Neck pain is something that just about everybody knows something about.
We’ve all awakened with a “crick” in the neck at some point, or sprained it somehow. Fortunately, most all of these pains go away in a few days to weeks. However, it is very common to have neck pain that persists a lot longer. By far, the most common problem I see in my office is plain old wear-and-tear arthritis of the neck. The neck is subjected to an awful lot of stress during our lifetimes. It has to support a head that weighs 15 to 20 pounds on a spinal column the diameter of a half dollar. Over the years, that does lead to some deterioration. Fortunately, in most people this wear is silent and only shows up as an increasing stiffness or occasional mild ache. Some people aren’t that lucky, and their pain can be more intense.
The pain from neck arthritis is confined to the neck itself, or it may travel into the upper shoulder, but never travels down the arms. It can be quite annoying but is never incapacitating. Treatment never involves surgery; usually I will prescribe medication, exercise, physical therapy, and sometimes a home traction kit.
If the pain travels from the neck down the arm, it can indicate a more serious problem of a pinched nerve. The nerves that provide sensation to our arms actually exit the spinal cord in the neck region. If anything pinches them in the neck, we can feel pain all along the course of the nerve down to the hand or fingers. There can also be a sensation of numbness or tingling in the hands, almost like the “funny bone” has been hit. Several things can pinch the nerves in the neck, but the most common are herniated (or ruptured) disks or bone spurs. The pain from a pinched nerve can be mild if the pinching is just from a small spur, but if there is a large disk rupture or spur, the pain can be extreme and associated with headaches, arm pain, tingling in the hand, and severe neck stiffness.
The treatment for a pinched nerve in the neck depends on how severe the pain is. If it is tolerable, then conservative measures can be tried very similar to those we use for neck arthritis. If the pain is severe, or if the conservative treatments fail to work within a reasonable period of time, sometimes surgery will be necessary to un-pinch the nerves. The exact operation depends on how the nerve is pinched. If the disk is ruptured, then it must be removed and replaced by a block of bone. If a bone spur is causing the problem, then it is excised.