A pinched nerve in the neck is not what it sounds like in most cases. Far more often than not, what people refer to as a “pinched nerve” in the upper back (or “cervical” region of the spine) is actually a strained muscle. The muscles in the neck region might become strained when you sleep with your head in an awkward position, or if your head turns quickly at an unusual angle. While extremely painful in some cases, the pain will usually subside after a few days, and can typically be managed using over-the-counter pain medication. However, there is another condition that actually does deserve the title, “pinched nerve,” and that can produce symptoms which are much more difficult to manage. Read more
Using an exercise ball to help improve muscle strength provides relief from ankylosing spondylitis according to a recent study. The results of this trial offer hope of effective conservative therapy for those with back and neck pain from the condition and may help reduce reliance on pain medications as well as delay the need for neck surgery. Read more
If you’re like many people, receiving a cervical herniated disc diagnosis gives rise to mixed emotions. On the one hand, it is likely a relief to finally know the cause of the neck pain and other forms of discomfort that you may have been struggling with for weeks or months. On the other hand, it can be scary to find out that you are suffering from a degenerative condition that has the potential to get worse over time.
The important thing to keep in mind when you do receive your diagnosis is to remain positive and patient. The treatment process many involve a certain degree of trial and error. It is unlikely that any one treatment will provide total relief, but a combination of conservative treatments like exercise, stretching, medication, and hot/cold compresses will probably help to alleviate your neck pain and other symptoms. Read more
Unlike lumbar and thoracic curves, cervicothoracic junction (CTJ) kyphosis, a distinctive and complex cause of neck pain and other symptoms, is not normally associated with scoliosis. Instead, CTJ deformity involves a sagittal imbalance, where the spine takes on abnormal curvature front to back rather than side to side.
Treating CTJ deformity can be difficult and likely involves back and neck surgery to reconstruct the spine in order to restore balance and realign the neck and head. Read more
Identifying herniated disc symptoms can be difficult, as they can be quite similar to the symptoms associated with other spine conditions. Your primary care physician or a spine specialist are the only ones qualified to properly diagnose a herniated disc, but just because you’re experiencing lower back pain doesn’t mean he or she will automatically assume that you have a herniated disc. Physical exams and tests come first. Read more
Many cases of whiplash and neck pain could be prevented by taking a few seconds to make some simple adjustments to your driving set-up. Don’t wait until you’ve experienced the pain of injury and have to research your whiplash treatment options before taking action. Adjust your seating position every time you get in the car if you share your vehicle with another driver and make sure to take the following safety tips into account when buying a new car. Read more
Those suffering from chronic neck pain may be interested to know that researchers have, for the first time, detailed the involvement of the spinal cord in pain hypersensitivity in humans. Spinal cord involvement has long been suspected in conditions such as fibromyalgia and neck and back pain where no other cause can be pinpointed for the pain but imaging the human spinal cord is somewhat problematic.
Animal research has previously demonstrated the link between spinal cord sensitization and chronic pain but this is the first human trial to show such a link using functional magnetic imaging. The study took place at the Pain Management Division, Stanford University, California, and may offer insights into new ways to treat chronic neck pain and other afflictions. Further tests, this time on patients with fibromyalgia, are planned by the same research team.
The Experience of Pain
The spinal cord receives and transmits nerve impulses throughout the body by way of the nerves that branch out through the neural foramina. Some of these impulses travel all the way from the skin on the fingertips up to the brain and others only to to the spinal cord where some nerve impulse feedback loops occur without signals ever reaching the brain for processing. Patients with fibromyalgia or conditions that affect the spinal cord itself may have overly sensitive reactions to ordinary stimuli, meaning that some find it painful even to wear clothing with zippers and/or have hypersensitive reactions to pain (hyperalgesia).
Fibromyalgia and Pain
A variety of mechanisms have been proposed to explain this oversensitivity in fibromyalgia patients, including small fiber polyneuropathy, abnormally high levels of substance P in the spine, as well as abnormally low levels of serotonin, norepinephrine and dopamine. These neurotransmitters are all involved in pain sensitivity. Fibromyalgia sufferers have also been found to have increased levels of excitatory amino acids in the cerebrospinal fluid (CSF) with an association noted between glutamate and nitric oxide metabolites and clinical assessments of pain.
Research into the Spinal Cord and Chronic Pain
Recognizing that something is likely going on in the spinal cord of patients with chronic pain has led researchers to carry out innumerable animal experiments but these, as with all animal research, have little bearing on human pain and disease and may actually prove to be deceptive and misleading in many cases. This latest research carried out tests on human subjects in order to improve our understanding of chronic pain and spinal cord involvement, using resting-state functional magnetic resonance imaging (MRI) on patients with and without induced central sensitization to pain.
The Spinal Cord and Pain Sensitivity
Presenting the findings of the new study, research assistant Brittney R. Reyes, noted that this work highlights the role of the spinal cord in chronic pain syndromes as being as important as that of the brain. The research team used a capsaicin (hot pepper) cream on the forearm of volunteers in order to block nerve signals transmitting pain to the brain. This was done after an initial application of heat to the area for five minutes, followed by measurements of mechanical pain. The cream remained in place for half an hour and then patients had the heat applied again for five minutes before mechanical hyperalgesia was measured once more.
Mapping the Brain in Pain
A second group had heat applied for 30 seconds to their left forearm, then had 40 seconds without heat and then had the process repeated seven times. No capsaicin cream was used for this group. Both groups had two scans performed, the first to map out the brain’s dorsal horn as the volunteers carried out a task and the second as a baseline for a resting state where the participant simply lay inactive in the MRI scanner.
How the CNS Talks to Itself
The purpose of these scans was to spot any signal fluctuations in the spinal cord and potentially isolate any connections between regions that may indicate a functional relationship. Signals and communication in the spinal cord continues at a low frequency when the participant is not performing a task and the researchers hoped to find which areas of the central nervous system were talking to each other and to what extent after administration of pain and when nerve signals were blocked.
Hypersensitivity to Pain and Spinal Cord Abnormalities
What the researchers found was that the subjects who had not been sensitized to pain had signs of functional connectivity in the C6 area of the spinal cord, while those in the group sensitized to pain had a wider spread of activity in the C6 to C5 regions of the dorsal horn. The results were indicative of activity occurring even when subjects reported having no pain, with ramifications for those with hyperalgesia and allodynia.
Fibromyalgia and Chronic Pain
The research team that carried out this study now intends to test those with fibromyalgia to determine if this increased functional connectivity is present in the spinal cord. Whether this will eventually lead to new treatments for fibromyalgia remains to be seen but these researchers are certainly a step closer to understanding the role of the spinal cord in chronic pain.
American Academy of Pain Medicine (AAPM) 29th Annual Meeting. Abstract 107. Presented April 12, 2013.
A bone spur in the cervical (neck) region of the spine does not often cause recognizable symptoms. In fact, many people develop these excess growths of bone and never even realize they exist. Others might experience nothing more serious than a popping or cracking sound, known as crepitus, that arises when they turn their head left or right. Still others might begin to feel mild stiffness, especially after sleeping or after hours of sitting hunched over a computer keyboard or standing at a work station. Then, there are more severe symptoms related to a spinal bone spur. These can become debilitating, or at the very least cause a person to scale down their level of physical activity. Read more
Bulging disc surgery is a perfectly legitimate option for alleviating the debilitating symptoms often associated with spinal nerve compression if – and this is a big “if” – the symptoms remain stubbornly unaffected by the potential benefits of a well-planned regimen of conservative, nonsurgical treatment. The fact is, more than 90 percent of patients who experience nerve compression related to a bulging disc need never consider surgery. And of the small minority who do consider it, many find through a second or third medical opinion that another, nonsurgical option had been overlooked or ignored. Who, then, should actually consent to surgical treatment for a bulging disc?