The spine in the neck, called the cervical spine, is made of a stack of seven block-like bones called vertebrae. These vertebral bones are separated by oval cushions called the ‘discs’ made of cartilage with a softer substance in the center.
If the discs become thin or worn the disease is called degenerative disc disease. If the soft jelly-like center in the middle of the disc is pushed through the outer disc, a herniated disc occurs – sometimes called a disc protrusion, or ‘slipped disc’. Even though the term slipped disc is used to describe a herniated disc, the disc does not slip out of place. Sometimes this will cause a pinching or compressing of the spinal nerves or the spinal cord.
Degenerative disc disease is a form of ‘wear and tear’ arthritis of the spinal discs in the neck. The cause may be from an old injury, or overuse causing repetitive stress on the spine. If the discs become thin, torn or ragged, extra calcium grows around the small spinal joints and the edges of the spinal vertebrae resulting in ‘bone spurs’. This calcium buildup is similar to that seen in the knuckles in people with osteoarthritis in their fingers. The calcium deposits may pinch nerves or even compress the spinal cord.
The symptoms of neck pain are different in many people, depending on which areas of the neck are affected. In general, the neck aches, feels stiff and may improve once the individual gets up and moves around. However the pain becomes worse with driving, poor posture, or working on the computer if the screen is not at eye level. The neck may make cracking or popping sounds when the head is turned.
Unless there has been an injury, X-rays of the cervical spine are often not necessary for the diagnosis or to start treatment. They may show narrowing of the disc spaces, the alignment of the spine, and the location of calcium buildup or bone spurs. They may also show unexpected conditions causing the pain.
Surgery is not helpful for routine neck arthritis, but is considered if nerves are being severely pinched causing pain or weakness in the arms or if the spinal cord is compressed to a point where the arms and legs become very weak with use. Many different treatments are tried, including physical therapy, aquatic exercise, ‘cortisone’ injections, acupuncture, chiropractic care, various medications and exercises including stretching. The best approach is the one that provides the best relief, with the fewest side effects.