The Neck ” Part Two
Irritability of inflamed or injured facet joints is high in terms of easily and quickly flaring up into pain when subject to unusual stresses, but then later can react badly even to normal stresses. The typical symptoms are local tenderness and aching throughout the neck, across the shoulder blades, over the neck/shoulder area and upper arms. All this pain can cause the muscles to go into spasm which compounds the problem by facet joint compression with consequent enhancement of the pain and joint forces. Some patients have severe neck muscle spasm which presents as tight, hard muscles.
Muscle spasm disturbs the whole function of the neck, reducing its ability to iron out sudden stresses. Muscles which would naturally switch off after a time remain contracted and tense the neck, making it more sensitive to jars and sudden movements. As the neck becomes more irritable the person consciously becomes more guarded with their neck movements and their upper arm activities, magnifying the problem again. The interplay of neck and thoracic posture has important mechanical consequences for painful problems in the neck as it throws abnormal stresses on the cervical segments.
A lack of thoracic kyphosis can mean that the thoracic spine approaches its junction with the cervical spine above it in too vertical a position, forcing the neck to adopt a correspondingly more vertical posture than normal. The loads the neck bears are usually spread between the discs and the facet joints by the normal lordosis and if this is lost then increased loads may be thrown onto the discs, causing increased degenerative changes within them. The opposite, where an increased thoracic curve forces a correspondingly increased neck curve, is countered either by neck or lumbar extension.
The increased curves in the cervical and thoracic spine means that the head is carried well in front of the centre of gravity, ensuring the supporting musculature has to work hard to keep the head positioned above empty space. The upper trapezius muscles are a major worker in this regard and their overwork can generate muscular trigger points, particularly painful spots in the muscles which can refer pain elsewhere too. This upper overactivity can result in the lower trapezius muscles becoming underactive, leading to a reduced level of scapular stability and a poorer control of the neck and shoulder complex for arm use.
Many different ways of injuring the neck are possible but usually involve some straight up and down compression/tension forces and/or shearing or twisting forces which are more lateral in direction. Such injuries damage the outer walls of the intervertebral discs and this sets off degenerative processes in the disc which follow from the pain, muscular abnormalities of over and under activity, range of movement limitation and poorer disc nutrition. The extension muscles of the neck can contract more continuously and forcefully, pressuring the vertebral levels together abnormally. A thinned and degenerate disc may lead to a stiff segment but can also develop excessive mobility as its water content has decreased and its stability reduced.
Segmental degeneration is often accompanied with time by the growth of osteophytes, outgrowths of bone, which sprout from the edges of the abnormal segment. An abnormally moving segment is likely to suffer this change and this may be an attempt by the bodys systems to improve the stability of the segment by splinting it with bone along the soft tissues nearby. The nerve roots exit from the intervertebral foramens each side of the spine and there are vulnerable to impingement at times by osteophytic outgrowth, causing severe nerve root pain in the arm. Surgical management of such impingement may be required in some people but overall this condition is not amenable to surgery.
The facet joints of the neck are now vulnerable once the affected segment has stiffened with degenerative changes. Narrowing of the discs causes the facet surfaces to suffer increased contact forces as the segment closes down on itself. The movements which should be performed by the gradually more abnormal and stiff facet are passed onwards to other parts of the spinal system above or below the stiff segment. Facet joints which are normal can then start to suffer from the abnormal forces and change.
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- The Neck ” Part Three The reduction in neck mobility exposes the capsules, fibrous bags around the joints, of the facet joints to traumatic stretching events. Turning the neck suddenly without conscious thought can push the joints to the limits of their movements, injuring the fibres of the capsular ligamentous tissues. This produces joint pain and scarring with increased capsular tightness as the healing process proceeds, making the joints tighter and less willing again to tolerate stresses. As the tight joints can occur in several parts of the neck this can cause a limitation of joint motion which doesn't become apparent until one day you find you can't turn your neck as you expect to....
- The Human Neck ” Part Three As mobility in the neck declines the facet joint capsules, the fibrous bags which surround the joints, are vulnerable to overstretching trauma. An unplanned movement such as turning without thinking about it can pull against the limits of the tightened capsules and cause trauma to the capsular fibres. The pain causes movement inhibition and as the capsules heal up with scar tissue they can tighten further and thereby tolerate further stretching even less. This process can spread to several areas of the neck, causing significant unnoticed restriction in range of movement until one day you suddenly realise that you cant turn as far as you need to....
- The Human Neck ” Part Three The reduction in neck mobility exposes the capsules, fibrous bags around the joints, of the facet joints to traumatic stretching events. Turning the neck suddenly without conscious thought can push the joints to the limits of their movements, injuring the fibres of the capsular ligamentous tissues. This produces joint pain and scarring with increased capsular tightness as the healing process proceeds, making the joints tighter and less willing again to tolerate stresses. As the tight joints can occur in several parts of the neck this can cause a limitation of joint motion which doesn't become apparent until one day you find you can't turn your neck as you expect to....
- The Secret Source of Neck and Lower Back Pain The Cervical Spine and Lumbar Spine are Complex Structures that oftentimes exhibit Complex Causes of Neck Pain and Lower Back Pain. The cause of the 2 most common forms of pain in the human anatomy, Neck Pain or Lower Back Pain, can sometimes be extremely complex at times due to the complexity of their structures. There is always a root cause or secondary cause of Neck Pain or Lower Back Pain, and that source of Neck Pain or Lower Back Pain is oftentimes labeled as a secret or hidden cause because it can be overlooked and very difficult to diagnose. That Secret or Hidden cause of Neck Pain or Lower Back Pain is better known as Facet Syndrome or Facet Joint Pain. Facet Syndrome or Facet Joint Pain is a collection of Chronic Neck Pain Symptoms or Chronic Lower Back Pain Symptoms directly related to pain in the facet joints, and that is why it is known as a Chronic Pain Syndrome....
Written by Jonathan Blood Smyth on December 9th, 2009 with
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