Individualized,
compassionate care
for pain
Browse >
Types of Neck Pain
Axial neck pain
Axial neck pain is caused by the complex interaction of muscles and ligaments. Also known as cervical strain, the condition frequently develops as a result of posture, sleep habits, ergonomics (e.g., computer monitor and bifocal position), stress, chronic muscle fatigue, postural adaptation to other primary pain sources (i.e. shoulder, temporomandibular joint, craniocervical) and cervical disc or facet joint degeneration). Axial neck pain is the most common source of neck pain, as well as the most resolvable. Surgery is only necessary in rare cases caused by single- or two-level degenerative disc disease with severe, unrelenting pain. Most patients achieve relief over time and there is a high rate of spontaneous resolution. In one study, after just three months of conservative treatment, 70 percent of the participants demonstrated complete or partial relief.
Axial neck pain symptoms
Presenting signs of axial neck pain typically include pain or soreness in the posterior paramedian neck muscles with radiation to the occiput, shoulder or parascapular region. Also quite common are stiffness in one or more directions of motion and headache. Local warmth or tingling as well as localized areas of muscle tenderness (trigger points) may also be encountered. Initially a very common secondary symptom is headache, and often such symptoms are interpreted and treated as migraines without success.
Whiplash-Associated Disorder (WAD)
Whiplash-Associated Disorder (WAD) is classified as a special case of acute or subacute pain in the neck that results from acceleration/deceleration transfer of energy. Typically, WAD involves multiple pain generators, including myofascial, ligamentous, discogenic and facet joint sources. Rear-end motor vehicle crashes and diving injuries are the most common causes of WAD. Each year in the United States, there are approximately one million cases of WAD resulting from motor vehicle accidents. Prognostic data is largely inconsistent, however, one of the larger studies observed the resolution of 60 percent of patient symptoms within just one month. The prevalence of chronic symptoms following acute onset of WAD is even less clear. WAD chronicity remains the subject of a lively medical debate because most patients do not have any readily identifiable injury in either the acute or chronic stage.
Whiplash-Associated Disorder (WAD) Symptoms
Presenting signs of WAD typically include pain or soreness in the posterior paramedian neck muscles with radiation to the occiput, shoulder or parascapular region. Also quite common are stiffness in one or more directions of motion and headache. Local warmth or tingling as well as localized areas of muscle tenderness (trigger points) may also be encountered. Initially a very common secondary symptom is headache, and often such symptoms are interpreted and treated as migraines without success.
Cervical Radiculopathy
Cervical radiculopathy is characterized by motor and/or sensory changes in the neck and arms, which results from extrinsic pressure on a cervical nerve root. This pressure is typically caused by disc material or osteophytes. A large study in Rochester, Minnesota, has reported the annual incidence of cervical radicular symptoms to be 83.2 per 100,000 population, and its prevalence most significant within a 50- to 54-year age group. In the study, 90 percent of patients were asymptomatic or only mildly incapacitated. Surgery is not often required for resolution of cervical radiculopathy symptoms.
Cervical Radiculopathy Symptoms
Radicular pain, the characteristic symptom of cervical radiculopathy, is often confused with radiating pain in clinical practice. Because specific treatments are exclusively indicated for radicular pain, an accurate distinction is important. True radicular pain follows dermatomal patterns and is usually—though not always—unilateral. Onset is often insidious but may be abrupt, and the pain is frequently aggravated by arm position and extension or lateral rotation of the head.
Cervical Myelopathy
A less common cause of neck pain is cervical myelopathy. Cervical myelopathy also results from extrinsic pressure; specifically, a decrease in the space available in the cervical canal for the spinal cord. Underlying causes can include a small congenital cord diameter, osteophytes, protruding disc material, dynamic changes in canal diameter or the vascular supply to the cord. The overall prevalence of cervical myelopathy is uncertain; however, it is known to be relatively rare.
Cervical Myelopathy Symptoms
The presentation of cervical myelopathy is subtle and varied. Mild symptoms may be present for years or paresis could occur acutely. The more common signs include clumsiness, weakness and stiffness in the upper and lower extremities. Common to about half of presenting cases are neck stiffness and deep, aching pain in the neck, shoulder or arm. Approximately one third of patients experience radicular symptoms. Additional warning signs include arm or leg dysfunction, gait and balance difficulties and nonspecific urinary complaints such as urgency or hesitancy.