The spine is made up of 33 bones called vertebrae. These bones are designed to provide protection to the spinal cord while allowing the back to bend forward and backward, twist and move in a variety of directions.

The back is divided into several areas, including the neck, the upper back and the lower back.

When neck pain occurs, it is due to a problem in the area of the following vertebrae:

• Atlas, the first of two specialized vertebrae at the top of the neck. These bones cover the lower part of the brainstem, the medulla oblongata
  
• Axis, the second of two specialized vertebrae at the top of the neck. The atlas and axis do not have discs between them like the other vertebrae and are shaped differently than the other bones of the spine.
  
• Cervical vertebrae. These seven bones are usually identified by number (C-1, C-2, etc.). They make up the neck. These are among the smallest bones of the neck. Their tissue is denser than that of other spinal bones.
  

Specific symptoms will depend on where along the neck the problem is and what its cause is. Pain is felt usually no matter which part of the neck has been affected. The pain is usually felt in the neck, shoulder and arms or causes other symptoms if the top two bones of the spine are affected.

Neck pain can be felt for a variety of reasons, including:

• Aging
• Disc degeneration
• Disc herniation
• Disease
• Injury or trauma
• Slippage in the alignment of the bones of the neck on top of each other
  
• Stress

A doctor will take the patient's medical history and do a physical examination. An initial diagnosis is usually based on the pain or other symptoms the patient is having. To confirm the diagnosis, it may be necessary to do magnetic resonance imaging (MRI).

Depending on the cause of the pain and how severe it is, treatment may range from a conservative approach to surgery.

Treatment options include:

• Chiropractic, to realign bones, if they have shifted
  
• Conservative treatment with rest, drugs to reduce pain and swelling or braces
  
• Interventional pain management. This includes such approaches as the use of chymopapain, an enzyme found in a tropical fruit that is injected into herniated discs
  
• Discectomy, a surgical approach to treat damaged discs and relieve pressure on nerve roots or the spinal cord.
  
• Fusion, a surgical approach in which bones are attached to each other to create more stability
  

• Cedars-Sinai Institute for Spinal Disorders
• Cedars-Sinai Orthopedic Center
• S. Mark Taper Foundation Imaging Center