Neck pain – or mechanical neck pain, in medical terms is caused by a host of factors. It is mostly due to the joints in your spine, the facet joints. These joints are located on both sided between the vertebrae and carry the weight of the spine along with the discs between the vertebrae. With damage to the discs, the weight is carried mostly by the joints and this can lead to osteoarthritis. This is a wear-and-tear kind of arthritis. Many people are predisposed to this kind of arthritis on a genetic basis. There are other factors such as pain from the discs, ligaments and other structures surrounding the spine that contribute. Sometimes injuries such as whiplash injuries will contribute to – and speed up – this degenerative process

The nature of damage to these structures is that the damage and resulting pain is cyclical and fluctuant in nature. As the damage mounts over time, the pain becomes more intense and the periods of pain last longer. Eventually it becomes permanent.

How can it be treated?

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Mechanical neck pain as above can give pain that extends beyond the neck. This is because the spine is very rich in nerves and all structures in the spine have nerves and these nerves can communicate with other nerves and pass the pain along in them to other regions of the body. Pain that is caused by the facet joints, discs and structures surrounding the spine can cause pain that extends into the shoulders, between the shoulder blades, down to the arms and up to the face and also causes headaches.

Pain that extends beyond the shoulder is usually because one of the major nerves that run down the arm is being compressed. This is a different situation to the pain above. The pain caused by mechanical back pain that extends to other parts of the body is called referred pain. Pain that extends beyond the shoulder is usually an indication of nerve compression. These large nerves that run down the arm are usually compresses because of a narrowing of the canal in which these nerves run. The compression can be caused by a slipped disc or by bony spurs that grow from the vertebrae (osteophytes).

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Mechanical neck pain is usually worse on neck movement. My patients will frequently tell me that they have pain when sleeping and suffer from a stiff neck and turning in bed can be quite painful. Trying to look up and bending the neck towards one side can also be painful. It is frequent to have referred pain to the shoulders, between the shoulder blades, down to the arms and up to the face and it also causes headaches.

This is a condition where the whole spinal canal is narrowed and all the nerve roots that supply the arms are being compressed. This is a slowly progressive condition and results from a combination of factors. It is usually a combination of slipped discs and enlargement of the joints of the back and thickening of the ligaments inside the spinal canal. This can be a hereditary condition but is usually a wear-and-tear age related condition affecting person in their sixth decade and beyond. The result is weakness of the arms with spasticity in the arms and legs. This is an extremely dangerous situation that requires surgery urgently.