RT Book, Section A1 Simopoulos, Thomas T. A2 Bajwa, Zahid H. A2 Wootton, R. Joshua A2 Warfield, Carol A. SR Print(0) ID 1131933239 T1 Neck Pain T2 Principles and Practice of Pain Medicine, 3e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 9780071766838 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1131933239 RD 2024/03/28 AB Neck pain is a common complaint. The prevalence is approximately between 75% and 80% in the U.S. population. Fortunately, acute neck pain has a very favorable prognosis, with 80% of cases resolved within 2 years.1 But 20% of cases are estimated not to improve and of these, 5% are characterized by severe disabling chronic neck pain.2 The International Association for the Study of Pain (IASP) describes chronic cervical spine pain as follows: Pain perceived as arising from anywhere within the region bounded superiorly by the superior nuchal line, inferiorly by an imaginary transverse line through the tip of the first thoracic spinous process, and laterally by sagittal planes tangential to the lateral borders of the neck.3 The potential sources of neck pain are derived from those structures that have abundant nociceptive innervation, which include the cervical zygapophysial (facet) joints (including atlantoaxial and atlanto-occipital), posterior neck muscles, cervical intervertebral discs, vertebral bodies, anterior and posterior ligaments, dura mater of cervical spine, prevertebral muscles, carotid and vertebral arteries, and the transverse ligament.4 The paucity of nociceptors in ligamentous structures makes them less likely to cause pain. The neck is a very mobile structure and is, therefore, susceptible to trauma in addition to wear and tear. It is further burdened by the weight of the head and rests on a relatively fixed thorax.