There’s no shortage of news reports and television commercials talking about low back pain. But let’s not forget about the other end of the spine — for many people, neck pain can cause plenty of trouble as well, from a “stiff” neck to severe, even debilitating discomfort.
Neck pain begins in the cervical spine, which starts at the base of the skull and consists of seven small bones, called vertebrae, and eight pairs of cervical nerves.
If those nerves are affected, the pain can extend into the arm as well, often causing soreness, numbness, weakness, or tingling in the shoulder, upper arm and even down into the hand.
These symptoms usually indicate that the roots of the nerves in the cervical spine are being compressed by the vertebrae or disks.
Because these nerves run all the way down into your arm, you feel symptoms in your arms even though the problem is in your neck. This condition is called cervical radiculopathy.
There are a number of factors, but one of the most common culprits is a herniated disc. The vertebrae in your spine are separated by discs, or fibrous pads with a soft, moist center that act as cushions between the bones.
A herniated disc is one that has deteriorated, and its soft center can protrude out into the surrounding area and put pressure on a nerve.
Another common cause is degenerative disc disease. Changes that take place in our bodies as we age can cause the disc to shrink and provide less cushioning to the vertebrae. Without it, the vertebrae may press against each other and put pressure on the nerve.
In many cases, neck and arm pain caused by a strain or mild injury goes away on its own within a week or two. Try to rest the area and avoid any activity that may aggravate it.
If the pain persists, the first step is to contact your physician. Usually, he or she will take a medical history to find out if you have had any injuries or have a family history of spine problems. During the physical examination, try to tell your physician exactly where you’re feeling pain — for example, is it in your neck, or do you feel tingling in your hand as well?
Your physician may also order X-rays to look for arthritis and bone diseases, or a CT or MRI scan to reveal problems with the disks or nerves.
Often, a few sessions with a physical therapist may be all that’s needed. In addition to exercises to strengthen and/or stretch the affected areas, your physical therapist may use massage, heat or cold treatments, electrical stimulation, ultrasound or traction to get your spine back to its normal condition.
Many people have found relief from neck and arm pain with acupuncture. Although we’re not quite sure how this ancient treatment works, clinical studies have found that it can be very effective in relieving pain related to the cervical spine.
When patients come to us after having tried everything else, our next step may be an epidural steroid injection.
This involves injecting a long-lasting steroid, or cortisone, into the area that surrounds the spine and the nerves. The steroid reduces the inflammation of the nerves, which usually relieves the pain and other symptoms caused by the irritated nerve.
Other than numbing the area where the needle is inserted, no other anesthesia is needed, and the injection takes only a few minutes.
If chronic, unremitting pain symptoms persist, surgery may be required. With surgery, our goal is to restore the normal environment of the spinal cord and nerve roots.
For the last 50 years, the traditional approach has been a minimally invasive procedure that results in very little blood loss or trauma to the surrounding muscles and tissue. Depending on the condition, we may also insert bone or a bone substitute to rebuild the area, holding everything in place with a metal plate and letting the body take it from there.
During the last few years new implants have been developed that accomplish the same goals but use a prosthetic device instead of bone that allows more normal motion and decreases stress on the surrounding areas.
At Scripps and other hospitals, clinical trials are underway to study the use of this new implant, and we expect FDA approval in the near future.
There are numerous options to help relieve cervical spine problems. If your neck pain doesn’t go away on its own, call your doctor for an evaluation.
And if you have any sudden, major changes, such as loss of strength or a change in your gait, call your physician right away. These symptoms can be warning signs of spinal problems that need immediate attention.