Neck Pain : Pain From The Vertebrae
Neck pain is a common disease that we often wake up in the morning with or experience at the end of a tiring day at work. It is usually a result of a minor strain or sprain and disappears with over-the-counter painkillers and symptomatic treatment at home. In some cases however, neck pain may be the result of a problem that requires emergency treatment.
Pain from the Vertebrae
Fractures: Fractures of the vertebrae could occur due to trauma like motor vehicle accidents or falls. They could also be a result of diseases affecting the vertebrae like osteoporosis or thinning of the bone, cancer infiltration of the bone or the use of steroids. Fractures of the vertebrae can cause compression and damage to the spinal cord and require immediate immobilization of the neck.
Tumors of the vertebral column: Tumors affecting the vertebral column may be benign (like osteochondroma or osteoid osteoma) or malignant (like osteosarcoma or chondrosarcoma). In addition, cancer from other parts can also spread to the vertebral column. Pain due to tumors is of unrelenting type and present even at night. It is not relieved by rest or by usual treatments. Other symptoms include neck stiffness, decreased range of motion, weakness or numbness in case of compression of nerves and general symptoms like as low-grade fever, night sweats, fatigue, malaise, and loss of appetite.
Vertebral osteomyelitis: Osteomyelitis or infection of the vertebrae could occur due to spread from other sites via the blood or local spread from the throat, tonsils or the lower spine. Osteomyelitis is often caused by bacterial infection; in rare cases, it may be caused by tuberculosis or fungal infection. It is commonly seen in intravenous drug users. An abscess may also form, which could compress various structures resulting in neck pain. The infection could also spread to the intervertebral disc. Neck pain is increased by motion and is not relieved by rest. Pain is felt on pressing the affected vertebra. Fever, an increase in ESR and an increase in white blood cell count may be present. CT scan helps to confirm the diagnosis.
Metabolic: Metabolic or hormonal conditions can also result in neck pain. Conditions like osteoporosis or thinning of the bone, hyperparathyroidism or increased secretion of parathyroid hormone, or immobility can result in compression fractures. Osteosclerosis or increased bone density can occur due to Paget’s disease. Neck pain may be localized or spread along the compressed nerve. Pain is increased by movement and can be reproduced by pressure on the affected vertebra.
Cervical spondylotic myelopathy: Cervical spondylotic myelopathy is a condition that arises due to degenerative changes that narrow the spinal canal. This could result in compression of the spinal cord. Along with neck pain and decreased movement of the neck, other symptoms due to spinal cord compression could occur like muscle weakness, inability to empty bowel or bladder and sexual dysfunction.