Physical Doctor consulting with patient About Shoulder Cervical Strain

Cervical strain is an injury to the tendons or muscles in the portion of the spine that makes up the neck. With a cervical strain, you may feel pain in the neck, often accompanied by a headache. Some who suffer a cervical strain may also experience irritability or lethargy.

The causes for cervical strain vary from regular daily activities like driving or working at a desk to trauma that causes the head to quickly move forward, backward, or side to side, such as a car accident.

Treatment can include heat or cold packs, over-the-counter or prescription medications to manage pain, massage, neck collars, and physical therapy.

Cervical Herniated Disc

A cervical herniated disc occurs when the cushion between the vertebrae (cervical disc) is exposed to excessive stress, perhaps through heavy lifting or accidental trauma. Those who suffer a cervical herniated disc could feel pain that radiates from the shoulder to the fingers and numbness, tingling, or weakness in arms or hands. Severe cases caused by spinal cord compression could affect your ability to walk or perform fine motor skills.

Treatment may involve physical therapy to relieve the pressure on the affected disc. Your doctor may also suggest NSAIDs and topical creams to alleviate pain. In some cases, patients may also receive steroid injections or nerve root injections to reduce swelling. Surgical treatments may be suggested if the condition lasts three months or more.

Degenerative Disc Disease

The discs that serve as cushions between your vertebrae can wear down over time, resulting in degenerative disc disease. These discs in your spine could dry out as you get older. Dryer discs lead to cracks and tearing of the outer walls of the discs. The closer those tears are to nerves, the more pain you’ll experience. In many cases, the disc’s soft core pushes through the tears, or the disc may slip.

Conservative treatment includes medication for pain, such as aspirin, NSAIDs, and acetaminophen to ease pain and swelling. If your condition leads to muscle spasms, your doctor may also prescribe muscle relaxers.

Cervical Myofascial Pain

Cervical myofascial pain is a deep, aching pain when sensitive spots in the muscles in your back and neck, known as trigger points, are compressed. This can lead to chronic pain that persists or worsens in these areas and in other parts of the body that may not seem related (referred pain). You may also experience tender knots in the muscle that can lead to difficulty with movement or sleep.

Treatment begins with physical therapy to relieve pressure on the affected areas. Doctors may also suggest over-the-counter medicines to manage the pain as causes are located and treated. In more severe cases, antidepressants, sedatives, or injections may also be recommended.

Post-Surgical Pain

Pain after surgical procedures is normal and can occur for days or even weeks, depending on the type and complexity of the surgery performed. This pain can occur in the skin or along nerves that may have been disturbed during the procedure, in the muscles, and even in the bones, if those bones were impacted.

Treatment is often as simple as pain management medication, whether a prescription-strength NSAID or narcotic. Your doctor may also recommend physical therapy to stretch and strengthen the affected areas of your body so that you can recover more quickly. Be alert and report to your doctor any pain that seems unusual or sharper than expected.

Cervical Radiculopathy

When the nerve function in the back is damaged or disturbed, this is usually the result of compression of nerve roots near the cervical vertebrae. Sufferers can experience pain or numbness along the nerve path through the arms to the hands or fingers. Pain may also exist in the neck, chest, upper back, shoulders, and upper arms, which can lead to weakness in the hands.

Your doctor may prescribe anti-inflammatory injections or medications if over-the-counter pain management with ibuprofen, acetaminophen, or naproxen isn’t enough. Physical therapy can also help you learn body positions that ease pain due to nerve compression.

Spinal Stenosis

Spinal stenosis, the pinching of the spinal cord or nerves, often the result of osteoarthritis. The small spinal canal, where the nerve roots and spinal cord are located, become compressed, leading to pain, numbness, or weakness.

Overall, the cause for spinal stenosis is usually osteoarthritis—a condition that simply occurs over time. However, the thickening of ligaments in the back, bulging of the discs that separate the vertebrae, inflammatory spondyloarthritis, and spinal tumors can also be causes. Some may have a higher chance of experiencing spinal stenosis, especially those born with a narrow spinal canal or who have had a previous surgery on the spine.

Your doctor may prescribe over-the-counter pain medications (acetaminophen, NSAIDs, or naproxen) for relief. If you experience muscle spasms, you may also receive prescriptions for muscle relaxers. In more severe cases where OTC medication doesn’t bring relief, corticosteroid injections may also be recommended. These injections help to reduce any swelling to give room for the affected discs.

If conservative treatments are ineffective, patients may be candidates for surgical procedures that remove the bony spurs and buildup of bone in the spinal canal, after which a spinal fusion may be performed.

Spondylosis

A condition involving general wearing down of the bones in the back, otherwise known as vertebrae, sometimes resulting in bone spurs or other inconveniences is broadly addressed as spondylosis.

The main cause of spondylosis is the aging process, as the most important indication of the condition is decomposition and dehydrating of the discs between vertebrae that occurs over time. Many patients with spondylosis do not experience any complaints, but of those who do, the most common are stiffness, tingling, or numbness in the area affected. Cervical spondylosis (occurring in the neck) and lumbar spondylosis (of the lower back) are reported more often than thoracic spondylosis (of the upper back.)

Spondylosis can occur in more than one vertebrae at a time, in a condition known as spondylitis. However, ankylosing spondylitis is a form of arthritis which involves more inflammation than degeneration.

The treatment for spondylosis can depend on the type of spondylosis and the severity. Your doctor may prescribe nonsteroidal anti-inflammatory medications, corticosteroids, muscle relaxers, or antidepressants. Some anti-seizure medications have also shown potential for dulling pain.

Radiculopathy

Damage to the nerves in the spine, usually caused by compression, is called radiculopathy. The two main varieties of radiculopathy are cervical (involving nerves near the neck) and lumbar (involving the nerves in the lower back), although less commonly, thoracic radiculopathy (involving the upper area of the back) can be identified.

The compression that causes radiculopathy can be the result of heavy weight on the area over time, or it can be from a sudden impact. Common complaints from this condition include pain or tingling in the area of, or extremities nearest to, the impacted nerve. Cervical radiculopathy will most often lead to pain in the shoulders, arms, and hands, while lumbar radiculopathy tends to lend itself to pain in the hips or legs. Problems associated with thoracic radiculopathy include chest pain and may be mistaken for other ailments common to that area. Severity of pain is mostly relative to the amount of damage done to the nerve.

Treatment of radiculopathy usually begins with medication or physical therapy. Your doctor may prescribe anti-inflammatory medicine or an epidural steroid injection. Chiropractic treatment may also be recommended. If these conservative treatments don’t bring relief, laminectomy may be an option, during which a small portion of the bone covering the offending nerve is removed. A discectomy, which removes a portion of the disc compressing the nerve, may be another recommended surgery.