Neck Pain

Neck pain is usually caused by one or more of the conditions below:

• Arthritis of the joints of the spine, which is also known as cervical spondylosis.
• Degeneration of the discs of the cervical spine.
• Disc herniation compressing a nerve.
• Musculoskeletal pain from the ligaments, tendons, and muscles of the neck.

Most patients with neck pain have a combination of these problems.

Aside from pain related to problems in the neck itself, neck pain can sometimes be caused by more serious conditions like cancer, carotid artery dissection, cervical dystonia, and many others.

This is why it’s so important to understand the underlying cause of neck pain rather than simply settling for a general diagnosis. Understanding what’s causing the pain can help guide the right treatment and make it much more effective in providing relief and improving your quality of life.

When exercise and oral medications don’t help, it’s hard to decide where to go. Some people go to chiropractors, which might help sometimes, particularly for soft tissue pain, whereas others go to surgeons, which will start them on the road to spine surgery while ignoring less invasive alternatives.

The first thing to do is try to figure out if something you’re doing is causing neck pain. Are you maintaining good posture while using your computer or looking at your cellphone? Are you doing overhead presses (military presses) or straining your neck and shoulders when working out? Are you under a lot of stress and tightening your muscles? If correcting your posture, using good ergonomics, and avoiding stress don’t provide relief, it’s time to get some help.

Many people start with rest and taking over-the-counter medications. Some will apply heat or cold, or both. It’s good to try to resolve problems on your own but, if the pain doesn’t improve in 3-5 days, continues to get worse, or you develop weakness, numbness, or incontinence (loss of control of your bowel or bladder), get help. In such cases, it’s usually not something that will go away on its own.

We are fellowship trained specialists in pain management, neurology, and orthopedics. Calling our office directly for an appointment, if that’s an option, allows us to get the most effective treatment started sooner rather than trying things that might not help and eventually needing a referral to a specialist anyway, which just delays care.

A lot of spine surgery is done simply to alleviate pain, with mixed results. This is because the surgery itself alters the patient’s anatomy. That brings other problems over time so many patients find they have some pain relief for a limited time and then the pain comes back worse than ever. At that point, treatment options are much more limited. This is why the goal is to avoid spine surgery as much as possible.

Most patients do not realize the main goal of spine surgery is to preserve neurological function so the patient can continue to walk and avoid incontinence. Pain control is a secondary consideration, although it’s a very important one.

Cervical spine surgery tends to have better results than back surgery because the anatomy is different. Even so, degenerative changes that caused the need for spine surgery can continue to progress after surgery so the pain control aspect of spine surgery rarely lasts a lifetime. Eventually, the pain may return.

For patients who are not at risk of permanent neurological injury, which is the majority of spine surgery patients, surgery might not be the best approach to provide pain control. We provide variety of treatment options that can be used to help control pain while avoiding opioids and maximizing the ability to remain physically active.

We also offer a Second Opinion Program for those contemplating surgery who want a second opinion from experienced specialists who can help determine whether surgery is the best option.

Many patients believe spine surgery is about relieving their pain. This is not correct.

The point of spine surgery is to preserve neurological function. An example of a successful spine surgery is if a patient with severe neck pain who was going to wind up paralyzed can continue to walk because of the surgery, even if the neck pain does not improve at all.

Another consideration is that, if the surgery does not resolve the underlying degenerative condition, the patient will likely need additional surgery or procedures in the future. For these patients, spine surgery is not a permanent solution to their problem, although it can be a useful part of an overall treatment plan.

Unfortunately, they usually get sent home with instructions to make an appointment with a hospital employed specialist after getting some IV medications. Sometimes, if they’re lucky, they might get a CT or MRI. For this limited service, they will typically pay thousands of dollars and, when they try to make an appointment with the specialist, are told they have to wait weeks or months to be seen.

There are times, however, when an ER visit is absolutely necessary. If the neck pain is accompanied by a fever, weakness, loss of sensation, or incontinence (loss of bowel or bladder control), or if it started suddenly after trauma, this might be an emergency. If the primary care physician or specialist says go to the ER, then treat it as an emergency and go to the ER.

Those with access to a good medical practice should be able to call the office to get a quick overbook appointment, either in person or via telehealth, so they can avoid an unnecessary visit to the ER. This can be difficult if the practice in question relies on a call center that is not very responsive or is part of a large, bureaucratic organization that does not have much flexibility to accommodate urgent cases.

The pain is usually located in the neck but can also spread to the shoulders. In some cases, bone spurs form and irritate nerves, causing pain that radiates into the arms, hands, or head.

We offer multiple treatment options to control the pain related to cervical spondylosis including epidural steroid injections, medial branch nerve blocks, facet joint injections, and radiofrequency ablations. In certain specific cases we may also use regenerative prolotherapy.

We often include physical therapy and a home exercise program as part of the overall treatment plan. Our goal is to address the various aspect of this pain.

The discs in the neck are smaller than those in the lower back because they carry a lot less weight. Because they are made of cartilage, these discs can still degenerate (wear out) or herniate, which may compress a nerve, causing pain radiating into the arm and hand (a cervical radiculopathy) or discomfort in the neck itself.

Disc herniations can even press on the spinal cord, leading to more serious conditions such as cervical myelopathy and paralysis.

Typically, we use epidural steroid injections to treat the reduce inflammation and allow the body to naturally heal itself. If the herniation is very large and compresses the spinal cord we may refer to spine surgery.

Physical therapy, a home exercise program, and good posture along with good ergonomics at work help prevent disc herniations from coming back or getting worse.

Neck pain is often caused by problems with the ligaments, tendons, and muscles that support the spine. Over time, the ligaments and tendons that connect to the spine can wear out, leading to strain and discomfort.

Weak neck muscles can also contribute to pain by making it harder for your neck to stay stable and supported during everyday activities. Muscle spasms can cause sharp or ongoing pain, making it even harder to move comfortably.

For many people who experience neck pain, these musculoskeletal issues play a role, even if there are other underlying causes like arthritis or disc problems. Addressing these issues is crucial for finding relief and improving your quality of life.

We offer a variety of specialized treatments to help control pain, ease inflammation, and promote natural healing. These treatments are directed at the ligaments, tendons, fascia, and other tissues in the body that have become inflamed, injured, or damaged. In certain cases, we may also offer prolotherapy to treat specific conditions.