Candida caused Rheumatoid arthritis of the cervical spine

Neck pain (or cervicalgia) is a common problem, with two-thirds of the population having neck pain at some point in their lives.^[1]
Neck pain, although felt in the neck, can be caused by numerous other spinal problems. Neck pain may arise due to muscular tightness in both the neck and upper back, or pinching of the nerves emanating from the cervical vertebrae. Joint disruption in the neck creates pain, as does joint disruption in the upper back.
The head is supported by the lower neck and upper back, and it is these areas that commonly cause neck pain. The top three joints in the neck allow for most movement of the neck and head. The lower joints in the neck and those of the upper back create a supportive structure for the head to sit on. If this support system is affected adversely, then the muscles in the area will tighten, leading to neck pain.

Contents

 [hide] 

• 1 Differential diagnosis
• 2 Treatment
  • 2.1 Conservative treatment
  • 2.2 Medication
  • 2.3 Surgery
• 3 Epidemiology
• 4 Prognosis
• 5 References

Differential diagnosis[edit]

Neck pain may come from any of the structures in the neck including: vascular, nerve, airway, digestive, and musculature / skeletal or be referred from other areas of the body.^[2]
Major and severe causes of neck pain (roughly in order of severity) include:

• Carotid artery dissection
• Referred pain from acute coronary syndrome
• Head and neck cancer
• Infections: retropharyngeal abscess, epiglottitis, etc.^[3]
• Spinal disc herniation – protruding or bulging discs, or if severe prolapse.
• Spondylosis - degenerative arthritis and osteophytes
• Spinal stenosis – a narrowing of the spinal canal

The more common and lesser neck pain causes include:

• Stress – physical and emotional stresses
• Prolonged postures – many people fall asleep on sofas and chairs and wake up with sore necks.
• Minor injuries and falls – car accidents, sporting events and day to day injuries that are really minor.
• Referred pain – mostly from upper back problems
• Over-use – muscular strain is one of the most common causes
• Whiplash
• Herniated disc^[4]
• Pinched nerve

Although the causes are numerous, most are easily rectified by either professional help or using self help advice and techniques.
More causes include poor sleeping posture, torticollis, head injury, rheumatoid arthritis, Carotidynia, congenital cervical rib, mononucleosis, rubella, certain cancers, ankylosing spondylitis, cervical spine fracture, esophageal trauma, subarachnoid hemorrhage, lymphadenitis, thyroid trauma, and tracheal trauma.

Treatment[edit]

Treatment of neck pain depends on the cause. For the vast majority of people, neck pain can be treated conservatively. Recommendations which help alleviate symptoms include applying heat or cold.^[5] Other common treatments could include medication, body mechanics training, ergonomic reform, and physical therapy.

Conservative treatment[edit]

Exercise plus joint mobilization and/or joint manipulation (spinal adjustment) has been found to be beneficial in both acute and chronic mechanical neck disorders.^[6] Both cervical manipulation and cervical mobilisation produce similar immediate-, and short-term changes; no long-term data are available.^[7] Thoracic manipulation may also improve pain and function.^[7][8] Low level laser therapy has been shown to reduce pain immediately after treatment in acute neck pain and up to 22 weeks after completion of treatment in patients with chronic neck pain.^[9]

Medication[edit]

Analgesics such as acetaminophen or NSAIDs are recommended for pain.^[10] Muscle relaxants are often prescribed and are known to be effective. However, one study showed that one muscle relaxant called cyclobenzaprine was not effective for treatment of acute cervical strain (as opposed to neck pain from other etiologies or chronic neck pain).^[11] Over the counter topical creams and patches may be effective for some patients.

Surgery[edit]

Surgery is usually not indicated for mechanical causes of neck pain. If neck pain is the result of instability, cancer, or other disease process surgery may be necessary. Surgery is usually not indicated for "pinched nerves" or herniated discs unless there is spinal cord compression or pain and disability have been protracted for many months and refractory to conservative treatment such as physical therapy.

Epidemiology[edit]

Neck pain affects about 330 million people globally as of 2010 (4.9% of the population).^[12] It is more common in women (5.7%) than men (3.9%).^[12] It is less common than low back pain.^[13]

Prognosis[edit]

About one-half of episodes resolve within one year.^[1] About 10% of cases become chronic.^[1]

References[edit]

1. ^ Jump up to: ^{a b c} Binder AI (2007). "Cervical spondylosis and neck pain". BMJ 334 (7592): 527–31. doi:10.1136/bmj.39127.608299.80. PMC 1819511. PMID 17347239. 
2. Jump up ^ Amal Mattu; Deepi Goyal; Barrett, Jeffrey W.; Joshua Broder; DeAngelis, Michael; Peter Deblieux; Gus M. Garmel; Richard Harrigan; David Karras; Anita L'Italien; David Manthey (2007). Emergency medicine: avoiding the pitfalls and improving the outcomes. Malden, Mass: Blackwell Pub./BMJ Books. p. 46. ISBN 1-4051-4166-2. 
3. Jump up ^ Amal Mattu; Deepi Goyal; Barrett, Jeffrey W.; Joshua Broder; DeAngelis, Michael; Peter Deblieux; Gus M. Garmel; Richard Harrigan; David Karras; Anita L'Italien; David Manthey (2007). Emergency medicine: avoiding the pitfalls and improving the outcomes. Malden, Mass: Blackwell Pub./BMJ Books. p. 47. ISBN 1-4051-4166-2. 
4. Jump up ^ Dr. Kevin Yip (2009). A Guide to Common Orthopaedic Problems. Singapore, Mass: Singapore Sports and Orthopaedic Clinic. p. 180. ISBN 1-4051-4166-2. 
5. Jump up ^ Garra, Gregory; Singer, Adam J. et al. (2010). "Heat or Cold Packs for Neck and Back Strain: A Randomized Controlled Trial of Efficacy". Academic Emergency Medicine 17 (5): 484–9. doi:10.1111/j.1553-2712.2010.00735.x. PMID 20536800. 
6. Jump up ^ "BestBets: Manipulation and/or exercise for neck pain?". 
7. ^ Jump up to: ^{a b} Gross AR (2010). "Manipulation or mobilisation for neck pain". Cochrane database of systematic reviews (Online) (1): CD004249. doi:10.1002/14651858.CD004249.pub3. PMID 20091561. 
8. Jump up ^ Huisman PA, Speksnijder CM, de Wijer A (January 2013). "The effect of thoracic spine manipulation on pain and disability in patients with non-specific neck pain: a systematic review.". Disabil Rehabil 35: 1677–1685. doi:10.3109/09638288.2012.750689. PMID 23339721. 
9. Jump up ^ Chow RT, Johnson MI, Lopes-Martins RA, Bjordal JM (2009). "Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials". Lancet 374 (9705): 1897–1908. doi:10.1016/S0140-6736(09)61522-1. PMID 19913903. 
10. Jump up ^ "UpToDate Inc.". 
11. Jump up ^ Khwaja SM, Minnerop M, Singer AJ (January 2010). "Comparison of ibuprofen, cyclobenzaprine or both in patients with acute cervical strain: a randomized controlled trial". CJEM 12 (1): 39–44. PMID 20078917. 
12. ^ Jump up to: ^{a b} Vos, T (Dec 15, 2012). "Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.". Lancet 380 (9859): 2163–96. doi:10.1016/S0140-6736(12)61729-2. PMID 23245607. 
13. Jump up ^ Deen, Hanifa; Bartleson, J. D. (2009). Spine disorders medical and surgical management. Cambridge, UK: Cambridge University Press. p. 3. ISBN 0-521-88941-3. 

[show] v t e Pain and nociception By region/system HEENT Headache Neck Odynophagia (swallowing) Otalgia (ear) Toothache Chest pain Cardiovascular system Angina pectoris Respiratory system Sore throat Pleurodynia Breast Mastodynia (Breast) Musculoskeletal Arthralgia (joint) Bone pain Myalgia (muscle) Muscle soreness: Acute / Delayed onset Neurologic Congenital insensitivity to pain HSAN Type I II congenital sensory neuropathy III familial dysautonomia IV congenital insensitivity to pain with anhidrosis V congenital insensitivity to pain with partial anhidrosis Neuralgia Pain asymbolia Pain disorder Paroxysmal extreme pain disorder Allodynia Chronic pain Hyperalgesia Hypoalgesia Hyperpathia Phantom pain Referred pain Abdominal pain Urogenital Dysuria Pelvic pain Dyspareunia Testicular pain Gastrointestinal Proctalgia Back Upper Lower Tests Cold pressor test Dolorimeter Hot plate test Tail flick test Related concepts Anterolateral system Pain management Anesthesia Cordotomy Pain scale Pain threshold Pain tolerance Posteromarginal nucleus Substance P Suffering OPQRST Philosophy of pain Cancer pain Drug-seeking behavior v t e Index of the central nervous system Description Anatomy meninges cortex association fibers commissural fibers lateral ventricles basal ganglia diencephalon mesencephalon pons cerebellum medulla spinal cord tracts Physiology neutrotransmission enzymes intermediates Development Disease Cerebral palsy Meningitis Demyelinating diseases Seizures and epilepsy Headache Stroke Sleep Congenital Injury Neoplasms and cancer Other paralytic syndromes ALS Symptoms and signs head and neck eponymous lesions Tests CSF Treatment Procedures Drugs general anesthetics analgesics addiction epilepsy cholinergics migraine Parkinson's vertigo other v t e Index of the peripheral nervous system Description Anatomy Nerves cranial trigeminal cervical brachial lumbosacral plexus somatosensory spinal autonomic Physiology reflexes proteins neurotransmitters transporters Development neurotrophins Disease Autonomic Congenital Injury Neoplasms and cancer Other Symptoms and signs eponymous Treatment Procedures Local anesthetics

[show] v t e Spinal disease (M40–M54, 720–724, 737) Deforming Spinal curvature Kyphosis Lordosis Scoliosis Other Scheuermann's disease Torticollis Spondylopathy inflammatory Spondylitis Ankylosing spondylitis Sacroiliitis Discitis Spondylodiscitis Pott disease non inflammatory Spondylosis Spondylolysis Spondylolisthesis Spinal stenosis Facet syndrome Back pain Neck pain Upper back pain Low back pain Coccydynia Sciatica Radiculopathy Intervertebral disc disorder Schmorl's nodes Degenerative disc disease Spinal disc herniation v t e Index of joint Description Anatomy head and neck cranial arms torso and pelvis legs bursae and sheathes Physiology Disease Arthritis acquired back childhood soft tissue Congenital Injury Symptoms and signs eponymous orthopaedic Examination Treatment Procedures Drugs rheumatoid arthritis gout topical analgesics

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