Neck Pain Treatment

Dr Shreedhar Archik

Cervical degenerative disc disease at a glance

• Neck pain can be caused by cervical (neck) disc degeneration.
• The spinal discs act as shock absorbers between the vertebrae, allowing the spine and neck to bend and twist. A fall or injury can cause degeneration of the discs, but the most common cause is wear and tear over time.
• Symptoms most commonly include a stiff or inflexible neck.
• Treatment can range from home remedies to spinal surgery.

Causes of neck pain & cervical degenerative disc disease

As a person ages, the discs in the spine and neck may begin to break down. This can lead to degenerative disc disease, which is a term used to describe the normal changes in your spinal discs as you age.

Disc degeneration is more likely in people who smoke, are obese or do heavy physical lifting.

Over time, wear and tear can lead to changes such as :

• Loss of fluid in the discs. Loss of fluid affects a disc’s ability to act as a shock absorber, and makes the discs less flexible. It also narrows the distance between the vertebrae.
• Small cracks in the outer layer of the disc may appear, allowing the jellylike material inside to be forced out through the cracks. This may cause the disc to bulge or even rupture.

Sudden injuries may also initiate the degeneration process.

Symptoms of neck pain & cervical degenerative disc disease

Many patients with cervical disc degeneration complain of a stiff or inflexible neck. Others have severe heck pain, numbness, tingling or weakness in the neck, shoulders and arms as the nerves in the neck become pinched or irritated. The pain usually worsens with movements such as bending or turning the neck.

If you have mild neck pain for more than a week or sudden onset of severe neck pain, see your health care provider. Your physician will review your medical history and perform a physical exam to measure neck extension and flexibility. You may be asked to perform certain movements and determine whether or not neck pain increases or decreases with the movements.

Your doctor may order imaging tests such as X-Ray, MRI or a CT scan if the physical exam warrants further investigation. Diagnostic images can determine if and where degeneration is occurring, or whether other conditions are the cause of your symptoms.

Treatment for neck pain & cervical degenerative disc disease

Treatment usually begins with conservative measures (non-surgical), and surgery is only recommended if other care fails to provide adequate pain relief or if the patient’s daily activities are inhibited. Conservative treatment options include :

• Applying ice or heat for relief
• Medication : Using over-the-counter medications such as acetaminophen and non-steroidal anti-inflamatories. Your doctor may also prescribe medications such as muscle relaxants, oral steroids and narcotic pain medications. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
• Exercise : Daily exercise is essential in maintaining flexibility in the neck, and can help relieve chronic neck stiffness. Your health care provider may develop an exercise plan for you. Here are a few helpful exercises :

◦ Slowly turn your neck from left to right and back again several times.
◦ Try several chin-to-chest stretches. This will stretch the back of the neck.
◦ Lift your chin upward and look up. This will stretch the front of the neck and upper thoracic area.
◦ Move your neck in an ear-to-shoulder stretch, in order to extend the sides of the neck as much as possible. You can assist this move by gently placing a hand on the head, but don’t pull or push your head to the shoulder.

• Physical therapy may provide some relief. Chronic manipulation can help to increase, at least for a time, the disc space in the affected area.
• Neck traction or a cervical collar may be helpful by stabilizing the neck. This may improve neck alignment so that disc compression does not worsen during everyday activities.
• Surgery : If pain is not relieved after six months of conservative care, or if daily motion becomes too difficult, your doctor may recommend surgery. Fusion may stop the motion of the affected vertebral segment. It involves removal of the disc, and decompression of the nerve root. A bone graft is then inserted to reestablish the normal disc space and neck alignment. A cervical plate can be used to promote fusion between the two affected vertebrae.

If you experience chronic neck pain or symptoms associated with degenerative disc disease, contact us to request an appointment with one of our orthopedic spinal physicians to learn about the best treatment options to relieve your symptoms.

Neck Pain : Cervical Stenosis

Cervical stenosis at a glance

• Neck pain can sometimes be caused by degenerative changes in the intervertebral discs of the cervical spine and the joints between the vertebrae. One of the most serious problems caused by degeneration of the spinal segment in the cervical spine is a condition called spinal stenosis.
• In cervical spinal stenosis, the spinal canal in the neck narrows and can squeeze and compress the nerve roots where they leave the spinal cord, or it may irritate or injure the spinal cord itself.
• This pressure can change how the spinal cord functions, and can result in pain, stiffness, numbness, or tingling in the neck, arms, hands, and legs.

Causes of cervical stenosis

A person’s body change with age. Cervical spinal stenosis may be caused by age-related changes in the shape of the spinal canal, and it is most common in those older than age 50.

Over time, aging can also result in the destruction of cartilage and excessive growth of the bones in joints. For some, aging can cause the spongy discs between the bones of the spine to bulge out farther than normal, or it may thicken the tissues that connect the ligaments.

These conditions can narrow the spinal canal and result in spinal stenosis.
Symptoms of cervical stenosis

Symptoms usually develop over time. Many people will have narrowing of the spinal cord, yet have not symptoms. Symptoms do not appear until the nerves or spinal cord becomes squeezed.

Symptoms may include :

• Pain, numbness, tingling or stiffness in the neck, shoulders, arms, hands or legs.
• Problems with coordination or balance, including tripping while walking.
• Weakness or spasticity in the legs.
• Incontinence.

If you are experiencing any of the above symptoms, see your health provider. Your doctor will take a complete medical history and provide a physical exam. To ensure an accurate diagnosis, your physician may order several diagnostic tests.

Treatment of cervical stenosis

For mild and moderate cases, symptoms of spinal stenosis may be managed with pain relieving medicine, physical therapy and exercise to build strength and flexibility.

For severe cases, your physician illay recommend decompressive surgery to relieve the pressure. This surgery involves removing some of the disc, bone, and/or tissue that may be pressing on the nerve roots. It may be done from the front or the back of the neck.

Vertebrae may also be fused surgically to provide stability to the spine.

Since cervical spinal stenosis can cause serious problems with the nervous system, your doctor will not wait until you have severe symptoms before considering treatment to relieve pressure on your nerves and spinal cord.

If you are experiencing neck pain and the symptoms of cervical spinal stenosis, contact Dr. Archik to schedule an appointment with orthopedic spine specialists.
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Disclaimer: The information provided here should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. The information is provided solely for educational purpose and should not be considered a substitute for medical advice.