Common Causes of Chronic Neck Pain

Dr.ALexander Feldman

Alexander FeldmanAs a practicing neurologist specializing in the diagnosis and treatment of various types of pain, I am helping a growing number of patients suffering from chronic neck pain. And because there are so many possible reasons and causes for this condition, a proper diagnosis can sometimes be challenging.

By chronic neck pain (often referred to as cervical pain) we should understand a condition that lasts longer than 3 months. The actual pain may result from any kind of disorders and diseases that affect almost any tissue, bone, or gland located in the neck area. These disorders often trigger the muscles of their necks feeling tender, numbness, tingling, sharp shooting pains, difficulty swallowing, dizziness, and other conditions.

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Facet joints are among the most common causes of chronic neck pain. Facet joints are small stabilizing joints located between and behind adjacent vertebrae. Because these synovial joints are deep in the spine, you cannot feel them, and you cannot see them without imaging studies. Your facet joints function like your knee, or your shoulder: they can become painful or arthritic just like your knee or your shoulder. Basically, the same kinds of things you can do to a knee or a shoulder you can do to the facet joint, especially in whiplash injuries where the neck snaps backwards. Facet joint pain is the most common cause of chronic neck pain after a car accident.

Another common cause of the chronic neck pain is a disc injury. The pain coming from the disc usually signals about a tear inside of the disc. The outer wall of the disc (called the annulus) can be torn by a whiplash injury. The disc might get weaker and hurting when stressed during normal activities. The actual pain comes from the nerve endings in the annulus. About 1/3 of all chronic pain sufferers complain of disc pain, and there can be both disc pain and facet joints pain in some people.

The above mentioned conditions are by far the two most common causes of chronic neck pain. Other disorders, like muscle strain of the neck, can cause acute neck pain, but usually heal within a short period of time. In some people, chronic neck pain may be caused by a pinched nerve from a herniated disc, but such cases are relatively rare.  Herniated discs usually cause arm pain, and not chronic neck pain.

Understanding the cause of pain is the key to proper treatment. In reviewing the history of symptoms, the neurologist must note the location, intensity, duration, and radiation of the pain. Any past injury to the neck and past treatments should be noted. Aggravating and relieving positions or motions must also be recorded, both at rest and in motion. Tenderness is detected during palpation of the neck. An examination of the nervous system is performed to determine whether or not nerve involvement is present.

Further testing of undiagnosed neck pain can include X-ray evaluation, CT and MRI scans, Electromyography (EMG), nerve conduction velocity test (NCV), and other. If you are in Denver, and suffering from any of the above described conditions, please call our center today.

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