Neck pain is a source for a discomfort that almost every adult will experience during her on his life. The most common causes for the acute neck pain are soft tissue injury or inflammation, benign or malignant mass formation, ligamentous strain, aggravation of underlying degenerative conditions sometimes even without preceding trauma. Neck pain is usually self limited and associated with limited motion but not radicular symptoms. Occasionally, pain will radiate to the shoulders and sometimes down to the affected arms and hands. This pain can provoke anxiety for patients, but it is generally resolved within several weeks. This mechanical type of the neck pain is usually relieved with anti-inflammatory medications, heat packs and short-term immobilization. When such localized acute neck pain persists for longer periods of time or true radiculopathy is present, the patient should be evaluated by a specialist for the presence of a more serious conditions.
Acute cervical strain (whiplash) with neck pain and stiffness is often a result of the motor vehicle accident and typically rear end collisions. Patients can complain about the pain initially, however, the onset of the pain usually occurs one day later. Whiplash pain is usually accompanied by neck and upper back pain, upper shoulder pain, headache, sensation of tingling and numbness and persistent stiffness. Cervical x-ray is the first step to evaluate the condition. Patients should be assessed by a specialist and more advanced studies could be necessary if the severe neck pain persists, or true radiculopathy or other neurologic abnormalities are present.
Patients with persistent and progressively worsening in severity neck pain, associated muscle pain, weight loss and soft tissue atrophy need to be assessed by a specialist for possible infection, inflammation or malignancy.
Radicular arm pain is most commonly caused by nerve root compression at the cervical spine. The cause for the acute radiculopathy is generally a result of soft disc herniation. Also acute foraminal disc herniation can cause severe nerve root compression with severe radiating to the chest pain that can be confused with the cardiac or pulmonary condition. Chronic cervical radiculopathy is generally caused by spondylosis or degenerative spine arthritis, with osteophyte complexes (extra bone formation) that cause various degrees of central and neuroforaminal stenosis. Chronic radiculopathy usually accompanied by neck pain and limited motion. Facet arthropathy and degenerative disc disease may also contribute to headaches as a frequent symptom of the patients with chronic radiculopathy.