NECK PAIN CAN LEAD TO SPINAL PROBLEMS :-

     Neck pain is highly prevalent and one of the most common symptoms reported to General Practitioners. The causes can be varied from a simple muscle strain to being the harbinger of major spinal disorders with the spine bearing the entire direct and indirect weight of the body; it experiences significant wear and tear. Add to that, the upright posture of humans and we have a recipe for disaster. This is the price we pay for evolution as four legged animals have a lower prevalence of spinal disorders.

    A large majority of individuals with neck pain have simple muscle strains which can be treated through management of posture, nutrition exercise, physiotherapy or occupational therapy.

     It is rarely necessary to resort to more invasive means including injections and surgery. Neck braces are rarely indicated and often do more harm than good.

     Degeneration conditions are next in frequency and increase with advancing age. There is also a correlation with occupation trauma, smoking, driving and certain sports. In the early stages the treatment is conservative.

   However, as the change increase surgery is frequently required to alleviate the symptoms especially related to nerve entrapment with pain, weakness and numbness in the arms. In advanced cases this can lead to spinal cord compression with difficulty in walking and performing activities of daily living (ADLs). This condition is called myelopathy and requires urgent surgical decompression. Many patients in eastern hemisphere have bone formation inside the spine (OPLL) with spinal cord compression. This requires surgical management to prevent paralysis.

    Congenital spinal disorders including defects in the spinal cord can lead to neck pain later in life. The dignosis and management of these requires a high level of expertise. At times surgery can be urgent in some to protect neurological function.

    Trauma to the neck is quite common and most injuries are mild. But due to the flexibility of the neck, significan injuries are common with fractures and dislocation. These should be managed immediately to prevent neurological problems and paralysis.

    Tumours in the spine are also common. To diagnose these requires a high index of diagnostic acumen as well as the judicious use of investigations to support the diagnosis. They are best trained spine surgeons who understand the history of the biomechanics of the spine.