Neck Pain Causes

1. Inflammatory and Infectious Disorders

Though infections and inflammation of the cervical spine are rare, if they are neglected for a period of time, or if there is a delay in diagnosis, they can become a significant source of pain and disability. Inflammatory spinal disorders include arthritis where inflammation is behind the cause of pain in the joints of the spine. Inflammation is a body’s natural response to tissue irritation or damage, and it can cause swelling, redness, heat, and loss of function. Inflammation of a joint is called arthritis, and it can be confined to a single joint, or it may be wide-spread, as in rheumatoid arthritis. Figure 2 illustrates the “crooked” or kyphotic cervical spine in a patient with rheumatoid arthritis causing compression on the spinal cord.

2. Trauma

Cervical spine injuries can range from mild cases of neck pain, called whiplash, to injuries that can cause paralysis of the rest of the body below the level of injury.

3. Tumours

The most common initial symptom that patients with a spinal tumor have is pain. Because neck pain is very common, it is also not a specific symptom of any medical condition.

Spinal cord tumors can be either primary (originating in the spinal cord), or secondary (metastases or spread of cancer that originated elsewhere in the body). Pain that continue to get worse despite treatment, or associated with other symptoms such as fatigue or weight loss, may suggest that a tumor is responsible. The pain may be worse at night. Pressure on the spinal cord and/or nerve roots that exit the spinal cord can cause pain, numbness, tingling, and weakness. Be aware of other physical symptoms, such as lumps and bumps, moles on your skin, and any other findings that might suggest that you have a tumor somewhere else in your body. Figure 4 shows destruction of the odontoid (second cervical vertebra) on CT scan due to nasal cancer.

4. Mechanical Problems

Mechanical problems are the most frequently encountered causes for neck pain. As a result of the natural degeneration conditions of the neck that occurs with aging, certain parts of the cervical spine start to degenerate and wear out. This process makes some of the structures of the cervical spine less flexible and less resistant to injury. Pain can be due to the loss of normal surface cartilage in the joints of the cervical spine, tears in the ligaments that surround the intervertebral discs, herniated intervertebral discs, and bone spurs that may be pressing on nerve roots or the spinal cord. These changes can create a variety of symptoms, ranging from sharp neck pain, arm and shoulder pain, arm numbness and tingling, to difficulty walking. Common mechanical problems are herniated disc and cervical spinal stenosis.