Latest update April 20th, 2024 12:59 AM
Apr 01, 2018 Features / Columnists
By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
Two out of three of us will have neck pain at some time in our lives. In most cases, it is not due to a serious disease or neck problem, and often the exact cause for the pain is not clear. Most persons tend to think that their high blood pressure is causing the neck pains and often present for “pressure treatment” instead of treatment for their neck pains.
Today, we will focus on neck pains and figure out where high blood pressure fits into all of this.
WHAT ARE THE TYPES AND CAUSES OF NECK PAIN?
Types and causes of neck pain include:
• Nonspecific neck pain – This is the most common type. This is sometimes called ‘simple’ or ‘mechanical’ neck pain. Often the exact cause or origin of the pain is not known. It may include minor strains and sprains to muscles or ligaments in the neck.
• A ‘whiplash’ jolt to the neck – This is most commonly due to an accident involving a vehicle, such as a car crash. It can cause neck pain.
• Sudden-onset (acute) torticollis – This is sometimes called ‘wry neck’. A torticollis is a condition in which the head becomes twisted to one side and it is very painful to move the head back straight. The cause of acute primary torticollis is often not known. However, it may be due to a minor strain or sprain to a muscle or ligament in the neck.
• Wear and tear (degeneration) – Wear and tear of the spinal bones (vertebrae) and the discs between the vertebrae is a common cause or recurring or persistent neck pain in older people.
• Cervical radiculopathy – When the root of a nerve is pressed on or damaged as it comes out from your spinal cord in your neck (cervical) region, the condition is known as cervical radiculopathy. As well as neck pain, there are symptoms such as loss of feeling (numbness), pins and needles, pain and weakness in parts of an arm supplied by the nerve.
• Rarer and more serious causes – These include rheumatoid arthritis, bone disorders, a heart attack, infections, cancers and serious injuries that damage the vertebrae, spinal cord, artery or nerves in the neck.
HOW WILL I KNOW WHAT’S CAUSING MY NECK PAIN?
Your best option is to go visit your doctor who will talk to you and do an exam. Often testing may not be needed, since your doctor may find the cause after examining and talking with you.
Sometimes your doctor might order imaging tests to get a better picture of the cause of your neck pain. Examples include:
• X-rays – X-rays can reveal areas in your neck where your nerves or spinal cord might be pinched by bone spurs or other degenerative changes.
• CT scan – CT scans combine X-ray images taken from many different directions to produce detailed cross-sectional views of the internal structures of your neck.
• MRI – MRI uses radio waves and a strong magnetic field to create detailed images of bones and soft tissues, including the spinal cord and the nerves coming from the spinal cord.
HOW CAN I TELL IF THE PAIN IS DUE TO A MORE SERIOUS CAUSE?
The following are the sort of symptoms that may indicate a more serious problem:
• If neck pain develops when you are ill with other problems such as rheumatoid arthritis, AIDS, or cancer.
• If the pain becomes progressively worse.
• If some function of an arm is affected. For example, weakness or clumsiness of a hand or arm, or persistent loss of feeling (numbness).
• If you feel generally unwell and have ‘general’ symptoms such as weight loss or a high temperature (fever).
• If the neck bones (vertebrae) are very tender (which may indicate a bone problem)
• If you develop any problems with walking or with passing urine. This may indicate problems with pressure on the spinal cord.
WHAT ARE MY TREATMENT OPTIONS?
The most common types of mild to moderate neck pain usually respond well to self-care within two or three weeks. If neck pain persists, your doctor might recommend other treatments:
• Medications – Your doctor might prescribe stronger pain medicine than what you can get over-the-counter, as well as muscle relaxants and tricyclic antidepressants for pain relief.
• Therapy – You may get referred to a physical therapist who can teach you correct posture, alignment and neck-strengthening exercises, and can use heat, ice, electrical stimulation and other measures to help ease your pain and prevent a recurrence.
• Traction – Traction uses weights, pulleys or an air bladder to stretch your neck gently. This therapy, under supervision of a medical professional and physical therapist, may provide relief of some neck pain, especially pain related to nerve root irritation.
• Short-term immobilization – A soft collar that supports your neck may help relieve pain by taking pressure off the structures in your neck. However, if used for more than three hours at a time or for more than one to two weeks, a collar might do more harm than good.
• Surgical and other procedures – Your doctor may give you injections near the nerve roots, into the small facet joints in the bones of the neck or into the muscles in your neck to help with pain. If all of this fails, then surgery may be the last option to fix the defect.
You would have noticed that I did not mention much about high blood pressure with neck pains. That’s because high blood pressure does not cause neck pains (unless it bursts an artery in your neck – which is extremely rare). Almost all the time it’s your neck pain that is causing your pressure to go up and not the other way around.
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