Noisy Joints

You may hear or feel clicking or grating (called 'crepitus') as you move your head. This is caused by roughened bony surfaces moving against each other or by ligaments rubbing against bone. The noises are often laudest at the top of the neck. This is a common symptom and can be upsetting.

Stiffness

This is common. You may find it painful to move and your muscles feel tight. Stiffness is often worse after long periods of rest or after sitting in one position for a long time. You may also have muscles spasm or, in cervical spondylosis, you may lose movement because of the changes to the bones and discs.

Pain

You may feel in the middle of your neck or on one side or the other. The pain may travel to the shoulder and shoulder blade or to the upper chest. In tension headaches the pain often travels to the back of the head and sometimes to the side of the head and behind the eye or even into the ear. If a nerve root is pinched, then as well as the pain you may have numbness or tingling that can be felt down the arm right to the fingers.

Tension

Most muscles of the body relax completely when they are not being used but some muscles (known as 'antigravity muscles') have to work all the time in order to keep your body upright. Muscles at the back of your neck must always be tensed, otherwise your head would fall forwards when you are sitting or standing. when these muscles work too hard it can cause neck pain and tension headaches. People who are worried or under stress often tighten their muscles more than is neccessary to hold their head upright - in other words, they are literally 'tense' Tension headaches are very common and are often wrongly called migraines.

Whiplash

This type of injury often follows a rear-end collision in a car. In this type of collision, first the body is carried forward and the head flips backwards. then, as the body stops, the head is thrown forwards following a whiplash injury there is often a delay before the pain and stiffness start. Although whiplash can badly damage your neck, the majority of peaople who suffer these shunt accidents do not have major damage. In most cases injuries feel better within a few weeks or months. Seat belts and properly ajusted headrests in cars have significantly reduced the damage from whplash injuries.

Cervical spondylosis

With everyday use over many years the discs and the facet joints become worn. This wear from person to person. The discs become thinner and this causes the spaces between the vertebrae to become narrower. Also, 'spurs' of bone, know as osteophytes, from at the edges of the vertebrae and the facet joints. In a way this is a particular from of osteoarthritis (see are booklet ' octeoarthritis) but it is known as ' cervical spondylosis'. These changes may also occur at the bottom of the apine where they are known as ' lumber spondylosis'. These conditions should not be confused with ankylosing spondylitis, where inflammation in the spine can cause the bones of the spine to fuse together (see arc booklet 'ankylosing spondylitis'). The abnormalities found in cervical and lumbar spondylosis can be seen on x-rays(see - figure 2) and are present in almost everyone by the age of 65. However, many people have to neck pain even though quite significant changes can be seen on their x-rays.

When these changes do cause pain it may come either from the lining of worn joints or from stretched ligaments. Occasionally buiging discs or osteophytes pinch the nerve roots and this causes pain or numbness that travels into the arm. If the vertebral artery is pinched, this reduces theblood supply to the area of the brain that controls balance and this may lead to dizziness. Rarely an extra rib ( cervical rib) can cause partial blockage of the blood supply to the arms, resulting in pain and numbness in the hands. Very rarely, in severe apondylosis, the spinal cord can be squeezed, which causes weaknes and numbness in the arms and legs.

Non - specific neck pain

Many people develop a stiff and painful neck for no abvious reason. it many happen after sitting in a draught or after a minor twisting injury, for example while gardening. The underlying cause for this type of neck pain is not fully understood, so it is called non-specific neck pain. Having non - specific neck pain does not mean that your neck is damaged and often it happens in people whose necks would appear completely normal under an x - ray. It s the most common type of neck pain and often disappears after a few days.