FAQs on Neck Pain and Treatment from a Pain Clinic in Phoenix
Pain can occur anywhere in the neck, from the top of the shoulders to the bottom of the head. Neck pain is often accompanied by loss of neck mobility and stiffness. Many things can contribute to neck pain, including arthritis and injury.
What are the neck structures?
The cervical spine supports the human head, which weighs around 15 pounds. The spine has a wide range of motion, which makes it vulnerable to injury. Seven small irregular shaped bones (vertebrae) make up the cervical (neck) spine, and these bones are separated by intervertebral discs, which absorb shock and cushion the bones. In addition, this part of the spine has eight nerve roots, 32 muscles, ligaments, and vascular elements. Any portion of the neck is susceptible to damage, trauma, deterioration, and/or injury.
What causes neck pain?
A fall from a ladder, down a hill, or a car accident all can result in a type of injury known as whiplash. Also called cervical strain, whiplash can lead to severe spasms of the neck muscles. In addition, neck pain can result from certain types of activity, slouching, or sleeping with the neck twisted. Growing older contributes to neck pain, with causes contributed to such disorders as spinal arthritis and degenerative disc disease. Other causes of neck pain include spinal stenosis (narrowing of the spinal canal), neck infection, and rheumatoid arthritis.
What are the symptoms associated with neck pain?
The symptoms of neck pan include pain in the upper back, shoulders, and neck region. Many patients also experience a headache along with the neck discomfort. If there is pressure on a cervical spinal nerve root, the patient may have tingling, numbness, or weakness of the arm.
How is neck pain diagnosed?
The doctor will take a history and conduct a physical examination. Imaging tests are used to assess the bone, muscles, and tissues of the neck. These include x-rays, magnetic resonance imaging (MRI) scan, and computed tomography (CT). To assess for nerve damage, nerve conduction studies and electromyography are done.
What are the treatment options for neck pain?
Neck pain treatment depends on the exact cause. Options include:
- Medications – Commonly prescribed drugs for neck pain include nonsteroidal anti-inflammatory drugs (NSAIDs), which are used to decrease pain and inflammation. For patients who experience muscle spasms, a muscle relaxant may help, such as Baclofen and Robaxin. For severe pain, analgesics are prescribed, and short-term steroids (Medrol dose pack) can reduce nerve inflammation.
- Trigger point injections (TPIs) – These injections are used to deactivate trigger points of the upper back and neck region. The doctor injects these contracted muscle groups with a numbing agent (lidocaine). Based on clinical studies, patients with neck pain experienced a 100% success rate with TPIs.
- Facet joint injections (FJIs) – For this procedure, the doctor inserts small needles into the facet joints along the back of the cervical spine. Using x-ray guidance to assure correct needle placement, the doctor will instill a corticosteroid, with or without an anesthetic agent, into the joints. Based on controlled clinical studies, FJIs proved to have an 83% efficacy rate for patients with neck pain.
- Medial Branch Block – This procedure is similar to facet joint injections, however the injection material is placed around the joints to block the tiny nerve endings and provide pain relief. On average, medial branch blocks offer 85% effectiveness for 3 months.
- Radiofrequency Ablation – If a medial branch block is effective and then wears off, a radiofrequency ablation can be performed. The procedure is outpatient and great for neck pain relief. Over 12 to 18 months of consistent pain relief is achieved over 80% of the time!
- Epidural Steroid Injections – for those patients who have arm pain in conjunction with neck pain, it may be due to a pinched nerve. This may be a herniated disc or spinal stenosis. The epidural injection is typically very effective at pain relief, although it may take a series of procedures for optimal relief.
- Physical therapy – For chronic neck pain, the pain specialist may recommend physical therapy sessions. The patient meets with the doctor 2-3 times each week to learn strengthening and flexibility exercises. Massage, ultrasound, and electrical stimulation are used to provide pain relief.