Seeking Medical Care for Neck Pain

Neck pain is one of the most common musculoskeletal disorders seen in the adult population, with prevalence rates ranging from 16.7% to 75.1% around the world [1]. With the aging population, the prevalence of neck pain is expected to rise over the coming years. This is cause for concern because neck pain can have a detrimental impact on an individual’s physical, psychological, and social well-being, and can drastically reduce an individuals’ quality of life. Additionally, neck pain has the ability to cause significant disability and morbidity and can contribute to increasing costs to society [1]. Understanding what neck pain symptoms warrant a visit to a healthcare practitioner is essential as neck pain can be an indicator that there is an underlying, more serious problem that needs to be addressed.

 

Causes of Neck Pain

The etiology of neck pain is quite complex and includes a number of factors, including [1]:
-Ergonomic factors (i.e. incorrect postural positions, repetitive movements, exposure to vibration, vigorous physical activity, etc.)
-Individual factors (i.e. genetics, age, past medical history, body mass index, etc.)
-Psychosocial factors (i.e. stress, depression, anxiety, level of job satisfaction, etc.)

 

The Neck Pain Task Force Classification System

The Neck Pain Task Force has recommended a classification system that includes 4 grades of neck pain that is determined by the severity of pain [2]:

Grade I – no signs or symptoms of major structural pathology, with limited or no affect on activities of daily living.

Grade II – no signs or symptoms of major structural pathology, with a major affect on activities of daily living.

Grade III – no signs of symptoms of major structural pathology, with neurological signs of nerve compression.

Grade IV – signs of major structural pathology, including conditions such as fracture, infection, spinal cord injury, tumor, and systemic disease.

 

Categorizing Neck Pain and Cervical Spine Disorders

Neck pain is typically categorized as mechanical neck pain, radiculopathy, or myelopathy.

Mechanical neck pain refers to neck pain without radiculopathy, myelopathy, or a notable serious underlying pathology. This type of pain may be referred to as myofascial pain, muscle strain/sprain, facet joint pain, etc. [3]. Mechanical neck pain is the most common type of neck pain, with acute episodes resolving in days to weeks, with symptoms becoming chronic in about 10% of individuals [4]. Mechanical neck pain often resolves on its own without treatment; however, in some cases, especially patients with chronic pain, treatment will help to decrease symptoms and improve function.

Radiculopathy and myelopathy are more serious than mechanical neck pain. Radiculopathy refers to a constellation of symptoms that results from the dysfunction of one of more nerve roots in the cervical spine, while myelopathy is the result of spinal canal narrowing leading to nerve root or spinal cord compression, most often due to spondylosis [4]. Radiculopathy and myelopathy often require a consultation with a medical professional to determine the best course of care.

 

When to Seek Medical Care

While most cases of neck pain are harmless, and will resolve within days to weeks, there are circumstances when an individual should seek out medical care. “Red flags” refer to factors that suggest that there is a significant, and potentially life-threatening, underlying condition associated with the individual’s neck pain.

If an individual has any of the following symptoms they should seek medical attention immediately and be referred to the appropriate medical professional [5]:

If an individual has any of the following symptoms they should seek medical attention immediately and be referred to the appropriate medical professional [5]:

  • Trauma (i.e. motor vehicle accident, significant fall, etc.)
  • History of rheumatoid arthritis
  • Progressive worsening of symptoms
  • Symptoms of infection (i.e. fever, lethargy, etc.)
  • Constitutional symptoms (i.e. night pain, weight loss, anorexia, history of cancer, etc.)
  • Neurologic symptoms (i.e. numbness, weakness, gait disturbances, increased muscle spasticity, etc.)
  • Tearing/ripping sensation in neck
  • Concurrent chest pain, sweating, and/or shortness of breath

 

Conclusion

While most cases of neck pain are not sinister in nature and resolve within a short period of time, there are certain circumstances that necessitate further medical assessment to rule out serious underlying conditions. Additionally, at the end of the day, if an individual is concerned about his or her neck pain symptoms, an appointment with a healthcare practitioner can help to assess the condition to determine the underlying cause and put the individual’s mind at ease.

 

References

1.Genebra C, Maciel N, Bento T, Simeão S, Vitta A. Prevalence and factors associated with neck pain: a population-based study. Braz J Phys Ther. 2017;21(4):274-280. doi:10.1016/j.bjpt.2017.05.005.
2.Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G. Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med. 2010;9(2):49-59. doi:10.1016/j.jcm.2010.03.002.
3.Evans G. Identifying and treating the causes of neck pain. Medical Clinics. 2014;98(3):645-661.
4.Binder AI. Neck pain. BMJ Clin Evid. 2008;2008:1103.
5.Teichtahl AJ, McColl G. An approach to neck pain for the family physician. Rheumatology. 2013;42(11):774-777.

 

 

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