Since there are many causes of neck and arm pain, finding the root cause of the pain is very important for the happiness of the patient and the physician dealing with that patient. If the true cause of the pain is not found and the wrong diagnosis is made, the physician cannot produce a solution and the patient is writhing in pain with the pain. Compression of the neck vertebrae and discs on the nerves going to the arm and spinal cord may be the source of pain.
Causes;
1-Poor posture and abuse of neck; In our daily life, all wrong movements and postures that are not suitable for neck health cause wear on the spine, disc, joint and connective tissue, causing the natural inclination of the neck to disappear and this is an important cause of pain.
2-Neck injury; As a result of straining the neck more than its normal movement, as in in-vehicle traffic accidents, injuries may occur in the disc, bone, ligaments and joints, and pain due to excessive mobility may occur in such cases in the late period.
3- Tension, stress, smoking; These are the most important reasons that increase neck pain and make it chronic, and our economic, social and psychological problems increase neck pain. There are complaints of constant tension and painful spots on the neck. Working regularly, social pursuits and commitment to life, and getting psychological support when necessary are the solution methods against neck pain for this reason.
4-Neck Stiffness, Muscle spasm; It is usually caused by excessive stretching of the muscles that support the neck. Muscle spasm can be caused by lifting something heavy above the head, excessive sports, work activity, improper desk work. Sleeping in the wrong position, high pillows and bad travel conditions can also cause stiff neck. Most of the time, spasm and stiffness are resolved with simple treatments, while myofascial pain, fibromyalgia and myositis cause long-term muscle pain, causing pain-triggering points in the muscle, local swelling that can be felt by hand, and requires long-term treatment of different disciplines.
5-Neck Hernia; It is the overflow and compression of the disc tissue, which is the jelly-like cartilage that serves as a cushion between the two neck vertebrae, towards the nerves that go to the spinal cord and arm. Depending on the size and effectiveness of the press, neck and arm pain, loss of strength in the arm muscles, numbness and clumsiness in the hands can be seen. If there is pressure towards the spinal cord, difficulty in walking, weakness in the legs and urinary complaints can also be seen. If the complaints do not go away despite conservative treatment, if there is severe spinal cord and nerve compression; then the treatment is surgery.
6-Disc degeneration, Calcification; As a result of aging and misuse of the spine, there is wear in the bone structure, ligaments and discs, and the jelly-like disc deteriorates and collapses, losing its force-absorbing feature and flexibility. The calcium content of the bone decreases and the body naturally calcifies these worn tissues. The newly formed ossicles, petrified ligaments and narrowed disc distances can press on the nerves and cause neck, arm and general body pain, and as a result, numbness and weakness can be seen in the hands and feet by compressing the spinal cord.
7-Narrowing in the spinal canal (Cervical Narrow Canal); Especially in advanced ages, numbness, weakness and clumsiness in the hands, difficulty in walking, and numbness in the hands and feet can be seen, and it progresses with the narrowing of the channels through which the spinal cord and/or nerves pass, and the deterioration of spinal cord nutrition. Permanent damage to the spinal cord can be prevented by early detection and early treatment of the disease.
8-Osteoporosis, osteoporosis; Osteoporosis is basically a gynecological disease, causing softening of the bones, causing easy fracture and therefore pain. Since calcium and vitamin D deficiency in nutrition, sedentary life, early menopause, excessive alcohol consumption, and corticosteroids increase the risk of osteoporosis, a treatment protocol should be determined by paying attention to these in the treatment
9-Spine fractures, vertebral shift; The vertebrae are normally quite strong and can sometimes be damaged by accident or other causes, cracked or broken completely. With the severity of the trauma, the cervical vertebrae may slip and damage the spinal cord. Serious spinal cord and nerve cuts can be seen. Determining the height with an absolute collar after the accident is life-saving, and early medical treatment and, if necessary, surgical treatment can save the patient with minimal neurological deficit for the future.
10-Trap of the arm and hand nerves; On the way to the hand, the nerves coming out of the spinal cord in the neck are trapped and compressed by the connective tissue where they pass. As a result of the compression here, weakness, numbness and pain occur in the hands and arms. Numbness at night, especially in the first 3 fingers of the hand, is typical for “carpal tunnel syndrome”. In patients with this type of pain and numbness, differential diagnosis should be made with absolute EMG test. Surgical decompression is required in patients who fail to achieve results with conservative treatment. Specific to Carpal Tunnel Syndrome during pregnancy, palpable pain and numbness in the wrist that wakes you up at night may increase and EMG may support this diagnosis. While waiting for a response to conservative treatment at the end of pregnancy, we should wait for the edema to pass, and the first choice should not be surgery.
11- Rheumatic Diseases; Normal bone and cartilage tissues in the spine are damaged and rheumatic diseases such as rheumatoid arthritis, ankylosing spondylitis may cause permanent limitation in neck movements. Joint stiffness lasting more than half an hour in the morning and difficulty in movement are typical for rheumatic diseases. Especially with this pain in the morning, when the head is placed on the pillow, the pain increases, strain or if the head cannot be placed on the pillow and stays upright, it should be examined in terms of rheumatic diseases.
12-Other reasons; Neck tumors, spinal cord tumors and “Syringomyelia” that creates fluid crevices in the spinal cord, bone infections (tuberculosis, brucellosis, etc.) can also cause neck and arm pain. Pain originating from the shoulder joint (Bursitis, Capsulitis, Tendinitis) may imitate neck and arm pain or may cause pain in the neck muscles as a result of limitation of movement. Diseases of the esophagus, trachea, thyroiditis and lung are also rarely causes of neck pain.
If the causes of neck pain are well known and appropriate tests are performed and no mistakes are made in the differential diagnosis, the patient’s treatment is unlikely to fail.
