On the Mend
Joe DiVincenzo
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Nearly everyone will experience a bout of neck pain at some point over the course of a lifetime. It's an unpleasant and unavoidable part of the human experience — plain and simple.
The cervical spine is a complex and delicate region of the body that has a number of structures capable of producing pain at any given time.
Quite possibly the two most common sources of pain, disc bulges and disc herniations can and do occur in the vast majority of the population — it's just a matter of when.
Disc problems range in severity from mere inconveniences to completely disabling catastrophes. Most cases will resolve on their own within a few weeks, but if your case is slow to resolve or if you're failing to make progress, read on to see if you have any of the classic signs of cervical disc dysfunction.
Deep pain in the neck and shoulder blade are hallmark symptoms of disc disease. Pain in this pattern — especially if it feels like there's a knot in the muscle of the shoulder blade — typically indicates that a disc has gone awry. If the feeling doesn't pass in a couple of weeks, get checked out.
One-sided neck stiffness and pain may indicate a disc bulge. Classically, discs cause a sensation of stiffness and pain that, ironically enough, is described as a 'stiff pain.' Focal disc bulges — which are the most common type (more than 80 percent) — cause a loss of range of motion and pain that is consistent from day to day. Pain that migrates or changes its nature frequently is likely not from a disc.
If looking up towards the ceiling causes pain or pinching in the base of your neck, it's probably because there's a disc bulge occupying space. Cervical extension (looking up) closes the vertebrae snugly on top of the disc, squeezing sensitive nerve endings. There's an old saying — you can't shut the barn door if the horse's head is in the way.
Numbness and tingling anyplace in the arm probably means that a disc is pinching a nerve. The term "pinched nerve" is the common slang term for compressive neuropathy.
Nearly all compressive spinal neuropathies are resultant from disc bulging or rupture. Pressing the nerve against the spinal wall usually causes severe symptoms. If this is the case, begin therapy as soon as possible or permanent nerve damage could occur.
If you've lost strength in your arm it's likely because of nerve root compression. In addition to sensory disturbance, nerve root compression may cause you to drop things, struggle to open jars or even have difficulty lifting the comforter off to make the bed.
If your neck makes a lot of noise when you move your head, it could be a sign of increased joint pressure. Joint pressure builds up when the mechanical parts to the neck no longer move congruently.
The snapping and crunching you feel when turning your head is a distinct sign that something is out of alignment.
Gloucester resident Joe DiVincenzo is a physical therapist and clinical specialist in manual therapy. He writes "On the Mend" weekly. Questions may be submitted to Joe by email at joedivincenzo@comcast.net.
