Neck Question
How do I tell if my chronic (9 days straight now) neck pain is from tension or because I pulled something? Do I need to visit a doctor or a chiropractor? If so, when?
This could be very long and involved, so I’ll do multiple spine posts. I worked neuro/neurosurgery and then in an ortho/spine clinic, but that doesn’t make this area any less grey. I can say a few things with certainty.
I didn’t post your name, but I know you are young, as in twenties young. This makes it more likely you have a muscle strain or are having some kind of muscle spasms. My first guess would be what I like to call computer neck (this website gives a good explanation of anatomy and muscle groups, but don’t feel like you need to buy anything). When you sit at a desk or computer and you put your head forward a little and round your shoulders, it puts a lot of strain on that entire area from between your shoulder blades on up across your shoulders and into your neck. If you strain this area, not only will you have what can be a really painful neck, but you can also end up with headaches because the muscle spasms can go up the back of your neck, up the back of your head and over the top to your forehead.
You should always go to the doctor ASAP if you have neck pain that is associated with numbness/tingling, burning or jolting electrical sensations in your arms (this is called cervical radiculopathy). This can indicate a pinched nerve, possibly due to a disc problem or vertebral fracture. Another symptom that should send you straight to the doc is neck issues with upper body or full body weakness or new coordination issues. That can mean pressure on your spine (this is called cervical myelopathy).
Any time you have a fall and crack your head or whiplash your neck, you should be seen by a doctor and have some sort of imaging, like xray or MRI. You can have a tiny fracture and not realize it. If it stays in place you might be fine, but if it is unstable, meaning it moves around or if a little piece of bone breaks off and is loose, you put your spine at risk. No one wants to do that.
If you go to an ortho or neurosurgeon and they determine you have spasms or a little disc problem that is not a risk to your spine or spinal nerves, they will most likely prescribe physical therapy. PT can make a huge difference, even if you only go to a few visits. It can help you avoid surgery, teach you better posture to prevent problems in the future, and what to do if you have those spasms again to head them off before nine days go by.
People still argue about chiropractors. They can really help if you have no problems that make it unsafe for you to go. For instance, if you have rheumatoid arthritis, you have to be very careful about allowing a chiropractor to adjust your neck. Go to a chiropractor with a good reputation in your area. Check the license look up to be sure they are licensed and have no complaints. If you have a lot of pain after an adjustment, or if you have visual changes, dizziness or any other symptom of compromised blood flow in your neck after an adjustment, go to the ER. It is not common, but there is a syndrome some people have if a neck adjustment is not done correctly where blood flow is compromised to your brain. That can be dangerous.
Another thing to consider is acupuncture. Acupuncture can be really great for neck pain if it is a strain and not something more serious. Some chiropractors are also certified in acupuncture, and some of them do the acupuncture with electrical stimulation. I have personally been to someone like that, and it did more for my chronic neck pain than anything else I have tried.
Lastly I will say if you are miserable, or if you feel very worried, always go to the doctor. Trust your knowledge of your body. One of the strongest signs that something is very wrong with a person’s health is their feeling that something is seriously wrong, or a feeling of impending doom. So trust your gut unless you are a silly person.
