The Latest Addition to the Texas Back Institute Surgical Team – Dr. Thomas Kosztowski – Explains the 8 Causes of Neck Pain
The talent pool at Texas Back Institute is deeper and wider with the recent addition of neurosurgeon Dr. Thomas Kosztowski. He received his Medical Degree and did his residency at Johns Hopkins Hospital. While there, Dr. Kosztowski completed a Complex Spine Fellowship followed by a Post-Graduate Spine Fellowship at Brown University Rhode Island Hospital.
Since 2013, he has worked in the Spinal Outcomes and Biomechanics Laboratory at Johns Hopkins Hospital and as a clinical consultant with the Food and Drug Administration. He has published several studies and written a book chapter on cervical spine conditions. He joined the staff of TBI in July 2018.
“I really enjoy the complexities of the spine,” Dr. Kosztowski said. “Every spinal condition is different and challenging. When the patient is helped by my work, it is very rewarding.
“I have always admired the clinical and research work of Texas Back Institute and, when the practice expanded into neurosurgery, I saw it as a wonderful opportunity to work with people who are doing cutting-edge work.”
With his training and knowledge about the brain and spine, Dr. Kosztowski is an excellent source of information about a painful condition that affects millions each day – neck pain.
A recent article from “Medical News Today” notes that, in most cases, neck pain is caused by muscle strain or another benign cause. The neck is comprised of spinal bones, muscles, and other tissue, and because it connects the head with the trunk of the body, it is exposed and at risk of injury. The neck is also prone to straining because it moves constantly throughout the day.
The 8 Common Causes of Neck Pain
#1 Degeneration of Discs and Bones Due to Wear and Tear
Gradual wear and tear may cause pain in the neck. The vertebrae and discs in the neck will wear down with age and, as they degenerate, someone may experience chronic, or persistent, pain in the neck.
“This is part of the natural process of aging,” Dr. Kosztowski said. “In some of us, the degeneration is quicker than others. This can be due to the type of work we do, our lifestyle, posture, and genetics.
“As we get older, the discs become shorter and they sometimes bulge, causing wear and tear on the joints. The ultimate result can be a narrowing of the spinal canal or damage to the nerves. In most cases, the pain resulting from this degeneration can be resolved with non-surgical measures, such as physical therapy. In more serious cases, surgery could be an option. Cervical (neck) surgery has progressed to the point where consistently good outcomes are possible.”
#2 Improper Sleeping Positions
The sleeping position, the number of pillows that are used and the firmness of the mattress can all affect how one feels upon waking in the morning.
“Improper sleeping positions are a huge component of neck pain,” Dr. Kosztowski said. “Sleep is something that many people don’t pay a great deal of attention to, but it has a tremendous impact on neck pain.
“It is very important to have a good sleeping position and a good bed and pillows. For example, a worn pillow can put the neck in a tilted position that can cause muscle strain. In many cases, it is recommended that patients who present with neck pain try sleeping on their side, with their neck in a neutral position. This will usually help.”
#3 Poor Posture and Text Neck
In many cases, neck pain is the result of poor posture when sitting or walking. It can also result from constant mobile phone use, sometimes referred to as text neck, and long hours in front of a computer screen.
“This is something that we are all guilty of,” Dr. Kosztowski said. “And that includes spine surgeons! Bad posture has a tremendous impact on spinal pathologies of the neck and spine, and can aggravate any existing symptoms.
“Patients who are experiencing neck pain from poor posture will feel a muscle ache, rather than a sharp pain. It will likely feel like a ‘burning’ sensation at the base of the neck. The best way to stop this type of pain is to be conscious of better posture.
“This condition can be more serious if the patient is experiencing weakness in the arms and legs or a numbness and tingling in the arms. Another symptom that suggests something more serious is a lack of dexterity in the hands.”
#4 Stress and Anxiety
Daily stress may cause the muscles of the neck to tighten, and pain can result from the excess strain.
“Psychological factors have a great impact on the way in which we perceive pain,” Dr. Kosztowski said. “Stressful situations also make us focus on pain more, which intensifies it.
“While it is easier said than done, stress management is extremely important for the alleviation of neck pain. In my case, I enjoy staying fit, and I try to channel my stress into physical fitness activities. Everyone is different, but finding some kind of coping strategy for handling stress is really important.”
#5 Sudden-Onset or Acute Torticollis
Torticollis is a medical condition in which the head becomes twisted to one side. It can often be very painful to try and straighten the head after this occurs. While the cause of torticollis is not always known, doctors suspect that most cases are due to minor ligament or muscle sprains in the neck. Exposing the neck to cold temperatures for an extended period could also be a cause.
“This type of muscle strain can certainly result in pain, but it can also put the head in a position where the nerve roots are exposed and potentially damaged,” Dr. Kosztowski said. “This condition occurs in a large subset of the population.”
#6 Brachial Plexus Injury
According to the American Society for Surgery of the Hand, the brachial plexus is a collection of nerves that connect the spinal cord in the neck to the hands. If these nerves are damaged, it may cause neck pain. Conversely, if an injury to the neck affects the brachial plexus, pain may also occur in the hand.
“There is a wide range of complexity with this condition,” Dr. Kosztowski said. “I have seen minor strains to the brachial plexus, which will eventually resolve on their own, as well as complete avulsions (tearing away) resulting from motorcycle accidents. In most cases, the injury is a strain and will resolve itself. However, in more severe cases, reconstructive surgery of the brachial plexus must occur.”
#7 Whiplash or a Sudden Jolt to the Neck
Whiplash describes an injury to the neck where the head jolts forward and then back into place very quickly.
“In many cases, whiplash will resolve itself over time,” Dr. Kosztowski said. “This sudden jolt can result in a strain that causes damage to the soft tissues of the ligaments in the neck and, with therapy, these tissues can be repaired. Whiplash can also be severe, and result in a fracture of the cervical spine or nerve damage. If a person has had an accident or sports injury and the neck pain continues to worsen, seeing a spine specialist is advised.”
Cervical radiculopathy, which is often referred to as a “pinched nerve,” occurs when irritation of the nerves originating in the spinal cord, in the neck, causes pain to radiate down the arm.
“Cervical radiculopathy is an impingement of the nerve roots,” Dr. Kosztowski said. “As the nerve roots are traveling down the spinal canal and then out into the body where they innervate (stimulate), they can get pinched up. This presents itself as a shooting pain down the arms and numbness or weakness in a region of the arm. The location of this numbness helps us determine which nerve is being pinched.”