Introduction Over many years, our necks are subjected to repeated stress and minor injury. These injuries may not cause pain at the time of injury. However, repeated injuries add up, and can eventually result in degeneration of the cervical spine, causing neck pain. Most neck pain is due to degenerative changes that occur in the neck. The overall condition of the cervical spine usually determines how fast you recover from an injury, and whether your neck pain will become a chronic problem.
For chronic neck pain, there may not be a quick fix or complete cure. You will need to work with your health care team to try to improve the problem causing pain and to slow down the
degenerative process. The physician's role in the treatment of neck pain is to find the main causes that need treatment right away. He or she will also try to keep your neck pain from becoming a chronic condition by teaching you how to slow down the degenerative process and prevent further injury.
The purpose of this information is to help you understand:
The causes of neck pain
The normal anatomy of the spine and neck
The signs and symptoms of degenerative changes in the neck
The treatments available to you now and later
What you can expect from those treatments
What you can expect long-term if you have a problem with neck pain
In order to understand your symptoms and treatment choices, you must start with some understanding of the general anatomy of your spine and neck. This includes becoming familiar with the various parts that make up the neck. You should have a general understanding of the function of these parts, that is, how they work together. The more you know, the more you will be able to talk with your doctors and health care team in words that will help them better understand your specific problem. It will also help you understand what they are telling you about your particular problem.
The purpose of this information is to help you understand your neck pain problem, so you can make the decisions that will best help you to prevent injury, make the best treatment choices, and speed up the healing process.
The Parts of the Cervical Spine and How They Work
In general, the neck includes the cervical spine (the upper most part of the spine) and the soft tissues that surround the cervical spine. These soft tissues include: nerves, muscles, ligaments, tendons, and blood vessels. The cervical spine is made up of the first seven vertebrae in the spine. Your doctor will usually refer to these bones as C1 through C7. The cervical spine starts just below the skull and ends just above the thoracic spine. The spine has two main functions:
• To protect and support the spinal cord
• To give structure and support to our body allowing us to stand up straight
The vertebrae are the 24 bones that are linked together to make up the spinal column. Just as the bones of the skull protect our brain, the bones of the spine protect the spinal cord. The spinal cord is the large collection of nerves that connects the brain to the rest of the body.
In the center of each vertebra is a large hole. Because the vertebrae are all linked together, these holes line up to form a "bony tube", called the spinal canal, through which the spinal cord passes. This bony tube makes up the spinal canal, which provides protection and support for the spinal cord.
As the spinal cord leaves the brain, it travels down the spinal canal to the tailbone. Along the way, it gives off smaller nerves that leave the spine between each vertebra through an opening called the foramen. The nerves that leave the spine in the upper area, or the cervical spine, travel into the arms to the hands. The nerves that leave the spine in the chest area, or thoracic spine, mostly go into the chest and belly area. The nerves that leave the spinal canal in the lower spine, or the lumbar spine, travel into the legs and feet.
To better understand how the parts of the spine work together, let's look at a spinal segment. A spinal segment is made up of: two vertebrae, the intervertebral disc between the vertebrae, and the two nerve roots, one from each side that "branch off of " the spine. The cervical vertebrae are the smallest vertebrae in the spine because they do not have the weight-bearing function of the vertebrae in the back. One pair of spinal nerves exits through the gap between the vertebrae in each segment. One common cause of pain comes from pressure on the nerve roots, sometimes causing pain and numbness in the neck or in the lower body.
The space between two vertebrae contains a large round disc of connective tissue, called an intervertebral disc. By looking at the intervertebraldisc from above, we can see an outer ring, called the
annulus, and a soft spongy center, called the nucleus pulposus. The annulus is the strongest part of the disc and helps keep the spongy center inside the disc. The nucleus pulposus acts as a shock absorber to cushion the bones from pressure during twisting, jumping, and weight bearing.
A joint is formed where two or more bones meet. Bony knobs, called facets, extend from each vertebra and overlap each other to form a facet joint. Facet joints link the vertebrae together like a chain, and provide a mobile connection between each vertebra. The facet joints are important because they allow the neck to bend and turn. Each vertebra can move only a little, but the chain of small movements combined makes the spine very flexible.
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Herniated Disks -
One Cause of Neck Pain
also called slipped disks, bulging disks, ruptured disks
Wear and tear weakens or flattens the fluid-filled pads, "discs", so they push against nerves, causing distress
Traction works to relieve compression of the disk, at the same time promoting more normal curvature of the spine. Symptoms are eased. The long-term aim is to provide enough relief to restore normal disk functioning.