The neck consists of seven cervical vertebrae that connect the skull to the torso. With trauma, the neck is more susceptible to injury than other regions of the spine because of its relative lack of protection, and because the head often acts as a fulcrum in any “whiplash-like” situation. According to a survey conducted by the National Institute of Health Statistics, about two-thirds of Americans will experience neck pain in their lifetimes, and neck pain is tied for second as the most common type of pain reported by Americans. The causes of neck pain due to injury depends on the structure affected.
Neck Strain
The most common tissue to be injured and cause pain with a neck injury is muscle / tendon. Generally, muscles of the cervical spine are thinner and not as strong as those in the lumbar spine and limbs. Muscles such as the splenius, suboccipitals, sternocleidomastoid and levator scapulae can be bruised, stretched and slightly torn with trauma, especially acceleration/deacceleration trauma commonly referred to as “whiplash.” Whiplash is most commonly caused by car accidents, which frequently strains neck muscles to produce soreness and achy pain. In the April 2003 edition of the "Journal of Spinal Disorders & Techniques," a study on whiplash incidence reported that Americans experience 120,000 whiplash related cases per year, with 94 percent of those cases involving neck pain.
Neck Sprain
Depending on the extent of the trauma, the small facet joints and related ligaments of the cervical spine can be injured and produce pain. Most car accidents produce enough force to injure the neck joints, as well as the muscles. The capsules and ligaments surrounding the facet joints are rich in pain receptors and can readily generate pain. Pain from cervical facet joints is often sharp and stabbing, especially with neck and head movement. Neck joints can also be irritated and injured with poor posture, or even from sleeping on an inappropriate pillow, which is often called a “kinked” neck. According to the MayoClinic.com, risk of neck pain may be higher if a job requires a person’s neck to be held in one position for prolonged periods of time, such as driving and computer work.
Disc Injury
In severe enough trauma, the intervertebral discs between the lower five vertebrae can be injured, leading to tears, disc bulging and even herniations. Severe car accidents, trauma from contact sports and falls from ladders and roofs are common causes of cervical disc injuries. Pain from disc injury can range from mildly achy to excruciating, depending on any nerve involvement. If a bulging or herniated disc injures the lateral nerve roots, then tingling, “electric” and/or shooting pain can occur into the shoulders, arms and hands. A posterior disc bulge or herniation has the potential to injure the spinal cord itself, which can cause strange pains and also numbness, weakness and spasticity in the arms and legs. Severe spinal cord injury results in paralysis, and often death if the injury is high enough up the neck to affect breathing.
Neck Fracture
Although very uncommon, fractures of the cervical vertebrae can occur with severe enough injuries. Compression or burst fractures of the vertebral body, end-plate fractures or avulsion fractures of parts of the vertebrae such as the spinous process, are the most common types of fractures, Terry Yochum notes in the 2002 text "Essentials of Skeletal Radiology." Pain with fractures is often severe and involves damage to other structures.
References
- National Institute of Health Statistics: Pain Statistics
- "Journal of Spinal Disorders & Techniques"; The Incidence of Whiplash Trauma and the Effects of Different Factors on Recovery; Ylva Sterner et al; April 2003
- MayoClinic.com: Neck Pain / Risks
- "Chiropractic Management of Spine Related Disorders"; Meridel Gatterman D.C.; 2001
- "Essentials of Skeletal Radiology"; Terry Yochum D.C.; 2002
