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NECK PAIN ANATOMYAnatomyNeck pain anatomy will help you understand the complexity of the neck. It is no simple organ. Neck pain is so common because of the extreme complexity and sensitivity of the many structures in the neck. A brief survey of the neck pain anatomy highlights its exquisite construction, and why a painful neck is so common. The heavy skull and brain are precariously balanced on seven highly complexly engineered and exquisitely made neck bones or vertebrae, each a possible source of neck pain. The cervical spine starts just below the skull and ends just above the shoulder. It normally has a lordotic curve (a backward C-shape) which, if altered by injury, almost always is associated with chronic neck pain. The cervical spine is much more mobile than both of the other spinal regions - think about all the directions and angles you can turn your neck, normally without any painful neck. The structure is tightly bound together by discs, ligaments and muscles, all potential sources of neck pain. Not so tight though that it cannot move. 33 joints make the neck highly mobile, though each may be a source of the common painful neck. Though the cervical spine is very flexible, it is also very much at risk for injury from powerful, sudden movements, such as whiplash-type injuries and falls. This high risk of harm is due to: the limited muscle support that exists in the neck, and because this part of the spine has to support the weight of the head. This is a lot of weight for a small, thin set of bones and soft tissues to bear. Therefore, sudden, strong head movement can cause damage. Horse-riders and gymnasts, boxers and rugby players almost always have injuries in this region causing a painful neck. Through the neck travel the most exquisitely sensitive pain structures in the body: the spinal cord and nerves emerging to supply various parts of the body, particularly the arms and scalp.
BonesTwo vertebrae in the cervical spine, the atlas and the axis, differ in their neck pain anatomy from the other vertebrae because they are designed specifically for rotation. These two vertebrae are what allow your neck to rotate in so many directions, including looking to the side. Because of their proximity to the brainstem and the spinal cord, any injury, fracture, displacement, or fixation (jamming) has the potential to cause severe neck pain, headache and a host of neurological conditions. Car accidents, falls, blows to the head commonly injure this part of the spine. The Hangman’s knot is specifically designed to fracture the axis, and rupture the spinal cord. Hence the not uncommon ‘Hangman’s fracture’, found in serious accidents.
The atlas is the first cervical vertebra -- the one that sits between the skull and the rest of spine. The atlas does not have a vertebral body, being made up of a complex ring. The atlas sits on top of the second cervical vertebra -- the axis. The axis has a bony knob called the odontoid process, also known as the the dens that sticks up through the hole in the atlas. It is this special arrangement that allows the head to turn from side to side as far as it can. Special ligaments between these two vertebrae allow a great deal of rotation to occur between the two bones. Seven delicate and highly complexly engineered vertebrae make up the bony structure of the neck pain anatomy, cushioned by disc material. JointsThere are 33 tiny joints between the bones of the neck and between the neck and the skull. The bones are separated by discs, made up of concentric circles of fibrous material with a bubble of gel in the centre, acting as shock absorbers for the all bouncing, jogging, jumping movements of the neck.There are several different types of joints in neck pain anatomy. Disc joints, facet joints, unco-vertebral joints but they all have one thing in common: important nerves, the most sensitive tissue in the body, travel close by. Any injury, swelling, strain and sprain has the immediate potential to affect the nerves causing pain, headache, tingling and dysfunction of the organs they supply. Nerves and Discs
The so-called brachial plexus is a large group of nerves that emerge from tiny foramena in the neck. They travel to and from the arms, as explained in neck pain anatomy, where they initiate muscle action (eg picking up a sandwich) and sense changes at the skin. Cold, hot, touch, vibration etc. They also tell the brain where the hand is in space for example, without your eyes having to look.
Between each pair of spinal bones is a large disc. It consists of two parts, an outer washer made of very tough fibres and an inner bubble of gel which is like a large shock absorber. I feel sure you have heard of the so-called slipped disc in which the gel has bulged out through the surrounding washer. Frank pinching of these nerves may cause severe pain and disability in the arm, but even irritation of the nerve roots will cause shoulder pain, and make one prone to Tennis elbow and other conditions in the lower arm such as carpal tunnel syndrome.
LigamentsThe neck is stabilised in the upright position by MANY very strong ligaments, that stretch from bone to bone maintaining the correct structure and preventing a painful neck. Some are tiny, for example the ligaments holding the ring of the atlas in position, whilst others are very large and strong. They are a very important part of neck pain anatomy.Ligaments are highly innervated, so that the brain will know where the neck is in space whilst the eyes are closed. Any excessive stretching of ligaments, as in whiplash will cause these nerves to fire off, giving pain. If the ligaments are stretched beyond their elastic limits then important changes in the posture of the neck, and the position of the bones will occur, causing further neck pain. In the normal neck, the curve is known as a lordosis. After a whiplash, the curve is reversed, producing a kyphosis. Kyphosis = Pain. MusclesPainful neck can originate in the muscles of the neck. The head and neck are able to move because of muscles that control and initiate the movements. Looking up at the ceiling, checking under your bed for your shoes, looking for traffic as you cross the street - all these movements are controlled by muscles. There are also stabilising muscles whose primary function to maintain the neck in the upright position.Muscles were designed to move. Even maintaining a healthy muscle in the same position for a long period of time (eg sitting in front of a computer, driving a car, or lying on the stomach all night with the head turned) will cause fatigue and neck pain. There are many large and tiny muscles in the neck, each a source of neck pain anatomy.
Manipulation of the neck has recently received strong condemnation from Chiropratic's critics as being highly dangerous and can cause a stroke. While this is acknowledged, it is so rare that it can large be ignored (approximately equivalent to being struck by lightning on the golf course). What our critics conveniently ignore is just how much more dangerous anti-inflammatories and analgesics are. All forms of treatment of any and every condition have potential dangers it should be candidly admitted, and in this regard chiropractic is no different. I hope NECK PAIN ANATOMY has given you some idea of the complexity of your neck. We haven't forgotten you, Maureen. One of those very special people. USEFUL LINKSDangers of chiropracticDangers of anti-inflammatory drugs Dangers of painkillers Meningitis - stiff neck and high temperature. To return from NECK PAIN ANATOMY to NECK PAIN
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