Combat neck pain effectively - the best way to do it

Combat neck pain effectively - the best way to do it 

(This article was published on 02/02/2024 at Orthinform - Patient information:
https://orthinform.de/patienteninformationen/nackenschmerzen-wirksam-bekaempfen-so-macht-man-das-am-besten)

The structure and function of the cervical spine

It is important to know how the cervical spine is structured and what it is used for in order to properly understand why the neck can sometimes really hurt.
The neck is the upper part of the spine and consists of 7 vertebrae. This is followed by the thoracic and lumbar spine with 12 and 5 vertebrae respectively.

Whereas the thoracic and lumbar spine have a load-bearing and postural function to cope with high loads on the arms and legs, the cervical spine combines the load-bearing and movement functions in one. It carries the head, which can weigh up to nine kilograms, and allows it to move in almost all directions, the most important of which are the rotational movements.

The different cervical vertebrae

There are some differences between the cervical vertebrae. The vertebrae in the upper part of the neck are generally smaller and more mobile, while the lower cervical vertebrae are larger to cope with greater loads from the neck and the head above.

The lower motion segment of the cervical spine connects the neck with the upper motion segment of the thoracic spine and together they form the so-called cervico-thoracic joint. This joint is characterized above all by the relatively sudden change from a highly mobile neck to an almost inflexible upper back. In addition, the backward curvature of the cervical spine reverses into a forward curvature of the thoracic spine. These typical characteristics of the crossover area lead to a higher mechanical load, particularly on the lower movement segments of the neck, and with a simultaneous lower anatomical load-bearing capacity, complaints can easily arise.

The vertebral joints

All vertebrae of the cervical spine are connected by a pair of facet or vertebral joints, an intervertebral disc and strong, tension-resistant longitudinal ligaments. The position of the articular surfaces of these joints, together with the structure of the vertebral/intervertebral disc segment and the complex movement mechanism, determines the mobility of the cervical spine.

Similar to other large joints, the vertebral joints are lined with cartilage and filled with synovial fluid. They are held together by a strong capsule and strong ligaments. As in other joint capsules and ligaments, these capsules and ligaments are richly supplied with nociceptors, sensory organs that can pick up pain stimuli. The nerve fibers connected to these receptors transmit the stimuli to the cerebral cortex, where they are perceived as pain.

The spine as the cause of pain

It is assumed that the intervertebral canals, through which these nerve fibers emerge from the spinal cord and run into the arms, legs, and facet joints, can narrow (stenosis) and pinch nerves due to, among other things, diseased intervertebral discs, which may then cause pain in the neck and arms or legs. Diseased intervertebral discs can also lead to excessive strain on the facet joints, which can cause neck pain in the same way, according to the widespread opinion.

Strong neck and shoulder blade muscles - healthy neck

It is the functioning muscles that give the neck its mobility, active stability, and relatively high resilience. Just think of urban and street dancers, who often perform the most amazing feats on their heads.
Firstly, there are the original deep neck muscles, which are the main actors in head movements. Secondly, there are the superficial back muscles, which only have a limited, secondary but important function for the neck.

Their main function is the stabilizing movement of the shoulder blade and the straightening of the thoracic spine but in close connection with the movements of the arm and a reduced backward curvature of the neck.
The most important superficial back muscle, which is also important for the cervical spine, is the trapezius or hood muscle. The lower part with ascending fibres and the middle part with horizontal fibres are very important for optimal alignment and therefore for the load-bearing capacity of the thoracic and cervical spine. The main function of the upper part with descending fibres is normally to turn the head and bend it sideways. It also lifts the shoulders and (over)stretches the cervical spine. This makes it a counter-player to the other parts of the same muscle.

As the cervical spine is very susceptible to simultaneous hyperextension, lateral flexion, and rotation, it is important to avoid these movements by minimizing the activity of the upper part of the hood muscle and encouraging that of the middle and lower parts.

What does science say?  

Scientific studies have shown that the middle and lower shoulder blade muscles work closely together with the shoulder muscle, and the deltoid muscle, as they form a strength pair. This strength pair functions optimally in a healthy shoulder joint. Reduced function of this strength pair leads to increased strain on the neck and can trigger pain, which can then be attributed to a dysfunctional shoulder joint.
Current studies show that radiating pain in the arm is not necessarily associated with dysfunction of the neck. Diseased shoulder joints can cause almost the same symptoms.
Imaging examinations can show abnormalities in the cervical spine without these necessarily being associated with symptoms. On the other hand, radiological findings do not show positive results in patients with neck complaints. Motor findings of both the cervical and thoracic spine and the shoulder joint are therefore preferable.

Conclusion

The cervical spine is particularly susceptible to asymmetrical forces or forces perpendicular to the longitudinal axis. Movements that trigger such forces should be avoided. Furthermore, exercise therapy should not be limited to the neck alone. Including the thoracic spine and shoulder is important to combat neck pain in the long term.

Exercise video

In this video you will learn how you can counteract your neck pain in a relatively simple but effective way: To do so, click on the above link that leads to the original publication.

© Paul Geraedts