What Causes Neck Pain

Neck Pain & Postural Issues

Postural neck pain issues are by far the most common causes of neck pain. We live in a world that predisposes us to poor posture and our necks are one of the most common casualties.

When your posture isn’t mostly held within the ideal range your neck may suffer. If you habitually sit with rounded shoulders and a sunken chest it causes shortening and compression of the vertebrae and soft tissues of the neck. Over time, as the upper back muscles weaken and the soft tissues adapt, our necks can become chronically shortened and drop forward, this is called a ‘forward head carriage’. 

Another type of postural neck pain is neck pain caused by unnatural sleeping postures. If you spend 8 hours per night at an awkward neck angle it can be just as bad as working 8 hours per day at a poor workstation. 

The impact of poor posture and a chronically shortened neck tissues can induce muscle tightness, muscle trigger points, disc compression, scar tissue formation and joint inflammation. These kinds of changes are what turn a posturally compromised neck into a very stiff, sore neck. 

Neck Pain & Emotional Issues

There is a reason why phrases like ‘he is such a pain in the neck’ are part of our language. When we are under emotional stress many of us clench our necks and jaws. 

Jaw clenching, despite being slightly less common than neck clenching is far more well known, probably due to the fact that it makes a grinding noise and visibly wears out the poor teeth. Neck clenching is more the silent killer when it comes to neck pain, and it is an ultra common cause of neck pain. 

There is a wide spectrum of how intensely people clench their necks in relation to stress. It’s important to know it’s likely that if you do cause your own neck pain through clenching you won’t be fully conscious of doing it. These kinds of patterns are deeply ingrained into the subconscious and our habitual way of relating to a busy and or stressful life. 

The impact of stressy clenching on the tissues of the neck can be quite severe over time. The habitual muscle tension exerts powerful crushing forces on the neck tissues. Clenching can induce muscle tightness, muscle trigger points, disc compression, scar tissue formation, and joint inflammation. These kinds of changes are what over time turn clenching into a stiff, sore neck.

Neck Pain & Old Injuries  

One of the most common causes of stubborn neck pain is old injuries to the neck that were not properly treated. These injuries can range from car crashes, sports injuries, and falls right through to birth trauma. 

The most classic history behind an old injury causing present day neck pain is a past injury of some kind that leads to a period of pain, but that later settled. Then some years later, stubborn neck pain and/or headaches develop, seemingly out of the blue.. 

The simple fact is that injuries only heal if they are given sufficient rest. The human neck has to bear the weight of an unusually large skull relative to body size; it does this all day every day, year in and year out. In other words our old neck injuries often don’t get the rest they need to heal the same way a wrist or hand might. Add to this the fact that we don’t generally do much by way of rehab for neck injuries in our culture and you have a recipe for unhealed trauma.

Necks with unhealed injuries generally suffer from a combination of scar tissue build-up, joint inflammation, and chronic muscle tension. Some cases even develop osteoarthritis and degenerative disc disease. 

Neck Pain & Occupation

Most of us spend a very significant portion of our lives working, and our necks must come along for the ride whether they like it or not. 

The classic occupational neck pain these days is the one that relates to desk work. It has been estimated that we are only around 20% as physically active as our great grandparents. Office workers partly drive those stats. Necks don’t benefit from being sat still in one position all day every day’, because it just isn’t natural for them. Unnatural activity means unnatural strain. Muscle tightness, muscle wasting, muscles trigger points, disc compression, scar tissue formation, and joint inflammation are all potentially on the table.

Occupational strain isn’t limited to desk work of course.  Professional sportspeople, truck drivers, and tradespeople are all classic and self-explanatory examples. The common theme is repetitive or stubborn compression of the delicate tissues in the neck, either by persistently unnatural or excessive loading.

Neck Pain & Degenerative Disc Disease

All of us develop wear and tear in our necks over time.. It’s natural for the discs to gradually lose hydration and reduce in height eventually. In most cases, this is a completely painless and normal finding, and the only symptom is a slow, gradual loss of flexibility. There are times however when disc degeneration can cause pain. 

If a disc degenerates badly enough in the wrong spot it can lead to direct pressure and irritation of a  nerve root. An example of this is a cervical disc herniation where the disc’s jelly-like inner layer (nucleus pulposus) leaks out through a tear in the disc’s protective outer layer. This can happen through injury but usually it happens in discs that had become damaged over time.

Neck pain caused by pressure on a nerve in this way will often involve severe radiating pain down the arm and will also often be somewhat resistant to treatment with normal physical therapies. It is important to understand that having disc degeneration on your scan or X-Ray does not necessarily mean the disc is the cause of you pain, in fact, they are often not. Neck pain is complex.

Neck Pain & Osteoarthritis

Facet joints are delicate little weight bearing joints in your neck that sit just behind the discs. When the cartilage in a  facet joint degenerates enough it can lead to neck pain associated with osteoarthritis. 

Facet joint arthritis is usually a painless condition. If however it gets mixed up with other causes of neck pain (listed here) or other issues with health and well-being (like a poor diet or nutritional deficiencies for eg.) it can make for a very stiff and sore neck indeed. The joints can become stubbornly swollen, stiff, and inflamed. The pain associated with facet joint arthritis can often be managed surprisingly effectively given the right treatment approaches and a bit of persistence with exercises.

Neck Pain & Spinal Stenosis

Spinal stenosis occurs when degeneration within the spinal column affects the spinal canal, such as from a herniated disc that pushes into the canal or bone spurs that grow into the canal.

When the spinal canal narrows enough to put pressure on the spinal cord ‘myelopathy’ can result. Myelopathy is the name given to the process whereby compression of the spinal cord starts causing symptoms, such as general muscle weakness or problems with motor coordination in the arms, hands, legs, or feet. Needless to say these type of symptoms should be investigated as a matter of urgency when they arise.

Neck Pain & Foraminal Stenosis

The spinal nerves that poke out from your spinal column carry life-essential messages between the brain and body. As they leave the spine these nerves escape through little holes (foramina). Foraminal stenosis is the closure of these little holes due to degenerative change in the spinal tissues.

Foraminal stenosis can reduce the amount of space the nerve root has to work with, this can be associated with radiating pains, numbness, and weakness in areas connected to the nerve that is pinched by the narrowing. It can also cause aggravation within the neck itself.

Fortunately, as is the case with all the degenerative causes of neck pain, foraminal stenosis only accounts for very few cases of neck and neck-related pain.

Neck Pain & Infection

Infections can spread throughout the body via the bloodstream, and the neck are not immune to this fact of life. Infections invade from the outside but once they are inside the body they can travel far and wide. If an infection spreads to the spinal tissues it can cause pain in the neck. 

Meningitis is a viral or bacterial infection of the spinal cord that we have all heard of. Severe neck pain combined with body-wide symptoms like fever, chills, lethargy, vomiting, skin blotches, and light sensitivity is a cause to get checked up real fast!

Neck Pain & Rheumatoid Arthritis

Rheumatoid arthritis is a form of inflammatory, auto-immune arthritis where the body’s immune cells attack the cartilage and cause degenerative changes. 

Rheumatoid arthritis can affect the hips, knees, hands, feet, and also spine, including the neck. Degenerative inflammatory change to the joints and their associated connective tissues is what leads to back pain caused by rheumatoid arthritis. 

Neck Pain & Fibromyalgia

Fibromyalgia is not really a ‘disease diagnosis’, it is more of a ‘syndrome’ that we don’t  understand fully yet. Typically fibromyalgia involves persistent pain in the muscles, tendons, and ligaments in multiple areas of the body, often including the upper back and neck.

The true underlying causes of ‘fibromyalgia’ are most probably a complex mix of postural pain, present-day life stresses, past emotional trauma, and dietary intolerances. These are the areas of care in which we have seen bring the most meaningful changes for folks diagnosed with fibromyalgia.

Neck Pain & Spinal Tumors

Unfortunately for us cancer can set itself up anywhere in the body, it has been known to establish itself in the cervical spine and press against a nerve. There are rare specific bone tumors that can do this but by far the most likely cause of neck pain related to cancer is a spread (metastasis from another part of the body).

If you have neck pain and unexplained weight loss, night sweats or any other unexplained medical symptoms it is important to get checked out by professionals. And to not let Dr Google do the diagnosing, it’s important. 

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