Easily inflamed and very reactive to both unusual or in time to normal stresses on the neck, the facet joints generate symptoms in a variety of areas. Local tender areas and more widespread aching can occur in the upper arm, shoulder blade and shoulder areas and in the neck itself. As a reaction to this pain, spasm can develop in the neck musculature which adds to the overall problem by further compression of the joints and thereby increased pain and joint pressure. This spasm can become very severe and shows as hardness and tightness in the neck muscles which can be easily felt.
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.
If the thoracic spine is much straighter than it typically is the reciprocal curves of the thorax and the neck can be lost, forcing the cervical spine to sit more vertically upon the thorax, without its typical lordosis. The lordosis distributes weight between the anterior discs and the posterior joints, preventing abnormal disc loading which can cause early degeneration and then secondary facet changes. Problems can also occur when the opposite anatomical misalignment occurs with an increased thoracic curve forcing a reciprocally increased cervical curve to maintain the face in a horizontal position.
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.
Neck injuries can occur in a variety of mechanisms, either the more vertical, compression like events or a sideways shearing and twisting incident. The disc outer walls are sensitive to these events and can be injured, starting the process of pain, muscular inhibition and muscular overactivity, reduced disc nutrition and loss of movement which progresses steadily to increased degenerative changes. As the pain progresses the neck extensor muscles add to the compression forces on the segments by becoming overactive, forcing the vertebrae closer together. Once a segmental disc has narrowed it may develop increased mobility rather than stiffness due to the reduction in strength of the disc unit when it loses its water content.
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 establishment of a stiff spinal segment in the neck forces the facet joints into an untenable position in terms of normal function. Compressed together by vertebral approximation secondary to disc narrowing, the facet surfaces suffer from the increased forces. The gradual joint damage reduces the movement available and this is picked up elsewhere in the spinal column, either lower down or higher up. This way previously normal joints can start to develop movement and structural abnormalities.
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.
If the thoracic spine is much straighter than it typically is the reciprocal curves of the thorax and the neck can be lost, forcing the cervical spine to sit more vertically upon the thorax, without its typical lordosis. The lordosis distributes weight between the anterior discs and the posterior joints, preventing abnormal disc loading which can cause early degeneration and then secondary facet changes. Problems can also occur when the opposite anatomical misalignment occurs with an increased thoracic curve forcing a reciprocally increased cervical curve to maintain the face in a horizontal position.
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.
Neck injuries can occur in a variety of mechanisms, either the more vertical, compression like events or a sideways shearing and twisting incident. The disc outer walls are sensitive to these events and can be injured, starting the process of pain, muscular inhibition and muscular overactivity, reduced disc nutrition and loss of movement which progresses steadily to increased degenerative changes. As the pain progresses the neck extensor muscles add to the compression forces on the segments by becoming overactive, forcing the vertebrae closer together. Once a segmental disc has narrowed it may develop increased mobility rather than stiffness due to the reduction in strength of the disc unit when it loses its water content.
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 establishment of a stiff spinal segment in the neck forces the facet joints into an untenable position in terms of normal function. Compressed together by vertebral approximation secondary to disc narrowing, the facet surfaces suffer from the increased forces. The gradual joint damage reduces the movement available and this is picked up elsewhere in the spinal column, either lower down or higher up. This way previously normal joints can start to develop movement and structural abnormalities.