Chronic Neck Pain: the Impact on Daily Life

Chronic pain in the posterior neck for several years?

Hello doctor, I have been troubled by neck pain recently and would like to make an appointment, but I want to ask you first if this is actually a medical issue.
When I was under 10 years old, my grandfather twisted my neck, and since then, I have experienced recurrent neck pain.
I have been relying on self-manipulation to relieve the discomfort, but in recent years, the situation has worsened.
Initially, I thought it was due to poor sleeping posture, and a traditional Chinese medicine practitioner suggested that I avoid raising my arms above my head while sleeping.
I have tried to have my boyfriend help me with this and have also attempted side sleeping, but nothing seems to work.
I am beginning to wonder if this is more than just ordinary muscle soreness and if it has involved issues with my bones and nerves.
I hope you can provide some insight into what might be happening, as this issue has been affecting my normal interactions with others.

YES, 20~29 year old female. Ask Date: 2016/01/04

Dr. Jiang Junyi reply Neurology

Hello, based on your description, the most common cause of neck pain is cervical myofascial pain.
Prolonged use of electronic devices in the same posture can lead to overuse of the trapezius muscle at the back of the neck, resulting in neck and shoulder discomfort.
Initially, resting may alleviate the pain, but it can progressively worsen and affect daily activities.
Some patients experience severe neck pain upon waking, accompanied by stiffness, tightness, and intolerable pain levels.

I recommend the following:
1.
Change positions: Alter your posture every 15 minutes to allow the neck tissues to rest.
Maintaining any position (including a normal one) for an extended period can lead to tissue fatigue and inflammation, so moving around briefly can reduce the risk of muscle inflammation.
2.
Rest: Resting allows the muscles to utilize their self-repair capabilities.
Avoid vigorous exercise during this time.
3.
Neck heat therapy: Apply heat for 15 to 20 minutes, ensuring the temperature is safe to avoid burns.
4.
Non-steroidal anti-inflammatory drugs (NSAIDs): If you do not have a history of peptic ulcers, allergies to NSAIDs, or normal kidney function, you may consider using NSAIDs to reduce inflammation and alleviate pain when necessary.
5.
Neck muscle stretching exercises: After the acute pain phase, develop a habit of performing slow and gentle neck stretches every 15-20 minutes at angles that do not cause discomfort.
If you experience numbness in your limbs, it may indicate compression of the cervical nerve roots.
I suggest consulting a neurologist or a rehabilitation physician for further evaluation and treatment.
Wishing you good health and peace.

Reply Date: 2016/01/04

More Info

Chronic neck pain can significantly impact daily life, and it is essential to understand its underlying causes and implications. Based on your description, it appears that your neck pain has been a persistent issue since childhood, exacerbated by an incident where your grandfather twisted your neck. This history suggests that there may be more than just muscular strain at play; it could involve structural issues related to the cervical spine or nerve involvement.

Neck pain can arise from various sources, including muscle strain, ligament sprains, herniated discs, or degenerative disc disease. Given your long-standing symptoms and the fact that they have worsened over time, it is crucial to consider the possibility of cervical spine pathology. The cervical spine consists of seven vertebrae, and any injury or abnormality in this area can lead to pain, stiffness, and neurological symptoms.

Your experience of needing to "crack" your neck for relief may indicate muscle tightness or joint dysfunction. However, habitual self-manipulation can sometimes lead to further instability or injury. Additionally, if you are experiencing pain that radiates into your arms or hands, it could suggest nerve compression, possibly from a herniated disc or cervical spondylosis. These conditions can lead to symptoms such as numbness, tingling, or weakness in the upper extremities.

The advice you received from your traditional Chinese medicine practitioner regarding sleep posture is valid. Poor sleep positions can exacerbate neck pain, especially if they place undue stress on the cervical spine. It is essential to maintain a neutral spine position while sleeping, which may involve using a supportive pillow and avoiding positions that strain the neck.

Chronic pain can also lead to psychological effects, such as anxiety and depression, which can further complicate the pain experience. The relationship between chronic pain and mental health is well-documented, and addressing both aspects is crucial for effective management.

To address your concerns, I recommend the following steps:
1. Consult a Specialist: Given the chronic nature of your pain and its impact on your daily life, it would be beneficial to consult a healthcare professional specializing in musculoskeletal disorders, such as an orthopedic surgeon or a neurologist. They can perform a thorough evaluation, including imaging studies like X-rays or MRI, to assess the condition of your cervical spine.

2. Physical Therapy: Engaging in physical therapy can help strengthen the muscles supporting your neck, improve flexibility, and teach you proper body mechanics. A physical therapist can also provide modalities such as heat, ice, or electrical stimulation to alleviate pain.

3. Pain Management: If your pain is severe, a pain management specialist may offer interventions such as injections or medications to help control your symptoms.

4. Lifestyle Modifications: Incorporating ergonomic adjustments in your daily activities, such as your workstation setup, can help reduce strain on your neck. Regular exercise, particularly activities that promote neck strength and flexibility, can also be beneficial.

5. Mind-Body Techniques: Consider exploring stress management techniques such as mindfulness, yoga, or meditation. These practices can help reduce muscle tension and improve your overall well-being.

In conclusion, while your neck pain may have started as a muscular issue, the chronicity and worsening of symptoms suggest that a more comprehensive evaluation is warranted. Early intervention can prevent further complications and improve your quality of life. Don't hesitate to seek medical attention, as addressing the root cause of your pain is vital for effective management and recovery.

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