Video presented by Grant Cooper, MD

In This Article:

Video Transcript

My name is Dr. Grant Cooper, the co-director of the Princeton Spine & Joint Center. I have been asked to talk to you today about the most common causes of neck pain. We talk about necks just like we would talk about lower backs – we make a distinction between acute neck pain and chronic neck pain. Chronic neck pain is anything that lasts longer than three months. When we talk about acute neck pain, there are a lot of different causes of acute neck pain, the most common of which are going to be muscle strains and sprains. As we get into chronic neck pain, there are two most common causes of chronic neck pain.

The most common by far are the facet joints. The facet joints – if here’s the neck, brain’s here, this is the front, this is the back, spinal cord, nerves come out the side – the facet joints are over here. The facet joints are like knees, shoulders, hips fingers…they are synovial joints; they have all the same basic parts as other joints. They are just a little more exotic because they are deep in the spine and you can’t see them without imaging studies. You can’t push on them just by pushing on the neck because they are too deep. But just like a knee or shoulder or hip, a facet joint in the neck can become arthritic, can become painful, you can tear the capsule. The same kinds of things you can do to a knee or a shoulder you can do to the facet joint, especially in whiplash injuries where the neck snaps backwards. You can imagine these are the joints where they snap backwards, you get a lot of pressure on those joints. In the neck, the facet joints are the most common cause of chronic neck pain.

The second most common cause of chronic neck pain are the discs. You’ve heard of herniated discs. When pain comes from the disc – pain in the neck comes from the disc – it is not exactly the same thing as a herniated disc. A herniated disc herniates out and irritates a nerve and that sends pain, numbness, tingling, sometimes you develop weakness in the arm. When the pain is in the neck itself and the pain is coming from the disc, it is because there is a tear inside of the disc. A tear in the disc will allow the jelly in the middle of the disc to ooze out into the outer third or outer two-thirds of the crust of the disc. What happens is that in that jelly in the middle of the disc, there are inflammatory proteins. And when there’s a tear and those inflammatory proteins ooze out, they irritate the nerve fibers that are sitting in the outer third or outer two-thirds of the crust of the disc and that’s where you get pain coming from the actual disc in the neck.

And those are by far the two most common causes of chronic neck pain. What sometimes happens is in addition to having facet joint pain or disc pain, the muscles will tighten up around it and go into spasms and often will push on the neck and make it tender as well. But the underlying cause of chronic neck pain is typically going to be coming from either the facets or the discs. I hope that’s helpful.