About half of all adults in the country complain of neck pain at some point in their lives. Most of the time it is acute pain that will resolve itself after a matter of weeks. Often these neck pains are due to injury (a fall for instance), muscle strains, ligament problems, a crick in the neck, or simply poor posture. Maybe you just had a bad night’s sleep and you slept on your head wrong. These types of neck pain often just take time to resolve themselves.
However, when neck pain lasts for more than three months, it can be considered a chronic problem. It is possible that you have a worn-out joint or a herniated disk that is not going to improve over time. Such conditions will require more aggressive treatment planning rather than just watching and waiting.
When To See A Doctor For Neck Pain?
There are many ways one can describe neck pain, i.e. sharp, dull, aching, electric, numbness, tingling, and pressure. Because there are many things in the neck that could be the cause of the problem, you should visit your primary care physician if you are experiencing any of these symptoms on an ongoing basis.
For more severe issues, your doctor may recommend you see a neurosurgeon. Neurosurgeons can help diagnose and treat a number of conditions that cause neck pain, such as a herniated disc or pinched nerve.
Note: With any aspect of personal health, there are emergencies. If neck pain is combined with severe muscle weakness, balance problems, coordination problems, or bowel/bladder incontinence, these are severe conditions and you should immediately go to the emergency room. These types of symptoms can occur when the spinal cord is pinched too much and these symptoms can become permanent if they go on for too long.
If your neck pain is combined with shooting pain into your shoulder or down your arm or you are experiencing numbness in your arms and hands, you should contact a physician right away.
Common Causes of Neck Pain
Essentially, the most common causes of neck pain are the muscles, the joints, the nerves, and the cervical disks (cervical disks sit between adjacent vertebral bones in the neck while enabling flexibility for head movements. They give your head and neck support by acting as shock absorbers between each vertebra). To treat neck pain, it is essential to first identify from which of these places the pain is coming as all treatment options will be focused on one of these four things.
Muscle Strain
Muscle strain can occur through things like overuse or poor posture. Muscles are soft tissue that can be strengthened and stretched and can heal over time. As the cause of neck pain, muscle strain can sometimes be treated by a physical therapist, massage, and home exercise. However, it can also be an indicator of something more serious if the neck pain persists.
Neck pain can be caused by an injury, like whiplash, a bone fracture, or a herniated disk. Any sudden changes altering the anatomy can cause overstretching and inflammation in soft tissues.
Worn Joints
Worn joints in the neck cause arthritis. When you get older, you wear out your joints over time. In medical and surgical diagnosis jargon, joints in the neck are referred to as “facets”.
Nerve Pain
Nerve pain can cause numbness, tingling down the arm and can have a number of different causes. You can herniate a disk which can cause a pinched nerve. Joints can enlarge over time and get inflamed which will irritate nerves that cause pain to go down the arm. There are different ways to irritate nerves that cause the same problem.
It is important to mention that the cause of neck pain can also be rheumatoid arthritis. Rheumatoid arthritis most commonly affects the hands, the feet, and the neck. It is a condition where the body is attacking its own joints because your own immune system is essentially attacking those joints. In this way, it is different than just the wearing of joints over time. Moreover, with rheumatoid arthritis, the hands and the neck are often the first places the pain appears.
Common Questions Doctors Ask about Neck Pain
- How long has your neck been hurting?
- What were you doing when the pain started?
- Are you doing some new activity?
- Have you ever injured your neck in the past?
- How would you describe the pain? Is it dull, sharp, or aching? Burning, electrical, or shooting?
- Do any particular neck movements make the pain improve or worsen?
- Do you have any numbness or weakness?
- Does the pain radiate into your arm?
- What medications, supplements are you taking?
Common Diagnostic Tests for Neck Pain
One of the very first steps in your exam at a doctor’s office or clinic is an x-ray. You will be looking for fractures, instabilities, misalignment in the joints, and most importantly if there is arthritis in the joints. X-rays are a really good way to check bone structures. Just looking at the bony structures can help the physician find any severe issues. However, x-rays may not reveal what is actually causing the neck pain.
Magnetic Resonance Imaging (MRIs)
If the x-rays are not providing enough information, the next step is an MRI. The MRI is used to get a more comprehensive look at the spinal cord. It is a great investigative tool to search for pinched nerves, disc degeneration, or associated infections as the cause of neck pain. The MRI will discover correlations between images and the points that may be the cause of neck pain.
Electromyographic Nerve Tests (EMGs)
Another test sometimes used to assess the health of the muscles and the nerves is EMG (electromyography). It checks how well nerves conduct nerve pulses down your arm to identify possible nerve damage, like that which occurs in diabetes. The main idea is to see if a nerve itself is damaged which results in numbing and/or tingling in the hand. EMGs can reveal nerve dysfunction. It is a way to see if focusing on the neck is appropriate.
Treating Neck Pain with Physical Therapy
This is one of the first things your doctor will have you get started on to treat your neck pain. It is very helpful to stretch, exercise, strengthen, and increase the range of motion of your neck. Physical therapy is an educational time – you go to the physical therapist and learn what to do and how to do it correctly so you don’t make things worse. Getting a good physical therapy routine can be really beneficial in the long term. There are several myofascial techniques including massage, electrical nerve stimulation, and dry needling.
When Physical Therapy Doesn’t Work
When neck pain persists or goes away for a short time but continues to reoccur, further tests must be performed to get a targeted diagnosis. As there are many possible causes, there are a number of procedures that can be performed and many treatment options.
But again, the muscles, the joints, the nerves, and the disks are the four possibilities for the causes of neck pain. As such, all treatment options will be focused on one of these four things. This means it is more than likely that you will be exposed to a variety of physicians before you are correctly diagnosed and treated.
Common Treatments for Neck Pain
A patient will likely be exposed to a variety of injection options, like cervical epidural steroid injections which can help diagnose neck arthritis. Arthritis in the neck is perhaps the most common cause of neck pain. Cervical epidural steroid injections are usually done at an outpatient clinic. Most injections will be diagnostic until the cause of the pain is found.
Another common treatment is nerve ablation. Nerve ablation can target specific nerves that are generating the pain. This procedure is referred to as “zapping”; this means that the nerve is only temporarily out of service and will eventually grow back usually within 6-18 months.
Nerve ablation will be extremely targeted and ultimately allow the physician to locate the cause of the pain. This procedure is also not normally done in a hospital, rather a procedure suite. More serious causes, like a herniated disk or spinal stenosis, can be treated with more aggressive steroid injections and ultimately surgical procedures.
But again, each person’s individual situation will require individualized solutions. Which doctor you should go to will depend on the specifics of your neck pain. Almost assuredly, you will be introduced to a spectrum of physicians or specialists to get to the bottom of things and get treated appropriately.
Chronic Neck Pain? The Road to Relief can be Long
For people living with chronic neck pain, it can take a while to find true relief due to the range of medical options available in Florida. As an example, let’s look at someone who decides to go to their primary care doctor to get help for their frequent migraines. Their doctor notes the symptoms their patient says they’re experiencing and decides to prescribe some pain medication for relief. Due to the underlying cause of the headaches, this prescribed treatment doesn’t end up working.
Nearly a month after the initial visit, the patient is back at their doctor asking for another solution to their chronic headaches. They are next referred to a physical therapist in Florida. They spend a month working with the physical therapist, but unfortunately, this course of the treatment proves unsuccessful as well.
Two months after the initial visit, the patient is referred to a local chiropractor who specializes in treating neck pain and other spine-related injuries. This is also not a course of treatment with a short timeline, so the patient proceeds to work with this chiropractor for the next 2 months. Sadly, this too fails to provide the relief they are seeking.
Now after 4 months, the patient schedules an appointment with a neurologist in Florida. Their prescribed treatment is a variety of pain relief injections in the patient’s neck. Unfortunately again, this does not provide relief from the chronic pain they are suffering from. However, it is at this point that the neurologist refers them to an outpatient surgery center in Florida that specializes in minimally invasive spinal surgeries. The patient then opted to undergo surgery to relieve pressure caused by pinched nerves in the neck. That coupled with some post-surgery physical therapy finally got this patient the relief they had so desperately wanted – 6 months after their initial visit to the doctor.
When asked later, this patient acknowledged that they wish they had chosen the neurologist as their starting point. It would have saved them from a lot of pain and saved them a lot of money.
