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Home | Health & Fitness | Medicine The workup consists of a detailed history and physical examination supplemented by imaging procedures such as x-ray, magnetic resonance imaging, and/or CT scanning. Neck pain has a variety of causes. For many people, it is caused by muscle spasm that could be related to strain or sprain. A strain happens when the muscle is stretched a bit. A sprain occurs when the muscles are actually damaged so that there is edema and bleeding into the tissue. Sleeping in a poor position can often lead to strain whereas a rough game of touch football or a whiplash injury can lead to sprain. The treatment for a strain consists of rest using a soft collar, ice for the first twenty-four hours, then moist heat, anti-inflammatory medication, and gentle stretches. A sprain is a more serious problem. This may require more extensive immobilization, the use of a neck support pillow, and aggressive physical therapy. Soft tissue injections with corticosteroid may also be necessary. Osteoarthritis of the neck along with degenerative disc disease is a common cause of neck pain in people over the age of 35. The treatment here is very similar to that for a sprain. Anti-inflammatory medication, physical therapy, and exercises are helpful. Gentle traction may also be effective, particularly if there is evidence of nerve root compression. A neck support pillow may be helpful. Care must be taken to exclude spinal cord compression or in stability of the neck before starting aggressive physical therapy. Patients with significant problems related to nerve root irritation, where there is no contraindication, may benefit from epidural steroid injections. People who have chronic neck pain may respond to the use of transcutaneous nerve stimulation (TENS) and a home traction/ exercise program. Inflammatory forms of arthritis such as rheumatoid arthritis and ankylosing spondylitis can also affect the neck. Control of the underlying disease supplemented by physical therapy may be helpful. Again, confirmation that no significant nerve or spinal cord compression or instability is mandatory. The reason for this is that patients with inflammatory diseases of the spine may have significant instability problems in the neck. This situation can be potentially life-threatening. Patients with myofascial pain or fibromyalgia may also have neck pain. Treatment here consists of medications, physical therapy, the use of a neck support pillow, and soft tissue injections. For patients with osteoarthritis and fibromyalgia, botulinum toxin (Botox) injections may provide good symptomatic relief for up to six months. Article Source: http://www.articlewheel.com
Nathan Wei, MD, FACP, FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland (www.aocm.org). He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and consultant to the National Institutes of Health. For more info: www.arthritis-treatment-and-relief.com/arthritis-pain-relief.html">Arthritis Pain Relief
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