Neck Injuries and Disorders Introduction Any part of your neck can be affected by neck problems. These affect the muscles, bones, joints, tendons, ligaments or nerves in the neck. There are many common neck injuries and disorders. Treatment for neck injuries and disorders depends on the cause. It may include applying ice, taking pain relievers, getting physical therapy or wearing a cervical collar. In rare cases, surgery may be needed. This reference summary explains common neck injuries and disorders, including common symptoms and treatment options. The Neck The neck supports the head and keeps it aligned with the body. It is at the top most part of the spine. The spine also runs through the middle and the lower back. The neck is made up of vertebrae, joints and muscles. The vertebrae are the bones of the spine. They protect the spinal cord inside the bones and give support for muscles and joints. In between the vertebrae are disks. Disks separate the vertebrae and cushion them during movement. Joints link the vertebrae and allow them to move smoothly. These joints are known as facet joints. Nerves spread out from the spinal cord between the vertebrae. They carry signals from the brain to the rest of the body. They allow the brain to control body movements like the movements of the arm. Nerves also carry sensation from the rest of the body to the brain. 1
The neck muscles are attached to the bones of the shoulders, spine and head. They allow the head to turn from side to side. The muscles also allow the neck to bend forward and backward. The neck can bend from side to side as well. How much and how far a joint can move is called range of motion. The neck joints have a greater range of motion than any other joints in the body. Symptoms Many neck injuries and disorders have similar symptoms. The main symptom is pain in the neck. Pain may also come from your shoulder, jaw, head or upper arms. Other common symptoms of neck injuries and disorders are: Bruising. Difficulty moving the neck. Headaches. Pain when moving the neck. Swelling in or around the neck. Some neck injuries and disorders may also cause: Difficulty walking or loss of balance. Loss of bladder or bowel control. Numbness or tingling in the arms, hands, legs or feet. Weakness in the arms and legs. Talk to your health care provider if you notice any of these symptoms or other changes. Finding a problem early makes treatment easier in most cases. Whiplash Whiplash is a soft tissue injury to the neck. It is also called neck sprain or strain. Whiplash can have many causes. Common causes include: Car accidents. Contact sports. Physical abuse. 2
Car accidents are the most common cause of whiplash, especially rear-end collisions. These types of car accidents cause the head to be thrown backward and then forward suddenly. This pushes the muscles and ligaments in the neck beyond their normal range of motion, causing injury. Sometimes injuries from contact sports can cause whiplash. For example, a person playing football may be tackled in a way that forces the head to be thrown backward and then forward. Physical abuse is another possible cause of whiplash. Being punched or shaken can cause whiplash. Whiplash is one of the injuries seen in shaken baby syndrome. Shaken baby syndrome is a type of traumatic brain injury that happens when a baby is abused by being violently shaken. Treatment for whiplash can include: Medicines. Therapy. Foam collars. Over-the-counter or prescription pain medicines can help reduce pain caused by whiplash. In some cases, injections of a numbing medicine or an oral muscle relaxant may be given. Therapy is the main treatment for whiplash. Ice or heat therapy may be recommended, as well as ultrasound therapy. Exercises to strengthen and stretch the neck muscles can also help. Soft foam cervical collars may be worn temporarily. Cervical Fracture A cervical fracture is another name for a broken neck. A fracture can affect any of the seven bones in the neck, which are called the cervical vertebrae. Cervical fractures usually result from some type of high-energy trauma, such as car accidents or falls. Athletes are also at risk for a cervical fracture. For example, a cervical fracture can happen if: A diver strikes the bottom of a shallow pool. A gymnast misses the high bar during a release move and falls. An ice hockey player is rammed into the boards. 3
Any injury to the vertebrae can have serious consequences. The spinal cord runs through the center of the vertebrae. Damage to the spinal cord can result in paralysis or death. Injury to the spinal cord at the level of the cervical spine can lead to temporary or permanent paralysis of the entire body below the neck. Treatment will depend on which of the seven cervical vertebrae are damaged. It also depends on the type of fracture. A minor fracture can be treated with a cervical brace worn for 6 to 8 weeks until the bone heals. A more complex fracture may require traction and surgery. In some cases, 2 to 3 months in a rigid brace may help the bones heal. Arthritis Like the rest of the body, the bones in the neck slowly degenerate as we age. This frequently results in arthritis. Arthritis of the neck is called cervical spondylosis. Arthritis is caused by age-related wear and tear to the discs and joints in the neck. More than 85% of people over age 60 have arthritis in the neck, but most do not have symptoms. With arthritis, the cartilage that covers and protects the joints wears away. If the cartilage wears away completely, it can result in bone rubbing on bone. To make up for the lost cartilage, your body may respond by growing new bone around your discs and in the facet joints to help support the vertebrae. Over time, these "bone spurs" may narrow the space for the nerves to pass through. This causes pain and other symptoms of arthritis. Some people are at a higher risk for arthritis in the neck. These people have: A family history of neck pain and arthritis in the neck. A history of smoking. A job that requires lots of neck motion. An injury to the neck, such as from a car accident. Treatment for arthritis in the neck depends on the severity of the disease. Some people may not need treatment if they do not have any symptoms. 4
Non-surgical treatments are often tried first when treatment is needed. These may include: Medicines, such as pain medicines or muscle relaxants. Physical therapy to strengthen and stretch neck muscles. Soft foam collars. Steroid injections to reduce pain and inflammation. Rarely, surgery may be needed. Surgery is often only used when other treatments fail to provide relief from symptoms. Disc Problems Discs can bulge, and part of them can push out of the actual disc space. The former is known as a disc bulge and the latter as a disc herniation. Spurs, mentioned earlier, can also happen around the disc. Disc problems can affect any area of the spine, including the cervical spine in the neck. Normally, discs act as cushions between the vertebrae. As you get older, the center of a disc in the spine may start to lose water content. This makes the disc less effective as a cushion. The disc and surrounding vertebrae can deteriorate. The disc can also move out of place, causing a herniated disc. Spurs can also form. A herniated disc or a spur can press on nerves along the spine. This can result in pain, numbness, tingling or weakness in the limbs. Many people can be successfully treated with nonsurgical treatments, such as: Anti-inflammatory and pain medicines. Injections. Physical therapy. Rest. A soft foam collar. Surgery may be needed for more severe cases or if non-surgical treatments do not help. The goal of surgery is to remove the portion of the disc or spur pushing on the spinal cord or nerves. 5
Summary Any part of your neck, including the muscles, bones, tendons, ligaments or nerves, can be affected by neck problems. There are many common neck injuries and disorders, including: Whiplash. Cervical fracture. Arthritis. Disc problems. Many neck injuries and disorders have similar symptoms. The main symptom is pain in the neck. Pain may also come from your shoulder, jaw, head or upper arms. Other common symptoms are: Bruising. Difficulty moving the neck. Headaches. Weakness in the arms or legs. Treatment for neck injuries and disorders depends on the cause. It may include applying ice, taking pain relievers, getting physical therapy or wearing a cervical collar. In rare cases, surgery may be needed. 6