Neck pain is a generalized term for pain in the cervical spine—the neck. It can have many potential causes. Often, damage to the cervical spine—such as a herniated disc—either instead of or in addition to pain in the neck will cause pain radiating down the arms or into the face or chest, which is known as radiculopathy.
Common Causes of Neck Pain
Neck pain has a number of possible causes. Low-energy events such as falls, high-energy events such as car accidents, sports injuries and chronic wear and tear are all possibilities. Causes can include:
- Cervical spinal stenosis
- Compression fracture
- Degenerative disc disease
- Herniated disc
- Muscle or tendon strain
Many times, what feels like neck pain is actually pain associated with a muscle or tendon injury in the upper back, such as the trapezius muscle. And, injuries that compress nerve roots in the cervical spine—most notably herniated discs and spinal stenosis—are more likely to cause radiculopathy than neck pain. Where that pain is felt depends on which nerve roots are being compressed.
Diagnosing Neck Pain
Accurately diagnosing the source of neck pain is important, because different causes require different treatments. Diagnosis usually begins with a careful medical history and physical exam. During the medical history, a spine specialist will want to know about any chronic conditions, any recent accidents or surgeries, when symptoms began, other symptoms besides pain and more.
During a physical exam, a doctor may manipulate the patient’s neck or arms to see where, when and how symptoms manifest. The exam will determine how well the patient can move the neck and arms, if there’s any loss of strength or motor control and the degree of pain.
If the medical history and physical exam provide no or few cues, an imaging study may be warranted. Common imaging studies include:
- X-rays: X-rays depict bone and other dense tissue well. They are useful in determining bone spurs from arthritis, vertebral compression fractures and other bone-related conditions. X-rays do not show soft tissue such as muscles and tendons, ligaments or intervertebral discs.
- MRI: MRI—short for magnetic resonance imaging—scans use powerful magnets and radiowaves to create images of the body. Soft tissue does show up on MRIs, making it a common tool to diagnose herniated discs, muscle strains and other soft tissue conditions.
- CT scan: Computed tomography (CT) scans are a series of X-rays that are combined and interpreted with advanced computer hardware and software. Like MRIs, CT scans can show damage to soft tissue.
Neck Pain Treatments
Most cases of back pain—which includes neck pain, since the neck is part of the spine—go away on their own after about two weeks. That is the ideal outcome, but it is not one people with neck pain should rely upon.
Conservative, nonoperative treatment will usually be the first treatment attempt. Common conservative treatments for neck pain are:
- Physical therapy
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
More intensive—but still nonsurgical—options include:
- Corticosteroid injections (powerful anti-inflammatory drugs)
- Muscle relaxants
If conservative treatment fails to relieve neck pain, but the pain has an identifiable source, surgery may be the next option. Surgery depends heavily on the cause or source of the pain. Procedures we perform at Edison Spine Center include:
- Laser disc decompression: This procedure uses laser energy to change the pressure inside a herniated disc, causing the herniated portion to retract and relieve compression on the nerve root.
- Microdiscectomy: This procedure removes a herniated portion of a disc that is compressing a nerve root.
- Anterior cervical discectomy and fusion: ACDF has two parts: First a damaged disc is removed from a cervical vertebra. Then a bone graft is added to encourage the vertebra without the disc to fuse with the one above it, which will eliminate painful movement.
- Cervical disc replacement: A cervical disc replacement swaps out a faulty or damaged intervertebral disc with an artificial implant.
- Laminectomy: A laminectomy involves the removal of the back portion of a vertebra called the lamina. It creates more room in the spinal canal. This procedure is useful both for herniated discs and for cervical spinal stenosis.
- Kyphoplasty or vertebroplasty: These procedures use bone cement to treat vertebral compression fractures, restoring stability and height to the bone.
If you are experiencing neck pain or radiculopathy that has persisted beyond two weeks, request an appointment at Edison Spine Center. Our experts will get to the root cause of your pain and recommend a treatment plan that’s right for you and your life.