Neck pain is extremely common, prompting many physician visits per year. In fact, about half of the population experiences neck pain at some time. It is second only to low back pain in frequency of patient complaints. Why neck pain occurs is, therefore, a question doctors are frequently asked. A brief explanation of the structure of the neck may prove helpful in understanding neck pain.
The spine may be compartmentalized into 3 separate sections: the neck, the mid back and the low back. When one talks about the neck, one is referring to the cervical spine, which is comprised of the top 7 vertebrae, the vertebral joints which connect them, and the ligaments and muscles that provide neck stability, function, and movement. More than other areas of the spine, the neck has a greater range of motion, especially in rotation. The neck also balances the head, a significantly heavy object, through an infinite number and variety of positions for hours on end. In effect, the neck has a complicated and important role to play and the specialization of its structures reflect these complex functions all of which means, in terms of potential muscle fatigue and the effect of degenerative changes or trauma, that the neck is vulnerable to injury and susceptible to pain.
With any physician visit for the evaluation of neck pain, a thorough history in conjunction with a comprehensive physical examination is performed. This includes evaluation of neck range of motion and a detailed neurologic evaluation of the spinal cord and limbs, including muscle strength, skin sensation, and examination of reflexes. The diagnostic evaluation may include X-rays and, depending upon the results, further diagnostic tests such as advanced imaging studies (CT scan, MRI, myelogram) might be suggested.