Have you ever awakened in the morning from a long restless sleep with neck pain? Do you sometimes have difficulty looking over your shoulders, especially when you’re trying to exchange lanes in rush hour traffic? Does your neck and muscles feel tight when you tilt your head in a downward motion (making your chin touch your chest or sternum) or when you tilt your head to the right or left?
If you answer “yes” to any of these questions, then read below to learn about the main sources or your pain.
Cervical (neck) pain has many causes:
- Whiplash related to a motor vehicle accident.
- Pulling on your neck while doing sit-ups.
- Using the arm of your couch as a pillow while lying down.
- Habitual neck popping.
- Playing sports such as wrestling, football or soccer.
- Jamming your neck into a pillow while sleeping.
- Chronic neck stiffness that may be caused by cervical lordosis (the straightening of the cervical spine and) or scoliosis (the curving of the spine). These conditions can lead to stiffness and occasional or constant headaches.
- Neck pain can also be idiopathic (unknown cause for the pain). One morning you wake up and notice that it is difficult to look over your shoulder; you have a mild headache that doesn’t go away, or you have numbness, tingling, dull, achy, electrifying, sharp, or stabbing pain that radiates into either shoulder, down your arm, and into your fingers.
Neck Anatomy
The neck begins at the base of the skull. It consists of seven vertebrae (bony structures) and five discs that act as shock absorbers and prevent the vertebrae from rubbing together. The brainstem (spinal cord) runs down the length of the spine ending in the lumbar (lower back) area. The nerves branch off the spinal cord and pass through the foramina to innervate the muscles.
Pain Origins
The best way to determine the origin of cervical pain is having either a magnetic resonance imaging (MRI) or computed tomography (CT). MRIs are more detailed than CT scans. However, both scans can show the tissue around the specified image, bone structure, and nerves. If you visit your primary care provider for neck pain, you will be sent for an X-ray first because insurance companies require it. If the cervical pain continues to persist, an MRI needs to be ordered.
Dermatome Map. Dermatomes are areas of the skin connected to the spinal nerves and can pinpoint
exactly where pain originates in the body (Figure 2). Dermatome maps can be used to pinpoint pain
located anywhere in the body. The dermatome map will come in handy when you try to read either your
CT or MRI on your own, as you try to pinpoint the source of your pain.
C2: The main function of this section is to allow the neck to rotate. Trauma to this area can cause chronic headaches, muscle stiffness, and difficulty turning your head from left to right.
C2-C3 and C3-C4: These areas are in the stem of the neck. Centralized neck pain and stiffness may be felt in this area.
C4-C5: Located at the base of the neck where the neck meets the shoulders, C4 supplies nerves to the shoulders, and C5 supplies nerves to the deltoids.
C5-C6: C5 supplies nerves to the deltoids, and C6 nerves stimulate the biceps.
C6-C7: C6 nerves stimulate the biceps, and C7 nerves stimulate the fingers.
References
Kayalioglu ,Gulgun. (2009). The Spinal Cord. Retrieved from https://www.sciencedirect.com/topics/medicine-and-dentistry/dermatome
Sciencepics. (2019). Cervical spine posterior view 3d illustration. [Illustration]. Retrieved from https://www.shutterstock.com/image-illustration/cervical-spine-posterior-view-3d-illustration-5
57218294?src=NGPBZayqmcWVkuMu91rDsg-1-48.
Stihii. (2019). Medical, didactic board of anatomy of human sensory innervation system, dermatomes
and cutaneous nerve territories, segmental, radicular, cutaneous innervation of the anterior trunk wall. [Drawing]. Retrieved from https://www.shutterstock.com/image-vector/drawing-medical-didactic-board-anatomy-human-141240661?src=l_6RTlrLPOjyPvA_JmoeVg-1-0.