Neck Anatomy 101

The typical adult head can weigh around 8-12 pounds. That is about as much as a bowling ball! You can imagine the stress that your vertebrae, muscles and ligaments go through on a daily basis having to hold that amount of weight up all day long. Not only does your neck have to have good endurance and strength but it also has to be able to move more than any other part of your spine. Normal amounts of motion for a healthy neck are up to 90° of forward motion, 70° of backward motion, 70-90° of side-to-side motion, and almost 50° of tilt to either shoulder. Your neck also called the cervical spine, begins at the base of your skull. It contains 7 small bones or vertebrae which are labeled C1 to C7 (the 'C' means cervical). The numbers 1 to 7 indicate the level of the vertebrae. C1 is closest to the skull, while C7 is closest to the chest.

The vertebrae are connected by a series of joints called facets. These joints control the movements of the neck in coordination with the neck muscles. There are 4 separate facets per vertebrae which makes the neck one of the most complicated areas of the skeletal system.

The Many Ugly Faces of Neck Pain

  1. Poor posture: "Chin back, chest out!", we may have heard our mothers (or drill sergeant) say! They were not too far off! When you sit in a slouched posture, your head migrates forward placing that 8-12 pound weight out in front of your body. That places a large amount of stress through the ligaments, muscles, discs and joints of the neck. Imagine holding a bowling ball on a stick out in front of your body with one hand. That gives you an idea of the kind of stress that is placed on these structures. Over time, the muscles will fatigue placing too much stress on the joints and discs of the neck and eventually those structures can fail under the pressure causing neck pain.

    What you can do: Always try to sit in an upright position and, if needed, with extra back (lumbar) support so that you maintain the natural curves of your spine. Change positions often (every 20-30 minutes is recommended) standing up to stretch and walk around a bit and work on strengthening the muscles in your upper back between your shoulder blades. Your physical therapist can direct you in specific stretching and strengthening techniques that will better your posture.

  2. Whiplash: Whiplash is defined as a sudden acceleration then deceleration, or slowing down, of the head in space when a sudden force is applied to the neck. This can happen in a car accident, playing sports or even slipping and falling on the ice. Studies have shown that speeds as a little as 8 mph can cause significant neck injuries. This sudden force can cause injury to discs, ligaments, cartilage and tendons in the neck. Whiplash can be a debilitating injury but the good news is that most whiplash symptoms clear up in as little as a few weeks. However, some structures such as joints, discs, and ligaments can take a few months to heal.

    What you can do: Most tissues in the neck such as discs and ligaments do not have a very good blood supply. Tissues need blood in order to heal and the primary way your neck gets its nourishment is through movement. If serious problems like a fracture are ruled out, the best thing you can do for that sore neck is MOVE IT!! Start with gentle movements to the edge of the pain but not into it. Do these 10-15 repetitions in all directions several times a day, not a lot all at once. The Physical Therapists at RehabAuthority use movement-based techniques to get that neck feeling good again! Your Physical Therapist can do a thorough movement-based evaluation on your neck and tell you of specific stretching and strengthening exercises to get you back into life again!

  3. Disc problems: "Bulging", "herniated", "ruptured", and "slipped" are terms (and scary ones at that!) to describe problems with the discs that lie between each of the vertebrae, also known as intervertebral discs. Sometimes the outer rim of an intervertebral disc will weaken and bulge out onto an exiting nerve. This can cause pain in the neck but also into the shoulder, down the arm or into the shoulder blade area. The symptoms can include pain, tingling, numbness and loss of strength in the arm and hand. Each muscle and area of the arm is fed by different nerves coming out of the neck. Your Physical Therapist can often determine which level of your neck is affected by which area of your arm or shoulder is symptomatic. Another problem with the discs is termed "degenerative disc disease or DDD". In a young, healthy person, the intervertebral discs maintain a healthy fluid content. Over time or with injury, discs can lose that healthy hydration and become less able to absorb shock and stress. With this "drying out" of the disc the spaces between the vertebrae lessen and the areas where the nerves exit the spine become more cramped for space. This lack of space for the exiting nerve is called "spinal stenosis" and can also cause the above-mentioned symptoms.

    What you can do: Being told you have a "bulged disc" can be a very frightening thing. However, discs do have the ability to heal much like any other area of your body. Sometimes the damage is too severe but very often, with time, proper care, and without re-injury, the disc will slowly heal and symptoms will diminish. The Physical Therapists at RehabAuthority have the proper training in spine care to perform a detailed movement assessment on your neck to determine if certain movements and exercises can reduce your symptoms. He or she can show you healthy ways to exercise your neck and not make your symptoms worse. These healthy exercises will provide the optimal environment in which your neck can heal.

  4. Headaches: There is nothing worse than a pounding headache! Headaches can have many origins. Migraine headaches are often caused by malfunctioning chemistry or neurology in the brain. Tension headaches can be caused by muscles in the neck or at the base of the skull that are aggravated or overworked. Doctors define a migraine headache as a recurrent headache that has additional symptoms. The pain can be throbbing and on one or both sides of the head. People with migraines will often feel dizzy or sick to their stomachs. There also may be an increased sensitivity to light, noise, or smells. Tension headaches originate usually from the tiny group of muscles at the base of your skull in the back or the muscles along the sides of your neck. Stress can cause tension to build in those muscles which will irritate nerve endings and set off a headache. Aggravated joints in the upper 2-3 cervical vertebrae can cause headaches as well.

    What you can do: If you are having true migraine headaches your best option is to see your doctor and find out if there is a medication or change of diet that may decrease your headache episodes. If your problem is due to tension taking time out of your work day to stretch occasionally is one of the best things you can do. The Physical Therapists at RehabAuthority have the proper training to teach you specifically what stretches to do and how many. Many people with headaches have tried dozens of treatment with no significant results. We've helped hundreds of people with terrible headache problems completely eliminate their headaches for good.

Prevention Each Day Keeps the Neck Pain Away!

You may ask yourself, "What can I do to prevent myself from getting neck pain?" Prevention is always the best cure. Here are some ways that you can decrease your chances of getting neck pain:

-Exercise. Studies show that 30 minutes of aerobic exercise a day can drastically reduce your chances of getting spine pain. These aerobic activities include brisk walking, running, bicycling, or swimming.

-Avoid "shoppers tilt" - carrying heavy items on one shoulder for long periods of time.

-Don't sleep on your stomach. Being in the sustained posture of having your neck rotated all night long can cause serious pain in the morning!

-Don't sleep with too many pillows. You should rest just like you stand. Your head should be in a "neutral" position. Not too much bend forward, backward or to the side.

-Don't lift or shovel cold. Always try to be warmed-up before you do any heavy lifting or shoveling snow.

-Try stretching exercises before bed and first thing in the morning.