The cervical spine is also surrounded by a thick, tangled web of nerves. In general, those nerves are amazingly difficult to irritate, much harder than people think, but it’s not impossible. Many sharp and shooting neck pains are probably caused by minor neuropathy (pain from nerve irritation) that will ease gradually over several days or a few weeks at the worst, like a bruise healing. It’s unpleasant, but not actually scary, like banging your funny bone (ulnar nerve): that thing can really take a licking and keep on ticking. So can the nerves in your neck.
There are many possible signs of spinal cord trouble in the neck,8 with or without neck pain, mostly affecting the limbs in surprisingly vague ways that can have other causes: poor hand coordination; weakness, “heavy” feelings, and atrophy; diffuse numbness; shooting pains in the limbs (especially when bending the head forward); an awkward gait. Sometimes people have both neck pain and more remote symptoms without realizing they are related.
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Five to 10-minute ice massages applied to a painful area within the first 48 hours of the start of pain can help relieve pain as can heat, which relaxes the muscles. Heat should be applied for pain of duration greater than 48 hours. Over-the-counter pain relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, frequently are enough to control episodes of neck pain, and muscle relaxants may help those with limited motion secondary to muscle tightness.
One of the most common concerns about the neck that is not especially worrisome: signs of “wear and tear” on the cervical spine, arthritis, and degenerative disc disease, as revealed by x-ray, CT scans, and MRI. Many people who have clear signs of arthritic degeneration in their spines will never have any symptoms, or only minor, and/or not for a long time.10 For instance, about 50% of fortysomethings have clinically silent disk bulges, and even at age 20 there’s a surprising amount of spinal arthritis. The seriousness of these signs is routinely overestimated by patients and healthcare professionals alike.11