The cervical spine in the neck is a complex structure that has great bearing on one’s health and vitality. It is comprised of seven bones or vertebrae that are the most flexible in the human spine.
The top vertebra is called the atlas and is shaped like a hoop. The atlas rests on the second vertebra, called the axis which pivots around a post like structure called the dens. There is no disc between the atlas and axis and this is where the majority of neck movement occurs when you turn your neck. The remaining five vertebrae are connected with discs.
The neck supports the weight of the head and contains part of the brain stem and the uppermost part of the spinal cord. Nerve roots branch out from between the neck vertebrae and converge to form the peripheral nerves that control the upper extremities (shoulder, upper arm, lower arm, wrist, and hand). Vertebral arteries run through the edges of the neck vertebrae and supply blood to the cerebellum which is the part of the brain involved with balance and coordination. The esophagus and larynx are situated in front of the cervical spine. Finally, several sets of muscles envelop the cervical spine and control precision movement. With all these delicate structures in one small area, it is easy to understand the neck’s potential to cause numerous kinds of problems if everything isn’t in working order.
The most frequent cervical injuries in athletes are probably acute strains and sprains of the musculature of the neck, as well as soft-tissue contusions.
A strain refers to an injury to a muscle, occurring when a muscle-tendon unit is stretched or overloaded. Cervical muscles that are commonly strained include the sternocleidomastoid (SCM), the trapezius, the rhomboids, the erector spinae, the scalenes, and the levator scapulae.
A sprain refers to a ligamentous injury, and the diagnosis of cervical sprain implies that the ligamentous and capsular structures connecting the cervical facet joints and vertebrae have been damaged. Clinically, a cervical sprain may be difficult to differentiate from a strain, and the 2 injuries often occur simultaneously. Pain referred to the muscle can arise from any source that is modulated by the dorsal rami.
Discs are the tough ligaments that hold vertebrae together while allowing them to move in unison. A disc is comprised of two main parts, an outer annulus and an inner, jelly-like structure called the nucleus pulposus. When healthy, the tight rings of the annulus keep the nucleus inside. When weakened, the nucleus can punch though the annulus, making it to the outside. This usually occurs from trauma, lifting a heavy load, or in rare cases, simply coughing or sneezing. The condition is called a herniated nucleus pulposus, or HNP for short. Being that the outer layer of the annulus has a high density of nerve endings, HNPs can be very painful. If the nucleus presses against a nerve root, it may cause radiating pain down into the arm.
Degenerative joint disease can cause bony projections to narrow the canal where the spinal cord resides. As a result, the spinal cord can get compressed. This can lead to local pain and bilateral numbness and weakness below the compression site.
Chiropractic adjustments and manual therapy techniques can help some cases of neck pain by gently moving the joint through its physiological range of motion, which improves disc hydration and facet movement. Adjustments also help to prevent the soft tissues surrounding the spine from shortening and calcifying.
Characteristics of neck pain include:
* Pain that occurs from the bottom of your head to the top of your shoulders. Pain may spread to the upper back or arms.
* Pain that is worse with movement.
* Limited head and neck movement. The neck may be stiff or tender.
* Headaches. These are common and may persist for months.
Nerve-related symptoms caused by pressure on the spinal nerve roots or spinal cord include:
* Numbness, tingling, or weakness in the arm or hand.
* A burning feeling when touched on the skin of the arm or hand.
* A pain that feels like a shock and extends into the arm or hand.