There are many conditions that can cause chronic neck pain. The following information describes symptoms of some of the more common causes of chronic neck pain.

Neck pain that radiates down the arm

Pain that radiates down the arm, and possibly into the hands and fingers, is frequently caused by a cervical herniated disc or foraminal stenosis pinching a nerve in the neck. The pain may be accompanied by numbness or tingling in the arms and/or hands. The symptoms may start suddenly or develop over time.

The approach to treatment for a cervical disc herniation is guided by how long the pain lasts, pain intensity and the degree to which the cervical nerve and/or spinal cord are affected. Most commonly, the symptoms are temporary and can be treated successfully with conservative care (such as medication, physical therapy, manipulations). If the pain does not respond within 6 to 12 weeks of conservative treatments, then surgery may be recommended.

• See Cervical disc herniation for more information about chronic neck pain

Neck pain that is related to certain activities or positions

Pain that develops slowly (often over a number of years) and tends to occur during or after certain activities or neck positions is frequently caused by cervical foraminal stenosis. Usually, impingement of one nerve root on one side of the spine causes most of the symptoms.

The condition is caused by wear or aging related changes in the joints of the neck (facet joints) or at the margins of the discs. These changes may be diagnosed by either an MRI or a CT scan with a myelogram. As with a herniated disc, the mainstay of treatment is medical care (medicine, therapy, exercise, injections, etc.). If the pain is severe or prolonged, or the functional impairment is sufficient, surgery may be recommended to open up the disc space and give the nerve root more room.

• See Cervical foraminal stenosis for more information about chronic neck pain

Arm pain with lack of coordination

Pain that radiates down the arm, along with symptoms such as lack of coordination in the arms and legs, difficulty with fine motor skills, and occasional intermittent shooting pains, is commonly caused by cervical stenosis with myelopathy.

These symptoms, which are caused by either a herniated disc or degenerative changes in the joints that can cause pressure on the spinal cord, generally develop slowly. Symptoms may not progress for years, and then the patient may notice progression of the coordination difficulties, only to be followed by another long period where there is no progression.

Conservative treatments may help relieve the chronic arm pain, but the definitive treatment option for the spinal cord compression (which causes the coordination difficulties) is surgery to decompress the spinal canal.

• See Cervical stenosis with myelopathy for more information about chronic neck pain

Neck pain that persists for more than a few months and may fluctuate

Neck pain that is often characterized by a low level of chronic pain that sometimes “flares” and gets worse, is made worse by certain positions or activities, and may be accompanied by arm pain, may indicate symptomatic cervical disc degeneration.

 

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