Congenital malformations and neck pain can be related, but neck trauma can also cause painful neck conditions.
The lower end of the cervical spine may have some cervical ribs in the lowest two levels (C6 and C7 levels). This in turn can put pressure onto the brachial plexus and lead to a brachial plexus injury, which can mimic a herniated disc in the neck. However, the real diagnosis in such a congenital cervical rib case with nerve root irritation is “thoracic outlet syndrome”. There are other malformations such as spondylolisthesis, (thanks to www.hughston.com for this link) where one vertebral body is overriding the one of the next level due to a malformation of a bony part, called “pars interarticularis”. Most of these malformations are harmless and need observation only. But a minority of these cases will need surgical attention after a careful work-up by a neurosurgeon.
Congenital Malformations and Neck Pain
Most of the neck pains can be managed by the patient at home. Remobilization with physiotherapy, acupuncture treatment, chiropractic treatment (manipulation) and professional massage (Ref.2) helps as well.
The physician likely will recommend one modality over another depending on what the preferences of the patient are and depending on what the clinical presentation is. For instance, if it appears that there is a locking of one of the facet joints along the back of the cervical spine, a gentle manipulation by an experienced chiropractor might give the quickest response. However, if there is a lot of muscle spasm, physiotherapy, massage therapy or acupuncture might be more beneficial.
References:
1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999. Chapter 2.
2. D Irnich et al. BMJ 2001 Jun 30;322(7302):1574.
3. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 140.
4. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000) W.B.Saunders
5. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
6. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
7. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008
