The neck portion of the spine, called the cervical spine, is comprised of seven vertebrae starting at the base of your skull. Ligaments, tendons, muscles, bones, cartilage, and nerves are all bundled within this small space, which makes the cervical spine prone to pain caused by injury or wear and tear. More than 37 million American adults suffer from neck pain every year. Fortunately, most neck pain goes away on its own in a few days or weeks. A small percentage of people have spine conditions, such as herniated discs, spinal stenosis, or facet degeneration, that will require treatment that might include steroidal injections, physical therapy, or neck surgery.
Download an infographic on the causes and treatments of neck pain. Continue to read below, or click on a specific topic to jump to that section and learn about:
- Cervical Spine Conditions That Cause Neck Pain
- Symptoms of Cervical Spine Conditions
- Neck Pain Testing and Diagnosis
- Conservative/Non-Surgical Neck Pain Treatments
- When to Consider Neck Surgery/Cervical Spine Surgery
Neck Pain Overview
The complexity and mobility of the cervical spine make it exceptionally prone to pain caused by injury or wear and tear. In fact, an estimated 15 percent of adults in the U.S. report neck pain in any given year. Most often, neck pain will go away within a few days or weeks. But pain that lasts for months could signal a condition that may require medical treatment, which could be medications or injections or cervical spine surgery. Read more in our neck pain overview.
A number of medical conditions can cause chronic or persistent neck pain, and several can occur simultaneously. While long-term neck pain can be caused by injury, the majority results from degenerative conditions or from ordinary wear over time. Injuries, such as whiplash, can cause neck pain on their own or they can hasten or worsen natural degeneration. Pain also can result from common conditions including:
- Displaced discs, including degenerated, herniated, slipped, ruptured or bulging discs, or pinched nerves, occur when stress or injury causes the spinal discs to become distorted or protrude in spots and pushes on a nerve or causes other symptoms.
- Facet degeneration occurs when the cartilage that cushions the joints between each vertebrae becomes damaged and causes pain, stiffness, and headaches.
- Spondylolisthesis happens when facet joints, which connect the vertebrae, disintegrate and slip on top of each other.
- Spinal stenosis results when the degeneration of the tissue between and around the vertebrae causes the ligaments to thicken and bone spurs to form, which narrows the spinal column and pinches nerves. Most common after age 50.
- Bone spurs are formed when the ligaments and tendons around the bones and joints of the cervical spine are damaged or inflamed. Read more about neck pain causes.
Types of Disc Degeneration
Symptoms of Cervical Spine Conditions
Neck problems don’t always cause just neck pain. Because of nerve involvement, cervical spine conditions also can cause pain in your arms or hands, even down your back. With more serious cervical spine conditions that require medical care, these symptoms tend to be constant, disrupt activity, and can be experienced during the day or night. Common symptoms include:
- Stiff or sore neck
- Sharp or shooting pain in a specific area of your neck
- Tingling, numbness, or weakness in your shoulders, arms, or hands—with or without neck pain
- Radiating pain from neck to shoulder, shoulder blade, arm, or hand
Read more about symptoms of neck pain.
While some neck pain is caused by simple strains and resolves on its own, persistent or recurring neck pain can be a symptom of an underlying condition. To determine the exact origins of your pain, your physician will take your medical history, and ask you about the location, frequency, and duration of your pain. Depending on your symptoms, your doctor may choose from several tests, including:
- X-ray is used to identify degenerative disease, fractures, or even tumors.
- CT scans produce detailed, cross-sectional images of the internal neck, which can help detect subtle changes in bones.
- MRI shows both tissue and bone and is useful in diagnosing a bulging, protruding, or herniated disc, or pinching of the nerves or spinal cord.
- Myelogram uses a special dye that is injected into the area around the spinal column, to allow better viewing of the spinal canal and discs, and the condition of nerves in and around the spine.
- Electrodiagnostic testing studies the electrical activity of nerves in your arms and legs.
- Bone scans identify abnormal activity such as inflammation.
Read more about neck pain testing and diagnosis.
Neck surgery is rarely the first treatment option explored for patients with persistent neck pain. The most common first-line treatments include:
- Medications including nonsteroidal anti-inflammatory drugs, muscle relaxants, antidepressants, anti-seizure drugs, and opiods.
- Steroid injections can reduce inflammation and relieve pain and pressure.
- Physical therapy combines exercises, ice, heat, and ultrasound to reduce pain and muscle spasms.
- Alternative medicine such as acupuncture can help alleviate pain in some patients.
Read more about conservative treatments for neck pain.
When to Consider Neck Surgery/Cervical Spine Surgery
If conservative treatments are not relieving your pain, your physician may want to discuss neck surgery. Nearly 50 percent of spine surgeries today are done on an outpatient basis, meaning you’ll be home the same day. Laser spine surgery, minimally invasive surgery, and robotic-guided surgery are all options that help improve the accuracy, decrease pain, and speed recovery. The most common types of cervical surgery are:
- anterior cervical discectomy and fusion (ACDF),
- cervical decompression surgery and spinal fusion surgeries,
- cervical artificial disc replacement.
To learn more about cervical spine surgery, go to our neck surgery hub where you can learn about:
- Types of neck surgery
- Anterior cervical discectomy and fusion (ACDF)
- Decompression and fusion
- Artifical disc replacement
- Choosing a surgeon
- Preparing for neck surgery
- Recovery after neck surgery
Watch a video about cervical spine fusion versus disc replacement:
Neurosurgery One’s (formerly South Denver Neurosurgery) four spine experts can help you find the treatment that will work best for your condition. To make an appointment, complete the form to the right and one of our schedulers will call you.
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