Sunday, November 26, 2006

Neck pain among youngsters

A pain in the neck, especially amongst the youth, may not always be spondylosis caution doctors

Creaky bones,an aching back,stiff knees and gnarled fingers were usually associated with the winter of one's years but today and increasing number of youngsters are complaining about severe neck pain and backaches. Cervical Spondylosis (CS) is a condition where the bones (vertebrae) of the neck (cervical spine) and the cushions between the vertebrae (disks) degenerate due to wear and tear. From school and college students to office going young men and women now claim to be ailing from CS.Does it mean this hitherto old age related disease has now cropped its ugly head amongst the youth?
"In a majority of the cases pain in the neck
among youngsters is not CS,though it has become fashionable to label it so," avers Dr Suresh Vengsarkar,senior orthopedic surgeon and consultant." Even if X- ray shows disk space narrowing and some amount of spasm it does not necessarily mean the patient is suffering from CS unless it is confirmed by clinical examination.Otherwise I would call it neck pain syndrome," he adds.
A view shared by Dr Ashith Rao,HOD,orthopaedic department,Rajawadi Municipal Hospital,Ghatkopar," Now days any pain around the neck is termed as CS which is not the case particularly among youngsters.Radiologically (through X-rays/MRI) a case may be identified as CS but such findings have to correlate with clinical evaluation." And the clinical assessment is based on physical examination of the patient,studying the patient's case history and symptoms. In a confirmed case of CS the symptoms include pain in the neck,spreading to shoulders and arms,neck stiffness,numbness or weakness in hands and fingers.But the symptoms of neck pain and stiffness,generally reported by youngsters are results of bad posture,lethargy,lack of physical exercise opine some orthopaedic surgeons.Urban life predominantly centred around computers,laptops, television with little or no outdoor /physical activity being the contributing factors.
"The most common cause for neck pain among 85 to 95 per cent of children and youngsters is bad posture.Children no longer walk or sit straight and their posture is getting worse with the loads of books they carry,the way they slouch in the chair while watching television or working on a computer," reveals Dr Rao.
Apart from the physical aspects enlisted above even mental and emotional disturbances like tension and stress due to exams,family disputes, work pressure can lead to neck pain.
"Stress causes the muscle of the neck to remain in a state of spasm which affects the disk joints and causes inflammation," reveals Dr Vengsarkar.And the same stress makes school going children complain of neck pain during exams."Each many children appearing for Std X and Std XII exams land up at my clinic complaining of severe neck pain.Often individuals with family problems and stressed relationships complain of neck pain. But all of them though radiologically diagnosed as CS clinically show no symptoms," says Dr Rao.

It is a natural consequence of aging where bones (vertebrae) of the neck (cervical spine) and cushions between the vertebrae (disks) and joints between the bones of the cervical spine progressively degenerate.The disks of the spine become drier and less elastic causing some disks to bulge,or cause the central cartilage of the disks to protrude through a crack in the ring that surrounds the disk.The surrounding ligaments become less flexible, and the vertebrae may develop bone spurs (abnormal growths) which can compress the spinal nerves (linked to shoulders/arms) and sometimes the spinal cord itself.
Neck pain that spreads to shoulders,arms,fingers,back of head or chest and stiffness Numbness/weakness in arms,hands and fingers (when spinal nerves are compressed) Numbness/weakness in legs,(when spinal cord is compressed)
The goal of treatment is generally to relieve pain and prevent futher damage .Most patients respond to non-operative treatments like medication,neck collar,traction and physiotherapy. However severe cases involving pressure on the spinal nerves or spinal cord may require surgery.

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