What a pain in the neck.

If you have ever experienced neck pain then you will know that it often begins suddenly and that it will most likely at worst last a few days. If this pain does not go away or becomes unbearable with simple pain relief then you may need treatment. This article looks at the latest research regarding the treatment of pain in the neck.

What can you expect?

There are several types of pain that one may get in their neck and the various types have differing causes. The most common type of neck pain is something that we call simple neck pain. Often with simple neck pain you will not know the cause of the pain and the doctor may not be able to help in this instance. Often this pain is the result of one having bad posture or stress. It is also possible that simple neck pain started as the result of pulling some of the ligaments or muscles in your neck, or it could even be because your head was in an awkward position during sleep. In older patients this pain may be due to the wear and tear that the joints and bones in your neck undergo as you age. Another type of neck pain comes about as the result of nerve damage. This is most commonly due to the discs pressing on the nerves as they come out of the spinal cord between the discs. A further type of neck pain can come about as the result of whiplash. This occurs most commonly on the sports field or in car crashes.

What symptoms occur with neck pain?

The majority of neck pain begins suddenly and you will most certainly know about it as it often causes much distress to the patient. More often than not the neck will be painful and moving will cause pain or discomfort. Sometimes as a result of the way that the nerves are positioned in the neck it can cause pain to spread up to your head or down into your shoulders and even arms. It is very important that you tell your doctor if your hands feel numb, weak or are tingling. Symptoms like this can occur because of a problem with a nerve or could be the result of one of the bony discs pressing on your nerve. If the pain in your neck does not feel better in a few days time, or if you feel as though it is getting worse then it is important to see your doctor. Your doctor will be able to rule out the more serious causes by taking a history and examining you or by ordering an X-ray or another type of scan. In some cases a blood test may even be done to look for inflammation or infection.

Are there treatments?

There are treatments that you can do that do not involve the use of medication and in many cases these should be tried first. Physiotherapists are experts in the field of manipulation and mobilisation and you will most likely benefit from seeing these health professionals. The important thing to note here is that some people do get injured as a result of having their necks manipulated and it would be wise to see your doctor first to see if this form of treatment is right for you. Visiting the doctor first is essential as they will be able to rule out more serious causes of neck pain that these therapists will not be able to pick up as they do not have the tools to do so. The benefit of this therapy is that the therapist will often give you exercises that you can do in the long term to strengthen your neck muscles and stop the pain from reoccurring.

There is research coming out now which looks at the benefits of acupuncture in patients with neck pain, Unfortunately at this stage not all of the studies are reliable and so the decision to undergo this form of therapy is very much up to the patient.

Many other forms of non-medical treatments have been tried to rid ones neck pain but once again the research for these techniques is limited at best. Some things that you may try include cold and hot packs, soft collar neck braces, special pillows to help you sleep, and stimulation of your nerves with an electrical current to interfere with the pain pathway.

Medications can help patients with neck pain although unfortunately there is no research that shows specifically that medicines help with neck pain. Painkillers that you can buy over the counter such as paracetamol may help in the short term. You can also try NSAIDS (Non-steroidal anti-inflammatory drugs) which reduce inflammation and are effective as reducing pain, but these have side effects if used in the long term. For stronger painkillers you will need to visit your family doctor, also if the pain persists after taking paracetamol and NSAID’s for a few days then you should visit your doctor anyway.

Interestingly antidepressants can be effective in patients that have had neck pain for a long time. This does not mean that the pain is the result of you being depressed. We do not fully understand why antidepressants have this affect on pain but they are certainly effective in many people. They do come with side effects though that include constipation, dry mouth, dizziness and nausea.

Muscle relaxants can be used in patients who have spasms or uncontrollable twitching of muscles in their neck. These can only be used in patients for a short amount of time but may give them a great sense of relief. These include drugs such as benzodiazepines. Unfortunately these drugs can make you feel drowsy, dizzy, or nauseas. They are also addictive and as such should be avoided for long periods of time.

Steroid injections can be used in some patients to reduce more severe pain that does not go away with simple pain relief. Unfortunately here there is a small risk of getting an infection or a collection of pus in your neck called an abscess following this treatment.

Surgery has not been shown to be effective in patients with neck pain and so you should not consider discussing this pathway unless recommended by your family doctor.

Final comments.

It is important to note that the majority of neck pain will go away within a couple of days to a week and can usually be managed with simple pain relief. Neck pain can come back or last for a longer period of time the second time around. If this is the case or if you are ever worried about it you should see your family doctor. Neck pain is extremely common and recent research has shown that 1 in 10 people have neck pain that lasts for a long period of time.

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