Introduction Over many years, our necks are subjected
to repeated stress and minor injury. These injuries
may not cause pain at the time of injury. However,
repeated injuries add up, and can eventually result
in degeneration of the cervical spine, causing neck
pain. Most neck pain is due to degenerative changes
that occur in the neck. The overall condition of the
cervical spine usually determines how fast you recover
from an injury, and whether your neck pain will become
a chronic problem.
For chronic neck
pain, there may not be a quick fix or complete cure.
You will need to work with your health care team
to try to improve the problem causing pain and to
slow down the
degenerative
process. The physician's role in the treatment of
neck pain is to find the main causes that need treatment
right away. He or she will also try to keep your neck
pain from becoming a chronic condition by teaching
you how to slow down the degenerative process and
prevent further injury.
The
purpose of this information is to help you understand:
•
The
causes of neck pain
•
The
normal anatomy of the spine and neck
•
The
signs and symptoms of degenerative changes in the
neck
•
The
treatments available to you now and later
•
What
you can expect from those treatments
•
What
you can expect long-term if you have a problem with
neck pain
In order to understand your symptoms and treatment choices,
you must start with some understanding of the general anatomy
of your spine and neck. This includes becoming familiar
with the various parts that make up the neck. You should
have a general understanding of the function of these parts,
that is, how they work together. The more you know, the
more you will be able to talk with your doctors and health
care team in words that will help them better understand
your specific problem. It will also help you understand
what they are telling you about your particular problem.
The purpose of this information
is to help you understand your neck pain problem, so you
can make the decisions that will best help you to prevent
injury, make the best treatment choices, and speed up
the healing process.
The
Parts of the Cervical Spine and How They Work
In general, the neck includes the cervical spine (the
upper most part of the spine) and the soft tissues
that surround the cervical spine. These soft tissues
include: nerves, muscles, ligaments, tendons, and
blood vessels. The cervical spine is made up of the
first seven vertebrae in the spine. Your doctor will
usually refer to these bones as C1 through C7. The
cervical spine starts just below the skull and ends
just above the thoracic spine. The spine has two main
functions:
• To protect and support the spinal cord
• To give structure and support to our body
allowing us to stand up straight
The vertebrae are the 24 bones that are linked together
to make up the spinal column. Just as the bones of
the skull protect our brain, the bones of the spine
protect the spinal cord. The spinal cord is the large
collection of nerves that connects the brain to the
rest of the body.
In the center of each vertebra is
a large hole. Because the vertebrae are all linked
together, these holes line up to form a "bony
tube", called the spinal canal, through which
the spinal cord passes. This bony tube makes up
the spinal canal, which provides protection and
support for the spinal cord.
As the spinal cord leaves the brain,
it travels down the spinal canal to the tailbone.
Along the way, it gives off smaller nerves that
leave the spine between each vertebra through an
opening called the foramen. The nerves that leave
the spine in the upper area, or the cervical spine,
travel into the arms to the hands. The nerves that
leave the spine in the chest area, or thoracic spine,
mostly go into the chest and belly area. The nerves
that leave the spinal canal in the lower spine,
or the lumbar spine, travel into the legs and feet.
To better understand how the parts of the spine
work together, let's look at a spinal segment. A
spinal segment is made up of: two vertebrae, the
intervertebral disc between the vertebrae, and the
two nerve roots, one from each side that "branch
off of " the spine. The cervical vertebrae
are the smallest vertebrae in the spine because
they do not have the weight-bearing function of
the vertebrae in the back. One pair of spinal nerves
exits through the gap between the vertebrae in each
segment. One common cause of pain comes from pressure
on the nerve roots, sometimes causing pain and numbness
in the neck or in the lower body.
The space between
two vertebrae contains a large round disc of connective
tissue, called an intervertebral disc. By looking
at the intervertebraldisc
from above, we can see an outer ring, called the
annulus,
and
a soft spongy center, called the nucleus pulposus.
The annulus is the best part of the disc and
helps keep the spongy center inside the disc. The
nucleus pulposus acts as a shock absorber to cushion
the bones from pressure during twisting, jumping,
and weight bearing.
A
joint is formed where two or more bones meet. Bony
knobs, called facets, extend from each vertebra
and overlap each other to form a facet joint. Facet
joints link the vertebrae together like a chain,
and provide a mobile connection between each vertebra.
The facet joints are important because they allow
the neck to bend and turn. Each vertebra can move
only a little, but the chain of small movements
combined makes the spine very flexible.
