Let’s first look at the anatomy of the neck in order to better understand the structures of the cervical spine that can generate pain.
Starting at the back of the spine, the facet joints allow us to move our neck and head in all directions. Each facet joint surrounds a joint capsule that is rich with nerve endings. When swollen, can generate pain both locally and radiate.
Neck Pain Study
One study of volunteers with existing neck pain looked at the various pathways that pain travels when investigators injected each individual facet joint capsule with a normal saline solution. Interestingly, the subjects felt pain in parts of the body other than just the neck. For example, injecting the C6 facet joint capsule consistently creates radiating pain down the arm into the thumb side of the forearm and hand. This is similar to when a disk herniates and a nerve root pinches. The primary difference was that a deep aching pain occurred in this area, as opposed to a more geographically well-defined pathway when disk ruptures and pinches a specific nerve root.
The intervertebral disks are small shock absorbers that lie between each vertebral body. These disks are sort of like jelly doughnuts, which can sometimes leak out and pinch a nerve root producing pain (as well as numbness, tingling, and even weakness) that radiates along the course of the nerve.
Poor posture is perhaps one of the most common causes of neck pain. The muscles in the chest tend to be stronger than those in the upper back and pull the shoulders forward resulting in forward head carriage with protracted shoulders. For each inch of forward head shift, an additional ten pounds adds to the weight of the head. The head already weighs around ten to twelve pounds. Hence, a five-inch forward head carriage places an additional 50-pound load on the upper back and neck just to hold the head upright!
Chiropractors train to identify these faulty postures and track down the pain generator(s) when a patient presents with neck pain. Through patient education, spinal manipulation, mobilization, exercise training, modalities, and more, chiropractors can greatly help those struggling with neck pain!
