|Choices to Reduce Your Neck Pain
Treatment for any back condition should involve two goals:
• Relieve pain
• Reduce the risk of re-injury
The treatment of neck pain can range from the reassurance that nothing is wrong to very delicate surgery. Treatment is always based on the individual and his or her symptoms. In general, treatment for neck pain falls into two broad categories: conservative treatment (non-surgical) and surgical treatment.
Non-Surgical Treatment for Your Neck Pain
Medications are commonly used to control pain, inflammation, muscle spasm, and sleep disturbance.
Some general tips about treatment with medication:
• Medication should be used wisely! Take all medications exactly as prescribed and report any side
• effects to your doctor.
• Some pain medicines are highly addictive!
• No pain medicine will control chronic pain if used over a long period.
• No medication will cure neck pain of degenerative origin.
A cervical collar is often used to provide support and limit motion while an injured neck is healing. It also helps keep the normal alignment. Cervical collars can be soft (made of foam) or hard (made of metal or plastic). Because these collars can restrict the movement of your head, you may need help with eating and other activities. The skin under the collar needs to be checked every day to prevent blisters or sores.
A cervical pillow is sometimes recommended for people who have problems with neck pain at night. The cervical pillow is designed to hold the neck in the best position to prevent excess stress on the cervical spine during sleep.
Your doctor may have a physical therapist work on an exercise program developed just for you. The physical therapist will teach you ways to prevent further injury to your neck.
For a complete description of the rehabilitation of neck pain, you may wish to review the document:
Epidural Steroid Injection (Nerve Block)
If other treatments do not relieve your back pain, you may be given an epidural steroid injection (ESI), or a cervical nerve block. An ESI places a small amount of cortisone into the bony spinal canal. Cortisone is a very strong anti-inflammatory medicine that may control the inflammation surrounding the nerves and may ease the pain caused by irritated nerve roots. The ESI is not always successful. This injection is often used when other conservative measures do not work, or in an effort to postpone surgery.
Common Operations Used for Neck Pain
Surgery is only necessary for a few people. However, no single type of surgery works for every neck pain problem. If your doctor thinks surgery will improve your neck pain, he will suggest the type of surgery he thinks is the best for you. Numerous surgical procedures have been designed to treat each type of neck pain. The following section describes different surgical treatments in a very general way, and gives an overview of what each type of procedure tries to accomplish. Surgical procedures are generally done for one of three reasons:
• To remove pressure from the nerve roots caused by bone spurs or herniated disc material (for cervical
• To remove pressure from the spinal cord (for cervical myelopathy)
• To stop the motion between two vertebrae - or a spinal segment (for degenerative disc disease)
One of the most common surgical procedures for problems in the cervical spine is an anterior cervical discectomy. The term "discectomy" means "remove the disc". A discectomy relieves the pressure on a nerve root by removing the herniated disc causing the pressure.
In the cervical spine, the disc is usually removed from the front. An incision is made in the front of your neck right beside your trachea (windpipe). The muscles are moved to the side. The arteries and nerves in the neck are protected as well.
Once the spine is reached from the front, each disc and vertebra are identified using an X-ray to make sure that the right disc is being removed. Once this is determined, the disc is removed all the way back to the spinal cord. Any bone spurs that are found sticking off the back of the vertebra are removed as well. Great care is taken to not damage the spinal cord and nerve roots.
In the cervical spine, a discectomy is usually combined with a anterior spine fusion, where the two vertebrae on either side of the removed disc are allowed to heal together, or fuse. The cervical fusion is described in detail below.
Once the disc has been removed between the vertebrae, a cervical fusion is performed. This procedure allows the surgeon to fill the space left by removing the disc with a block of bone taken from the pelvis. Placing a bone graft between two or more vertebrae causes the vertebrae to grow together, or fuse. If your neck problem is caused by segmental instability, a spinal fusion may also be recommended - even if you do not have a cervical radiculopathy.
The bone graft is usually taken from the pelvis at the time of surgery, but some surgeons prefer to use bone graft obtained from a bone bank. Bone graft from a bone bank is taken from organ donors and stored under sterile conditions until it is needed for operations such as spinal fusion. The bone goes through a rigorous testing procedure, similar to a blood transfusion. This is in order to reduce the risk of passing on diseases, such as AIDS or hepatitis, to the recipient.
There are two basic types of spinal fusion:
Anterior Interbody Fusion
This type of fusion is much more common in the neck. This type of fusion is described above. In the interbody fusion, a bone graft is placed between two vertebrae and replaces the removed disc. During the healing process, the vertebrae grow together, creating a solid piece of bone out of the two vertebrae.