Wrinkles Inside Your Neck

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You or someone you know has most likely experienced neck pain. Neck pain occurs in an estimated 22%-70% of the general population at some point in their lives and the incidence increases with age.1 This can be attributed to a number of things including poor posture, muscle imbalances, physical and emotional stress or possibly degenerative changes in our spines.

Our spines and vertebrae age along with the rest of our bodies. Just as grey hairs or wrinkles appear over time, the spine also develops age-related changes. These changes can be observed in people as young as 30, but are more common with increased age.2 If you have complaints of ongoing neck pain with or without an inciting incident or trauma, a physician may suggest that imaging (x-ray, MRI, CT scan) be performed. Varying degrees of anatomical changes (disk space narrowing, disk bulges, herniations, fractures, and ligamentous damage) can show up on imaging in people with or without pain.1, 3

A recent long-term study (Daimon et al in the Journal of Bone and Joint Surgery) looked at asymptomatic, healthy subjects over a span of 20 years. An initial MRI was performed on these pain-free individuals. As expected, cervical degeneration on MRI increased with age and time in 95% of the subjects studied. However, the study found that clinical symptoms (neck pain, stiffness, numbness) did not correlate with MRI findings. One exception was in the case of stenosis (narrowing) of the canals that nerves travel through in the spine. This narrowing did correlate with the presence of arm and hand symptoms because of nerve root compression.

The bottom line is that imaging findings usually do not influence your prognosis for recovery. Neck pain can be treated by a skilled physical therapist even if you have received potentially intimidating findings on an MRI. Age-related degenerative changes on an MRI were most likely present before you experienced pain and will still be there once your pain has resolved.3 At Integral Physical Therapy, our highly trained therapists can develop an individualized treatment plan for your neck pain and any contributing body regions that may be affecting your symptoms.

References:
1. Blanpied PR, Gross AR, Elliott, JM, Devaney LL, Clewley D, Walton DM, et al. Neck Pain: Revision 2017. Clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American physical therapy association. J Orthop Sports Phys Ther 2017: 47 (7): A1-A83
2. Daimon K, Fujiwara H, Nishiwaki Y, Okada E, Nojiri K, Watanabe M, et al. 20-Year Prospective Longitudinal Study of Degeneration of the Cervical Spine in a Volunteer Cohort Assessed Using MRI: Follow-up of a Cross-Sectional Study. J Bone Joint Surg 2018: 100 (10): 843-849
3. Elliot J, Flynn T, Al-Naijar A, Press J, Nguyen B, Noteboom T. The Pearls and Pitfalls of Magnetic Resonance Imaging for the Spine. J Orthop Sports Phys Ther 2011: 41 (11): 848-860