A PAIN IN THE NECK

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Having a pinched nerve in your neck (a cervical radiculopathy) is a pretty common condition. Itís often painful, and sometimes disabling. Though some cases of pinched nerves may eventually need surgery, the vast majority doesnít. Pain in the shoulder or arm that can be caused by tilting or turning the head in a particular way is likely due to a pinched nerve in the neck. Just as you can feel pain down your arm by hitting the funny bone (ulnar nerve) in your elbow, shoulder and/or arm pain is often caused by neck problems.

Pain is an early symptom of nerve pressure. Sometimes pain is constant: at other times it comes after work or after standing, sitting, or walking all day. Numbness or tingling is also common with a pinched nerve, and may be more serious than pain, though not as uncomfortable. If your arm is numb: that is, if you can pinch it or stick it with something sharp and not feel it, you need to seek care promptly. Nerve pressure that continues can permanently damage the nerve. Weakness is another symptom that can be caused by nerve pressure. Occasionally, an arm can be completely numb and paralyzed. Needless to say, this requires treatment without undue delay.

It helps to understand the anatomy of the neck. Your neckís composed of seven bones (called vertebrae) in a row. Between each one is a soft disc. The discs have a tough covering with a softer inside: think of a waterbed full of jello. Your spinal cord is inside the vertabra, right behind the solid part, in the spinal canal. There are openings on each side where the nerves to your neck, shoulders, and part of your arms come out. If a nerve is getting pushed on, you may have pain, numbness, and/or weakness in the neck, shoulder, arm, or hand. Varying amounts of pressure cause varying symptoms.

In some cases, the inside part of a disc will push through the covering: this is a ruptured disc (or herniated disc). Problems occur when the disc pushes on a nerve or the spinal cord. Another common cause of pinched nerves is an opening out of the spinal canal (the foramen) which is too small. This can be caused by bone spurs or by arthritis.

Itís usually possible to start treatment of cervical radiculopathy at home. Commonly used anti-inflammatory / pain medicines, like Advil, Nuprin, and Motrin (ibuprofen) or Aleve (naproxen) are helpful. Also helpful is avoiding things that compress the spine, like bouncing up and down driving on a dirt road, or jumping down from a height (even as little as a foot or two).

One of the most helpful treatments in my experience is home traction. All you need is a small towel, a piece of rope or strong cord, and a doorknob. First, tie one end of the rope to one end of the towel. Then loop the rope over the doorknob, and bring it back to the other end of the towel and tie it. You want it to be just long enough that the middle of the towel barely touches the floor under the doorknob.

Next, lie down on your back with the top of your head close to the door. Rest the back of your head (about even with your ears) in the sling formed by the towel. Your head should be held comfortably, just barely off the floor: it should not be tilted forward or back. If you do this correctly, it should be pretty comfortable. Itís helpful to wiggle your head side to side a little bit now and then while youíre lying there.

Lie there for seven minutes only on the first day you do this. It might feel good right away, or you might not feel any difference. But if you do it for too long it may stretch your neck muscles and make them cramp, causing you to feel worse. You can do it twice the first day if you like, but at least eight hours apart. Then add a minute a day until you get to fifteen minutes twice daily. Continue at fifteen minutes twice a day for as long as you need to, depending on symptoms.

Doing this often relieves the pressure on the nerve, which can reduce pain / numbness / weakness. And relieving the pressure often allows a swollen, irritated nerve to recover, becoming small enough that itís not pinched anymore.

A couple of pointers: make sure you have a loud timer with you, so you donít fall asleep. If you do, you may overstretch your neck muscles. Also (this is very important) be sure to lock the door so nobody comes through it while youíre lying there.

Donít ask me how I know this.

© flash gordon md

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