Neck pain is common in people of all ages and is usually caused by how we use our necks. Neck pain can be acute (occuring immediately as a result of an injury) or chronic (occurring gradually over a period of time) and has a profound effect on quality of life.
In surveys, 25 % of women and 20 % of men report neck pain in an apparently healthy population. In the UK, 15 % of hospital-based physiotherapy referrals are for neck pain. An acute attack usually settles within days or weeks, but at long-term follow-up, 58 % of patients who suffer an attack still have pain in the neck at 1 year.
Anatomy of the Neck
The cervical spine is made up of 7 vertebrae. The first 2, C1 and C2, are highly specialized and are given unique names: atlas and axis, respectively. C3-C7 are more classic vertebrae, having a body, pedicles, laminae, spinous processes, and facet joints.
C1 and C2 form a unique set of joints that provide a great degree of mobility for the skull. C1 serves as a ring or washer that the skull rests upon and articulates in a pivot joint with the dens or odontoid process of C2. Approximately 50% of flexion extension of the neck happens between the occiput and C1; 50% of the rotation of the neck happens between C1 and C2.
The cervical spine is much more mobile than the thoracic or lumbar regions of the spine. Unlike the other parts of the spine, the cervical spine has transverse foramina in each vertebra for the vertebral arteries that supply blood to the brain.
Intervertebral discs are located between the vertebral bodies of C2-C7. They serve as force dissipators, transmitting compressive loads throughout a range of motion. The discs are thicker anteriorly and therefore contribute to normal cervical lordosis. The intervertebral discs are involved in cervical spine motion, stability, and weight-bearing. Interverebral discs in the neck are vulnerable to injury by rotation force.