Cervical Spine Pain Definitions

Cervical Spine Pain

Definition

Cervical Spine Pain

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 borders of the neck

This can be further divided into

• Suboccipital pain - between superior nuchal line and C2
• Upper cervical pain - above transverse line through C4
• Lower cervical pain - below C4

Bogduk emphasises that cervical spinal pain is perceived posteriorly, but this is opinion. He states that pain in the region of the anterior cervical spine is called throat pain and there is a lack of any definition by an international authority. He further states that practitioners wanting to use the term "anterior neck pain" need to prove that it is coming from the cervical spine. He does not provide any references for these claims. In the editor's opinion, the claims are wrong.

• The term "neck lump" usually refers to pain in the anterior neck - throat lump has a completely different meaning, and refers to a lump in the pharynx.
• The anterior neck is divided into the "triangles of the neck," not "triangles of the throat."
• What Bogduk calls "throat pain" is commonly used to mean pain in the oropharynx, and is not usually used to refer to pain in the anterior or posterior triangles of the neck.
• With regards to proof of causation, he provides no justification as to why such a higher standard of evidence be required for anterior neck pain than posterior neck pain. To use his own argument for posterior neck pain, anterior neck pain simply references a location, not the cause of the pain. Furthermore, "anterior neck pain" does not include the term "cervical spine."

Timing of pain

• Acute pain: Pain <3 months
• Chronic pain: Pain > 3 months