Persistent or unusual neck pain could signify an underlying health problem. If you have had neck pain for longer than 6 weeks, or if you have experienced a traumatic event or injury to the neck, you should come in for spinal imaging and evaluation. A proper diagnosis of the source of your neck pain will indicate which treatment could best alleviate your symptoms.
- Pain or stiffness in the neck
- Pain may be dull or sharp
- Pain that radiates to the arms, shoulders, or upper back
- May be accompanied by burning, numbness, weakness, or tingling in one or both arms and hands
- May be accompanied by neurological issues with balance, walking, using hands, fine motor skills, and even bladder function (all caused by more severe cervical disc herniations)
- Pain may worsen slowly, go through cycles of remaining stable or rapidly worsening, and flare during certain activities or physical movements
- Trauma or injury to the neck
- Age-related wear and tear on the neck
- Gradual degeneration of neck bone and/or cervical discs over time
- Disrupted or slipped cervical disc
- Arthritis/osteoarthritis of the neck
- Bone spurs on the neck
- Conservative Treatment: Initially, nonsurgical treatments such as lifestyle modifications, physical therapy, medication, and/or spinal injections may be recommended to treat neck pain. If these have failed to get rid of neck pain, surgery may be recommended.
- Cervical Disc Replacement Surgery: This surgery replaces a herniated or degenerative cervical disc with a fully mobile artificial disc. This can significantly improve pain and allows the neck to continue moving in a natural, physiological way.
- Cervical Stenosis Surgery: This surgery removes a herniated disc and small portions of bone spurs or arthritic bone. It also aligns and decompresses enlarged facet joints. This procedure relieves pressure on the spinal cord to alleviate pain and neurological symptoms.
- Cervical Laminectomy/Posterior Cervical Decompression: This surgery involves removal or restructuring of the lamina and sometimes one or more enlarged facet joints, possibly with fusion of one or more vertebrae.
- Anterior Cervical Discectomy and Fusion (ACDF): This surgery is performed through a small incision in the front of the neck. The damaged cervical disc is removed, and a bone graft and/or implant is inserted to stabilize and fuse the vertebrae together. This can alleviate pain but restricts some movement due to the vertebral fusion.
Frequently Asked Questions
The key to determining whether you will need neck surgery for neck pain is to identify the cause of the pain. If you have had neck pain for longer than 6 weeks, or if you have experienced a traumatic injury to the neck, and especially if your pain radiates down to your shoulder or arm, you should come in for spinal imaging and evaluation so that a proper diagnosis and treatment plan can be determined.
If surgery is necessary to resolve your neck pain, the recommended procedure will be based on the cause of your neck pain as well as various other factors. For example, if you have cervical stenosis, your doctor may recommend one of a number of procedures to address this particular problem. In most cases, conservative treatment will be the first recommended form of treatment, and surgery will be recommended in the event that nonsurgical treatments have not substantially improved your pain levels.
Neck pain can have a variety of causes, and many times it is misdiagnosed or overlooked. It is best to meet with an orthopedic spine surgeon; as an expert in this area, your surgeon will know what to look for and how to reach a conclusive diagnosis for your neck pain. A combination of a detailed medical history, physical examination, MRI, CT scan, X-rays, reflex testing, and other evaluation methods may be used to diagnose your condition and ensure that you get the treatment you need.
All surgeries carry some risks. These include but are not limited to reactions to anesthesia, nerve injury, reduced movement, discomfort, failure to alleviate symptoms, temporary voice hoarseness/change, temporary discomfort when swallowing, and others. The risks of nerve injury are incredibly low due to modern techniques and careful monitoring of the patient during the procedure. All potential risks and the potential benefits will be discussed with you in detail when you are evaluated in clinic.
The details of surgical recovery will vary depending on the surgical technique chosen. In most cases, patients can return home on the day of the surgery or within 1 to 2 days. A neck collar may be placed to support the spine as it heals; this may need to be worn for up to several weeks depending on the procedure. Typically, some pain and stiffness are common during recovery but will subside as the tissues heal. More details will be provided for you based on your surgical plan.
In many cases, conservative treatments can provide sufficient relief, and you will not need to undergo surgery. However, it should be noted that some conditions that cause neck pain will likely worsen over time. For example, cervical spinal stenosis can eventually lead to cervical myelopathy, which can cause paralysis and severe loss of nerve function. Similarly, a slipped or degenerative disc may not cause serious symptoms now but may require operation in the future if the condition worsens. Once you have a proper diagnosis, your surgeon will be able to help you determine whether or not you should undergo surgery to improve your health and quality of life.