A PAIN IN THE NECK
Having a pinched nerve in your neck (a cervical
radiculopathy) is pretty common. It’s often painful, and
can be disabling. Though some cases may need surgery,
the majority doesn’t. 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
neck’s 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 vertebra, 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 (or herniated) disc.
Problems occur when the disc pushes on a nerve or on the
spinal cord. Another common cause of pinched nerves is
an opening out of the spinal canal (the foramen) which is
too small. This is often caused by bone spurs or by
arthritis.
It’s usually possible to start treatment of cervical
radiculopathy at home. Commonly used anti-
inflammatory / pain medicines, like Advil® and Motrin® pretty comfortable. It’s helpful to wiggle your head side to
(ibuprofen) or Aleve® (naproxen) may be helpful. Also, side a little bit now and then while you’re lying there.
avoid things that compress the spine, like bouncing up and
Lie there for seven minutes only on the first day you do
down driving on a dirt road, or jumping down from a
this. It might feel good right away, or you might not feel
height (even as little as a foot or two).
any difference. If you do it for too long you may over-
One of the most helpful treatments in my experience is stretch your neck muscles and make them cramp, causing
home traction. All you need is a small towel, a piece of you to feel worse. You can do it twice the first day if you
rope or strong cord, and a like, at least eight hours apart. Then add a minute a day
doorknob. First, tie one until you get to fifteen minutes twice daily. Continue at
end of the rope to one end fifteen minutes twice a day for as long as you need to,
of the towel. Then loop depending on symptoms. Whatever you do, don’t overdo
the rope over the it.
doorknob, and bring it
back to the other end of
the towel and tie it. You This technique often relieves the pressure on the nerve,
want it to be just long which reduces pain / numbness / weakness. And relieving
enough that the middle of the pressure often allows a swollen, irritated nerve to
the towel barely touches recover, becoming small enough so it’s not pinched
the floor under the anymore. If this technique doesn’t help, or if you get
doorknob. worse, see your doctor.
Next, lie down on your A couple of pointers: make sure you have a loud timer
back with the top of your with you, so you don’t fall asleep. If you do, you may
head close to the door – it overstretch your neck muscles, which can cause cramps
should be about an inch and more pain. Also, be sure to lock the door so nobody
away. Rest the back of opens it while you’re lying there.
your head (about even
(Don’t ask me how I know this.)
with your ears) in the
© 2006 flash gordon md
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