Neck Pain


Anatomy of the Neck

The neck or cervical spine is made up of 7 vertebra, each separated by small gel like discs. Movement in the neck comes from a pair of joints on each vertebra which glide against either the vertebra above or below. These joints are called facet or Z joints and enable the head and neck to bend forward, extend backwards, rotate left and right as well as lateral bend to the left and right. The spinal cord passes through the vertebra and as it passes down to the lower back, nerve roots arise off the cord on both sides (left and right) at each level of the cervical vertebra. These nerve roots supply sensation, movement etc to the shoulder, arm, forearm, hand and fingers/thumb.

Neck Pain and Pinched Nerves

People often talk about having a “pinched nerve” in their neck when they have localised neck or neck/shoulder pain. This is a misnomer, it is possible to have a pinched nerve, but it is usually caused by more serious factors such as a disc injury, moderate to severe osteoarthritis in the cervical spine, displaced cervical vertrabe, a space occupying lesion (ie. tumour). This results in referred pain such as pins and needles, tingling, numbness, weakness into the arm, forearm, hand, fingers.

Mechanical neck pain, that is “conditions causing neck pain with or without referral into the shoulder and upper arm” (Aker,, 1996, British Medical Journal) usually has local neck and/or shoulder pain without numbness, tingling, burning, weakness. Mechanical neck pain is the correct term for localised neck/shoulder pain as opposed to a “pinched nerve in the neck”. Its causes are varied but can include restricted movement of the facet joints, muscle spasm, mild osteoarthritis, minor trauma (such as mild whiplash) among other causes. Research shows that mechanical neck pain usually responds well to conservative therapy such as spinal manipulation combined with exercise rehabilitation.