Neck pain is usually the clinical manifestation of wear and tear to the cervical spine, the medical term for which is cervical spondylosis. Spondylosis is described elsewhere in this website (hyperlink). The pain, therefore, relates to the wear and tear in the joints of the cervical spine, namely the disc joint and facet joint. The anatomy of these is described again elsewhere in this website (hyperlink). As you might expect, the pain is typically in the back of the neck but commonly radiates into the midline spine between the shoulder blades or up into the head and, therefore, can be associated with headaches, particularly in the back of the head. In addition to radiating up and down the midline, namely to the head and area between the shoulder blades, it is commonly associated with pain radiating out to one or other shoulder.
In terms of treatment, there are a range of options depending on a number of factors, most notably whether the pain is associated with nerve root entrapment radiating down the arm (brachialgia). It should be emphasized that the treatment options are wide ranging and need to be individualised to the patient. As a general principal, most episodes are self-limiting and can be managed with simple analgesia. Non-surgical options such as physiotherapy, osteopathy and chiropractic treatment may have a role. Particularly in the neck, before active manipulation is carried out it is sensible to undergo specific imaging of the cervical spine in the form of an MR scan to ensure that such treatment is safe. Interventional options include steroid injections which may either be into the epidural space or into the facet joints. Surgery itself is rarely indicated for neck pain unless associated with brachialgia (arm pain) in which case surgery can be extremely successful in relieving the symptoms. The nature of the surgery is described in the section of this website entitled Spine Procedures.