Neck Pain Information
Neck pain is a common problem that severely impacts the quality of your life. It can limit your ability to be active and can cause you to miss work, lose sleep and feel generally unwell. If you suffer from neck pain you are not alone and you have many options to help manage it.
Neck pain can be acute or chronic. Acute neck back pain generally comes on suddenly and resolves over few days. It is commonly due to muscle spasm or ligament strain. It is rare for acute flair ups of neck pain to be due to a serious pathology. Acute flare ups of neck pain may be associated with muscle spasm, termed a wry neck. A wry neck (torticollis) typically improves over a couple of days. Anti-inflammatories, diazepam, physiotherapy and massage may help to resolve acute wry necks.
Chronic neck pain can affect patients for weeks, months or longer. The most common cause of chronic neck pain is cervical intervertebral disc degeneration. Rarely neck pain can be caused by more serious health problems such as trauma, cancer or infection. These rare causes need to be managed in an urgent fashion by a neurosurgeon or spine surgeon. Basic medical assessment and radiological investigations can safely differentiate between the common degenerative types of neck pain and the more serious causes. If you are worried you are not getting the appropriate management please contact us on 1800 DO SPINE (1800 367 746) or email contact@keyholeneurosurgery.com.au.
Chronic neck pain is commonly caused by cervical spondylosis and intervertebral disc degeneration. This is where the intervertebral discs, or shock-absorbers in the spine, wear out over time. When symptoms become chronic and unresponsive to treatments, permanent disability with reduced quality of life can follow. In addition, chronic pain and disability can lead to psychological illness, such as depression or anxiety.
For more information about neck pain watch the video below.
Video - Neck Pain
Cervical spondylosis, or cervical degeneration, is a major cause of neck pain. The neck is a very mobile region of the spine and as such is very prone to "wear and tear" over time. Neck pain can come from different areas of the neck and sometimes the exact cause may be difficult to identify. Sources of neck pain include
In addition to neck pain, cervical spondylosis can be associated with symptoms of nerve compression which include:
The symptoms of cervical spondylosis are usually progressive and get worse with time. However, with appropriate management the degree of progression can be slowed or even halted. Sometimes compression of the spinal cord can cause symptoms of cervcial myelopathy.
Investigations
Following the initial clinical assessment it is usual for some type of radiological investigation to be organised to look in more detail for the cause of the neck pain and discomfort, and the degree of nerve compression.
Dr Oehme will arrange all of the necessary tests for you.
Management Options
Unless you have severe pain or significant neurological deficits, such as arm weakness, the initial treatments for neck pain and cervical spondylosis are conservative non-operative therapies. These treatments include:
Following exhaustion of non-operative measures or when the degree of nerve compression is severe, surgery is sometimes indicated Where symptoms of nerve compression predominate, the goal of intervention is to decompress the nerves, relieving the pressure on them. Relieving the pressure on the nerves reliably improves the symptoms of pain in the arm.
Surgery generally involves a procedure such as anterior cervical discectomy and fusion (ACDF) or cervical laminectomy. Dr Oehme will advise you which procedure is most appropriate.
- Intervertebral discs
- Facet joints - see our facet joint injection page for more information
- Bone/Periosteum
- Ligaments
- Paraspinal musculature and fascia
- Nerve roots and spinal cord
- Psychological causes
In addition to neck pain, cervical spondylosis can be associated with symptoms of nerve compression which include:
- Arm pain (brachialgia)
- Loss of feeling, numbess, tingling or parasthesias in the arms
- Shoulder, arm or hand weakness - for example difficulty writing
- Reflex changes - such as loss of elbow jerk
- Headache
The symptoms of cervical spondylosis are usually progressive and get worse with time. However, with appropriate management the degree of progression can be slowed or even halted. Sometimes compression of the spinal cord can cause symptoms of cervcial myelopathy.
Investigations
Following the initial clinical assessment it is usual for some type of radiological investigation to be organised to look in more detail for the cause of the neck pain and discomfort, and the degree of nerve compression.
- MRI (this is the best test to assess cervcial spondylosis, disc prolapse and brachialgia)
- CT
- X-ray
- Dynamic x-ray
- Bone scan including SPECT CT
- Nerve conduction studies and EMG (Electromyography)
Dr Oehme will arrange all of the necessary tests for you.
Management Options
Unless you have severe pain or significant neurological deficits, such as arm weakness, the initial treatments for neck pain and cervical spondylosis are conservative non-operative therapies. These treatments include:
- Analgesics (pain medication)
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Physiotherapy
- Steroidal injection therapies, such as facet joint injections or nerve root injections
- Behaviour modification - e.g. avoiding heavy lifting
- Bracing or wearing a collar
- Pilates
- Hydrotherapy
- Swimming
- Weight loss is also important as extra weight places more stress on the spine contributing to back pain.
- Strengthening exercises to strengthen core and paraspinal muscles will help provide extra stability to the spine reducing pain.
- Pain management
Following exhaustion of non-operative measures or when the degree of nerve compression is severe, surgery is sometimes indicated Where symptoms of nerve compression predominate, the goal of intervention is to decompress the nerves, relieving the pressure on them. Relieving the pressure on the nerves reliably improves the symptoms of pain in the arm.
Surgery generally involves a procedure such as anterior cervical discectomy and fusion (ACDF) or cervical laminectomy. Dr Oehme will advise you which procedure is most appropriate.
