Cervical Pain
Cervical pain is the
third leading cause of pain following headaches and then low back pain.
At some in their life, at least 80% of the population will experience some
form of cervical or neck pain.
45% of working men
have been affected with at least one episode of stiff neck. The frequency
of cervical pain syndromes doubles from ages 25-45.
To understand
cervical pain, it is essential that one have a concise knowledge of
cervical anatomy.
In the adult spine
the neck is held in a slightly lordotic position with a slight scoliosis
that can be identified in 80% of the people to the left.
All range of motion
is possible in the cervical spine with flexion having the chin touch the
sternum, extension to have the eyes horizontal to the ceiling, rotation 90
degrees is to have the chin over the shoulders.
The cervical spine
is comprised of seven vertebrae. Just below the occiput or the skull the
first and second vertebrae are unique in their anatomical structure and
function.
The more distal
cervical vertebrae of the third through the seventh vertebrae are more
identical and functionally perform as a unit in flexion, extension
rotation and lateral flexion.
The first two
vertebrae C1 and C2 are unique. C1 is called the atlas adjacent to the
occiput. The primary function of the atlas is to allow flexion and
extension having flexion of 10 degrees and extension of 25 degrees.
Some have
functionally related the atlas as being a washer when using the analogy of
a bolt and nut.
The second cervical
vertebra is called the axis. Its function is to provide rotation, which
gives 50% of functional rotation of the cervical spine. It allows for 45
degrees rotation to either side.
Cervical vertebrae
three through seven inclusive allow for another 50% rotation to
accommodate for the full 90 degrees to either side as well as optimize
flexion and extension and promote lateral flexion.
Lateral flexion is
obtained from the primary lateral flexors, the scalenes which have their
origin in the upper cervical attachments.
The spine achieves
its greatest flexion in the mid cervical region of C4-5 and C5-6. The
greatest extension is noted in the C4-5 region. Therefore it is obvious
that with repetitive motions and repetitive use, osteoarthritic changes
can be first noted in the regions of C4-5 and C5-6.
The cervical area
contains many pain sensitive structures, which includes the bone
vertebrae, the many including the large ligaments being the anterior and
posterior longitudinal ligaments, the nerve roots, the facet joints and
capsules as well as the attaching muscles of the neck.
The source of pain
can originate from any one of these structures, as well as create a
pattern of referred pain for these structures that mimic peripheral nerve
neuropathics.
Should you have any further questions
regarding this article, please direct your questions or comments to "Ask
the Doctor" section.
Copyright © 2004 - 2008 Taras V.
Kochno, M.D. All Rights Reserved
Board Certified in
Physical Medicine and Rehabilitation
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