The healthy spine
Before discussing how the spinal disc can cause neck pain with or without down the arm irradiating pain, it is useful to first understand the role of a healthy disc in the spine and its anatomy.
The cervical spine is comprised of seven vertebrae – C1, C2, C3, C4, C5, C6, C7 (often noted as C1-C7) – that begin at the base of the skull and extend down to the thoracic spine. The cervical vertebrae are composed of cylindrical bones (vertebral bodies) that lie in front of the spinal cord, and work with the muscles, joints, ligaments and tendons to provide support, structure and stabilization to the neck.
The first cervical vertebra is unique in that it is a ring that rotates around the second vertebral body (the odontoid). The cervical vertebrae closest to the skull are the smallest.
Cervical Vertebrae Functionalities
Stacked on top of each other with a cervical disc in between them, the cervical vertebrae provide strength and structure to the cervical spine and support the head. The cervical vertebrae also provide for structure and control of certain types of movement in the neck (with the movement described in terms of the two vertebral bodies that are connected), including:
- Rotation (rotating the head from side to side and back and forward). Most rotation of the neck takes place in the first two segments of the cervical spine, specifically the atlas (C1) and the axis (C2).
- Lateral (moving the head from side to side).
- Flexion (moving the head forward) and extension (moving the head backward). Most flexion and extension movements in the neck are controlled by the C5-C6 and C6-C7 segments of the spine. Unlike the first two cervical vertebrae, the remaining five cervical vertebrae, C3 through C7, are constructed more similarly to the rest of the spine, with three joints making up each vertebral segment (a disc in the front and two facets joints in the back).
The uncovertebral joints are peculiar but clinically important anatomical structures of the cervical vertebrae. In the aged or degenerative cervical spine, osteophytes arising from an uncovertebral joint can cause cervical radiculopathy, often necessitating decompression surgery.
Cervical Spine Degenerative Disease Symptoms
There are several symptoms that may indicate the presence of a degenerative condition in the cervical spine. Symptoms include neck pain, pain around the back of the shoulder blades, arm complaints (pain, numbness, or weakness), and rarely, difficulty with hand dexterity or walking.
The degenerative process may begin in any of the joints in the cervical spine, and over time it may also cause secondary changes in the other joints. For example, an intervertebral disc may be primarily affected. As the disc narrows, the normal movement of that segment is altered, and the adjacent joints (also called ‘osteoarthritis’ or ‘degenerative joint disease’) are subjected to abnormal forces and pressures, leading to degenerative arthritis (ie, inflammation of a joint).
Neck pain as a result of spondylosis (eg, a degenerative change) is relatively common. The pain may radiate, or spread, into the shoulder blade or down the arm. Patients may have an arm complaint (such as pain or weakness) as the result of nerve root compression from a bone spur.
- “The doctors’ encouragement, patience and affection, were transformed into energy for my recovery to become a reality.”
– Cristina Colorado / Barcelona – Spain
Neck anatomy is a well-engineered structure of bones, nerves, muscles, ligaments and tendons. The cervical spine (neck) is delicate – housing the spinal cord that sends messages from the brain to control all aspects of the body – while also remarkably flexible, allowing movement in all directions, and strong.
The neck begins at the base of the skull and through a series of seven vertebral segments connects to the thoracic spine (the upper back). With its complex and intricate construct, and the many stresses and force that can be placed on it through a trauma or even just daily activities, the cervical spine is at risk for developing a number of painful conditions, such as:
- Cervical degenerative disc disease
- Cervical herniated disc
- Cervical stenosis
- Simple muscle strain resulting in a painful neck.
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