain, but they may not be completely safe to do without the supervision of a physical therapist. The best way to go around this, especially if you have a serious underlying medical condition is to talk to a specialist and establish what types of exercises are best for you. It is important that you find something you also enjoy doing because otherwise you may risk quitting sooner than you should and that will not have a positive effect on your general state.
Neck Pain Prevention: Things Everyone Should Know
Although certain medical conditions that lead to neck pain are not actually avoidable (such as arthritis that develops once the patient gets older), there are many things you should definitely do to avoid any kind of neck and back problems. Some of these things may have been covered briefly throughout this entire book, but it is extremely important that you should keep them in mind.
1- Avoid slouching and try to sit up straight as much as possible. Although it may seem that slouching is something that mainly affects the lower and middle back, it can affect your neck as well. When you sit, make sure you do not bring your head forward, that you keep your back up straight and that you lower your shoulders. Try to keep your back supported and your feet flat on the floor as much as possible. Also, always remember to take small breaks to stretch your back and your neck every hour. Furthermore, try not to sit for more than one hour and try to get up to move at least for a bit.
2- If you work at a computer on a daily basis, remember to adjust the monitor and the documents you use to be at your eye-level. This will prevent you from slouching and it will be better for your eyes as well.
3- If you drive a lot, do make sure that you adjust your seat so that you never have to bend your back too much. Your arms should be relaxed and easily flexed on the wheel as well.
4- If you work in a call center, do not hold your phone between your shoulder and your ear. Instead, use a headset.
5- When you sleep, use a good pillow that can actually support your neck. Do invest in a quality pillow, since this will be extremely important for the health of your neck and back. Also, do not sleep with your stomach or back bent, since this can lead to pain as well.
6- When you lift heavy objects, do make sure you bend your knees, rather than bending your entire back. This kind of mistake is among the first causes for injuries that lead to back pain.
7- Try not to gain a lot of weight (and to lose the extra-pounds if you have any) since every pound can weigh heavy on your entire vertebral spine. If you do decide that you have to lose some weight, do make sure that you do this the right way: eat healthily and work out.
8- Exercise regularly. This is something you should never avoid and something that will benefit your entire body, not just your neck or back. Your state of mind will be better, you will have more energy, you will sleep better, think better and, generally speaking, you will “function” better. Do remember to warm up for at least 5-10 minutes before performing any kind of exercise, since it can be very easy to strain your muscles otherwise (and this includes your neck muscles as well).
9- If you live a stressful life, do bear in mind that this can be one of the causes that lead to chronic pain as well. Try to relax, to practice relaxation techniques, to exercise and, if possible, to get professional massages every once in a while.