Uncovering the root causes of chronic neck pain: What you need to know

Chronic neck pain is a multifaceted condition that causes persistent discomfort that requires a personalised approach to treatment. While occasional neck discomfort is common and often resolves on its own, persistent pain can indicate underlying issues that require medical attention.

Mrs Anne Mitchener, experienced consultant neurosurgeon, provides a comprehensive overview of chronic neck pain, including its causes, diagnosis, and treatment options.

What is chronic neck pain, and how is it defined?

Chronic neck pain is defined as discomfort, stiffness, or aching in the neck region that persists for 3 months or longer.

Some people experience constant, dull pain, while others may have sharp, intermittent discomfort. Pain may also radiate to the shoulders, arms, or head, often accompanied by stiffness, reduced mobility, or muscle spasms.

In some cases, people may report associated symptoms such as headaches, tingling, or numbness, particularly if nerves in the cervical spine are involved.

What are the most common causes of chronic neck pain?

Chronic neck pain can arise from a variety of factors, ranging from lifestyle habits to underlying medical conditions.

Some of the most common causes include:

Degenerative conditions: As we age, wear-and-tear changes like cervical spondylosis (arthritis of the neck) and degenerative disc disease can lead to chronic neck pain. These conditions may also cause nerve compression or bone spurs.

Other medical conditions: A herniated (slipped or bulging) disc in the cervical spine can press on surrounding nerves, resulting in neck pain, numbness, or weakness. Additionally, disorders such as fibromyalgia, rheumatoid arthritis, and infections affecting the spine can also cause persistent neck pain.

Poor posture: Extended use of phones, tablets, or computers can lead to "text neck," a condition caused by prolonged forward head posture. Over time, this places undue stress on the neck muscles and cervical spine.

Injuries: Traumatic injuries, such as whiplash from a car accident or a fall, can damage the soft tissues and vertebrae of the neck, leading to long-term discomfort.

What diagnostic tools do you use to identify the root cause of neck pain?

The process begins with a detailed medical history and physical examination. During this consultation, your neurosurgeon will assess your symptoms, lifestyle, and any history of injuries or pre-existing conditions. A physical examination will involve evaluating range of motion, reflexes, and muscle strength to identify areas of dysfunction or neurological involvement.

When further investigation is required, imaging tests like X-rays, MRI, or CT scans will be employed. These tools will provide detailed views of the cervical spine, helping your neurosurgeon detect structural abnormalities such as herniated discs, arthritis, or spinal stenosis.

In some cases, electrodiagnostic studies like electromyography (EMG) or nerve conduction studies will be used to assess nerve function.

Can chronic neck pain be prevented?

Most cases of chronic neck pain can be managed with non-surgical interventions. These include physiotherapy, where targeted exercises are designed to strengthen the neck muscles, improve posture, and enhance mobility. Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or prescription painkillers, can also provide temporary relief.

For people with inflammation or nerve irritation, epidural steroid injections or nerve blocks can be recommended. These minimally invasive procedures deliver medication directly to the affected area, reducing pain and swelling. Stress management techniques, such as mindfulness, can also be beneficial, especially for people whose pain is exacerbated by tension or anxiety.

In severe cases where conservative treatments have failed, or when structural issues like herniated discs or spinal stenosis cause significant nerve compression, surgery may be necessary. Your neurosurgeon will perform procedures such as discectomy, spinal fusion, or artificial disc replacement to address the root cause of the pain.

If you would like to book an appointment with Mrs Anne Mitchener, head on over to her Top Doctors profile today.