Cervical (Neck) Pain
Pain in the neck area that lasts over four weeks can be due to an underlying spine problem. The pain is usually created either by a disc irritating one of the cervical nerves or due to an inflamed cervical facet. ( joint) The discomfort can be either just in your neck, or it may create pain into the shoulders, down the arms or even up the back of the head. The source of the pain can be identified with special diagnostic procedures.
Herniated Disc (Cervical)
Facet Joint Syndrome
This page offers the answers to some of the most common questions related to pain occurring within the neck area, as well as the procedures used to diagnose and treat it effectively. Click on the questions to reveal the answers. Additional questions and answers about spine-related pain and our procedures are featured in the Ask the Doctors section.
Persons who have experienced any of the following are good candidates for our procedures:
- If you have had constant neck pain that has not responded to conservative care, including rest, medications, physical therapy and/or chiropractics over a 4-week period.
- If you have arm or leg pain, numbness or weakness that radiates from your neck.
- If you have had surgery on your neck and did not improve.
- If your neck pain limits your normal functions and keeps you from enjoying a full, active lifestyle.
An MRI only shows what is there and does not necessarily tell you that an abnormality is causing pain. About 80% of people between the ages of 40 and 60 years old without any pain will have a herniated or bulging disc on an MRI, so not all abnormalities cause pain. Additionally, many lesions that cause pain in the spine are not even visible on an MRI including internal disc tears and facet joint injuries. This is why so many whiplash injuries are never diagnosed on MRI and only through these special procedures can the source of the pain be pinpointed.
Most of our patients report relief that lasts from weeks to years from these procedures. Of course, the length of time that you will experience relief will depend upon several factors, including the cause of your problem and your general health. Our physician will advise you of special steps that you can take after the procedure, including exercises, to decrease the likelihood of further pain.
To date we know of no “cure” for neck problems. The purpose of our treatments is to decrease or eliminate your pain, but it will not necessarily “cure” the problem for everyone. Unfortunately, all of our bodies undergo a natural degenerative process and we all strive to get the most out of our bodies with the least amount of symptoms. It is important that you take care of your neck by using good body mechanics, exercise and avoid doing things that can trigger neck pain. Over time, everyday “wear and tear” takes its toll on all of us and our goal is to give you the highest quality of life possible with your given set of circumstances.
Yes, if needed, the procedure can be repeated up to 2 to 3 times each year for as long as significant gains in your quality of life occur with the treatments.
If my MRI is negative, is it still possible that I can have an irritated nerve in my neck or back that is causing the pain?
Yes. An MRI is an indirect image of the spine and does not always show everything. In addition, an MRI usually is taken while you are laying down. Nerves can shift when you change positions, especially if your pain is worse with when you stand or sit. The disk can leak part of its “jelly” center˜or nucleus˜around the nerves, which can cause significant chemical inflammation and pain. Our procedures can dramatically reduce the pain and inflammation resulting in increased circulation and healing.
All sensation in your shoulders and arms are carried by nerves coming out of your neck. If you irritate or injure the nerve in your neck that goes to your thumb, for example, you will feel the pain in your thumb and not at the actual site where the injury is located. It is like having a “nick” in the telephone line outside your house, but you only hear the static inside at the telephone headset.
If your problem really is a strained muscle, then you should have gotten better with a short course of physical therapy. While your muscles may hurt, when it comes to spine disorders, the muscles are usually reacting in a protective fashion to an underlying spine disorder.
If your pain has lasted for over two weeks, then it‚s very possible that the spine is a source for the muscle spasm and pain. If you wish to get better, you have to get to the real source of pain˜not just treat the symptoms.
Generally speaking, trigger point injections are not effective for treating spine disorders. These types of injections usually only mask the symptoms for a short period of time. If you want longer-term relief, you must get to the source of the problem, which rests in a disorder of the spine itself.
We do not recommend Botox for treating back or neck pain. Botox paralyzes the very muscles that are trying to support your spine when an underlying disk or joint creates a problem. We have seen people treated this way who might have recovered from an initial minor disorder only to need surgical fusion because of the instability that developed after the supporting muscles were taken away by Botox.
Popping is believed to represent the movement of nitrogen bubbles within a joint. These bubbles build up when a joint is not moved for a long period. Most persons with neck pain “splint” their necks subconsciously. When they finally move or stretch the joint, neck popping develops. This is similar to moving your knuckles first thing in the morning after keeping your fingers still all night. Arthritic joints become stiff and a more active stretching program is needed to maintain joint flexibility. The popping itself is not harmful.
I read a newspaper article about a new treatment for back pain that involves traction on a disk using a special machine that can even reverse disk herniations. Should I try this treatment?
Unfortunately, the “latest and greatest” spine treatments are easily peddled in America. Studies have shown that treatment for pain has a placebo response rate between 20% and 30%. That means that any “snake oil” or sugar pill will make about 25% of people feel better˜at least temporarily.
About 80% of all initial back injuries also resolve spontaneously and most disk herniations will resorb in time without any treatment. So, it is easy to see how these new “treatments” can claim success by using a few patients who felt better. The same goes for magnets, many balms and tonics.