Neck Pain (“Shoulder” or “Scapula” pain)

Neck pain is a very common symptoms affecting the general population. With the usage of mobile devices and deskbound screens with poor ergonomics, the incidence of neck pain has increased over the years. Text neck is a common term that has been used to describe neck pain from over usage of such devices. (https://www.straitstimes.com/singapore/health/5-tips-to-prevent-painful-text-neck)

Neck pain can occur from the muscles in the neck, the discs (cushions), bones and joints. Fortunately, most cases of neck pain get better by itself. If it doesn’t, medical attention should be sought by someone experiencing persistent or severe neck pain.

Muscles in the neck

Looking down increases the force experienced by the structures of the neck including the neck muscles. Strain of these muscles of neck can cause neck ache when someone is looking down for prolonged periods.

Discs

Discs are cushions that act as shock absorbers between bones. A jelly-like substance sits inside the disc (nucleus pulposus) surrounded by collagen fibres (annulus).

Degeneration of the disc or tears in the disc (annular tears/ annular fissures) can cause neck ache. Slipped disc is a term used to describe the nucleus pulposus “slipping” out of its usual confines. This is termed as a slipped disc or herniated nucleus pulposus. Slipped discs can be a cause of neck ache or even nerve symptoms as sometimes, they compress the nerves around them.

In rare cases, infections can occur in the disc. This is called discitis or inflammation of the disc. Discitis is a very serious condition and needs prompt medical attention.

Bones of the spine (Vertebra)

The bones of the neck are much smaller than the bones of the low back. Moreover, the upper part of the neck (1st and 2nd cervical vertebra) are quite unique in structure as compared to the rest of the spine. Fractures of the bones of the neck can occur from falls, trauma or road traffic accidents. Some conditions that affect the spine such as infections, tumours, inflammatory conditions like rheumatoid arthritis or ankylosing spondylitis can increase the chances of a spine fracture.

Osteoporosis is a condition where the mineral (calcium) density of the bone decreases. This causes the bones to weaken pre-disposing to fractures. Osteoporotic fractures are usually more common in the lower back as compared to the neck.

Joints (Facet joints and uncovertebral joints)

The bones of the spine (vertebra) move against each other at the back through the facet joints. Arthritis of the facet joints can cause neck pain. There are special joints in the neck between the vertebrae called uncovertebral joints. These also can cause problems with degeneration.