Cervical Axial Pain: Causes, Symptoms, Diagnosis, and Treatment Options for Neck Pain Centered in the Spine

Understanding Cervical Axial Pain

Neck pain is a common complaint that most people experience at some point in their lives. However, when the primary pain is centered specifically in the cervical spine, it is referred to as cervical axial pain. This type of neck pain can arise from musculoskeletal problems or more serious underlying conditions. Learning about the causes, symptoms, diagnosis, and treatments for cervical axial pain is key to properly managing this discomfort.

Anatomy of the Cervical Spine

The cervical spine consists of the first seven vertebrae of the spinal column, which are located in the neck. These vertebrae are labeled C1 through C7 from top to bottom. The C1 and C2 vertebrae connect to the base of the skull. Below these bones, C3 through C7 make up the lower cervical spine. Between each vertebra are cervical discs that act as cushions or shock absorbers.

The cervical spine supports the weight of the head and allows flexible movement in all directions. Key nerves branch out from the spinal cord in this region to connect to the arms, chest, shoulder blades, and upper back. The cervical spine also plays a role in balance and coordination when turning the head.

Causes of Cervical Axial Pain

Cervical axial pain refers specifically to pain centered in the cervical spine itself rather than muscular pain or referred pain that radiates outward. There are several potential causes of this type of neck pain:

Cervical Spondylosis

This age-related degenerative condition causes wear and tear on the cervical vertebrae and discs. Over time, it can lead to bone spurs, disc herniation, and narrowing of the spinal canal (spinal stenosis). These changes put pressure on nerves, resulting in cervical axial pain.

Herniated Disc

Discs between the cervical vertebrae act as cushions and allow flexibility. A herniated or ruptured disc occurs when the inner gel pushes out through tears in the disc wall. This can irritate nearby nerves and cause painful inflammation.

Spinal Stenosis

When the hollow spinal canal narrows due to cartilage overgrowth or bone spurs, it puts pressure on the spinal cord and nerves. The resulting compression causes cervical axial pain, especially when moving the neck.

Osteoarthritis

This type of arthritis develops from cartilage breakdown in joints. In the neck, osteoarthritis can affect the facet joints between cervical vertebrae and lead to bone-on-bone rubbing.

Whiplash Injury

Sudden hyperextension and hyperflexion of the neck, such as during a car accident, can injure the cervical vertebrae, discs, joints, nerves, and ligaments. Whiplash often causes both muscular pain and cervical axial pain.

Spinal Misalignment

Poor neck posture and improper alignment of the cervical vertebrae can alter nerve function and lead to axial discomfort. Chiropractic manipulation can realign the cervical spine to relieve pain.

Symptoms of Cervical Axial Pain

The hallmark symptom of cervical axial pain is a centralized, deep ache within the cervical spine. Those affected may feel like the pain is coming from within the bones themselves. Common symptoms include:

• Deep, dull, or sharp neck pain focused within the spine
• Intensified pain when moving or bending the neck
• Stiffness and reduced range of motion in the neck
• Pain when holding the head upright without support
• Discomfort when putting weight on the neck and head, such as while lying down
• Headaches at the base of the skull or back of the head
• Burning or tingling pain radiating down the arms (in severe cases)

Those with cervical axial pain may find relief when immobilizing their neck with a brace or collar. Pain accompanying neurological symptoms like numbness, weakness, and radiating pain may indicate a serious underlying condition requiring prompt medical attention.

Diagnosing the Cause of Cervical Axial Pain

To pinpoint the underlying cause of cervical axial pain, doctors utilize:

Medical History

Information about symptoms, family history, medication use, trauma, and lifestyle can help identify risk factors and guide diagnosis.

Physical Examination

Doctors check for injury, range of motion, alignment, pain levels, muscle weakness, reflex changes, and more. They may manipulate the neck to assess pain responses.

Imaging Tests

X-rays, CT scans, and MRIs evaluate bone changes and soft tissue problems in the cervical spine. Doctors can assess discs, vertebrae, nerves, and more.

Discography

This procedure involves injecting dye into cervical discs to identify damage based on dye patterns when imaged. The provocative discography assesses pain levels upon injection.

Electromyography

EMG tests measure electrical activity in muscles. It can determine if nerve dysfunction is causing muscle issues.

Nerve Conduction Studies

These studies evaluate how well nerves transmit electrical signals and can locate compressed nerves affecting neck pain.

Treatments for Cervical Axial Pain

Treating the underlying cause is key to resolving cervical axial pain. Some beneficial treatment approaches include:

Medications

Over-the-counter pain relievers, topical analgesics, steroid injections, and muscle relaxers can help manage cervical axial pain episodes.

Physical Therapy

Stretching, massage, ultrasound, hot/cold therapy, and exercises guided by a physical therapist can ease pain and improve neck mobility.

Chiropractic Care

Spinal manipulation, mobilization, and soft tissue therapies applied by chiropractors can realign cervical vertebrae to reduce pain.

Surgery

Those with herniated discs, bone spurs, or stenotic narrowing that does not improve with other treatments may require surgery to decompress nerves.

Lifestyle Modifications

Improving posture, reducing neck strain, managing weight, quitting smoking, and exercising can help minimize cervical axial pain.

Exercises for Cervical Axial Pain

While exercise may initially increase discomfort, gentle stretching and strengthening of neck muscles can alleviate cervical axial pain. A physical therapist can provide personalized exercise guidance. Some helpful exercises include:

Chin Tucks

Draw your chin straight back to give a double chin, holding for 5-10 seconds. Repeat 10-15 times.

Upper Trapezius Stretch

Gently pull your head to one side until you feel a stretch. Hold for 30 seconds and repeat on the other side.

Levator Scapulae Stretch

Turn your head to look down and over your shoulder. You should feel a stretch on one side of your neck. Hold for 30 seconds.

Neck Rotations

Slowly rotate your neck side to side and up and down through a comfortable range of motion. Repeat 5-10 times.

Isometrics

Gently press your hand against your forehead and hold for 5-10 seconds. Repeat, pushing from other angles to work all neck muscles.

Lifestyle Changes to Help Cervical Axial Pain

Modifying daily habits and behaviors can significantly reduce cervical axial pain episodes. By minimizing strain, strengthening muscles, and practicing good posture, you can support cervical spine health. Lifestyle measures that help reduce pain include:

Improve Neck Posture

Avoid hunching forward or craning your neck, which strains muscles and joints. Keep your head centered over your shoulders.

Use Cervical Pillows

Choose pillows that support neck alignment when sleeping and avoid those that are too high or firm.

Strengthen Neck Muscles

Do targeted exercises using resistance bands to improve muscular support for your neck.

Manage Stress

Chronic stress causes muscular tension that can exacerbate cervical axial pain. Try relaxation techniques.

Modify Workstations

Adjust your workstation setup to promote proper neck positioning when using computers and phones.

Wear a Cervical Collar

Temporary immobilization during pain flares can provide stability and rest for the cervical spine.

Use Hot/Cold Therapy

Apply heating pads or ice packs to help ease muscular tension and pain symptoms.

Quit Smoking

Smoking is linked to degenerative cervical spine changes. Quitting can slow progression.

Lose Excess Weight

Carrying extra weight, especially in the abdomen, strains the neck. Losing weight reduces this stress.

Consider Acupuncture

Acupuncture may help reduce chronic neck pain by stimulating pressure points in surrounding muscles.

When to See a Doctor for Cervical Axial Pain

It is important to consult a doctor for any neck pain lasting more than one week or causing significant impairment. You should seek prompt medical care if cervical axial pain is accompanied by:

• Arm numbness, weakness, or tingling
• Headaches, especially after injury
• Dizziness
• Fevers
• Unexplained weight loss
• Pain at night
• Loss of bowel or bladder control (emergency symptom)

These symptoms can indicate serious underlying conditions like nerve damage, infections, fractures, or spinal cord injuries needing urgent treatment. Even if your pain started after an accident and seems musculoskeletal, it is wise to visit your doctor for evaluation.

Outlook for Cervical Axial Pain

For most people, cervical axial pain is treatable with conservative self-care, physical therapy, chiropractic medicine, and anti-inflammatory medications. Practicing good neck posture and performing strengthening exercises can keep pain at bay. Surgery may be required in cases of severe disc herniation or spinal stenosis.

Some degenerative causes like spondylosis will worsen over time and can only be managed, not cured. However, with proper treatment guided by your doctor, most cases of cervical axial pain can be reduced to a manageable level. Seeking care is essential, as uncontrolled chronic neck pain can impact quality of life. Addressing the issue promptly maximizes your chances of alleviating cervical axial discomfort.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.