Neck Pain

• Nonspecific neck pain is generally attributed to cervical strain which is defined as pain or stiffness associated with neck movement. Strains to the muscles and ligaments by sleeping in improper position, poor posture like working on computers and smart devices, etc. Physical exam is generally notable for painful palpation of the neck and trapezius muscles. X rays are usually inconclusive. If symptoms lasts longer than 6 weeks, then advanced imaging is considered.
• Cervical disc degenerative disease presents with pain and stiffness in the neck region which may or may not be associated with pain in upper extremities. Degenerative disc disease is a condition in which the shock-absorbing discs between your vertebrae slowly dry out, becoming thinner and more rigid. That might cause few if any symptoms at first but can lead to herniated discs and spinal stenosis (narrowing of the spinal column), which, in turn, causes painful radiculopathy (pinched nerves). Symptoms are exacerbated with provocative maneuvers which can include neck held in one position. Pain is considered largely mechanical due to inability of discs to effectively distribute pressure. If a disc bulge is associated with impingement of cervical nerve roots, symptoms often present with numbness/tingling/pain radiating up to the fingers. An MRI is generally very useful to delineate the level of the disc(s) affected but most commonly levels C4-C7 are more commonly affected. 
• Cervical Spondylosis (osteoarthritis of facet joints) is commonly an age-related condition, developing after years of wear-and-tear on your spine, which causes the facet joints that link your vertebrae to lose their protective cartilage. As a result, the bones start rubbing together, causing chronic inflammation and pain. You might also develop bone spurs – little bony growths in your facet joints that your body produces to support arthritic vertebrae. Bone spurs are another common cause of pinched nerves. Degenerative changes can also cause conditions like spondylolisthesis, in which weakened ligaments in your spine allow the vertebrae to slide over each other.
• Spinal stenosis (narrowing) due to degenerative arthritis (also knowns as spondylosis and spondylolisthesis) can put pressure on the spinal cord causing symptoms of neck pain associated with achy arms and legs with burning sensation. 
• Whiplash Injury is defined as neck injury resulting from an acceleration-deceleration mechanism that causes sudden extension and flexion of the neck. It can cause injury to ligaments, muscles, and facet joints. The symptoms can include neck pain, headaches, dizziness, fatigue. It most commonly occurs due to rear-end motor vehicle collisions. Some patients can continue to experience symptoms up to 1 year from the original injury. 
• Myofascial Pain Syndrome (MPS) is a regional pain disorder associated trigger points, taut bands, and pressure sensitivity. 
• Other etiology includes diffuse skeletal hyperostosis, psychological stress (nonspecific pain throughout the body), fibromyalgia, etc.
• Other medical non-spine related medical conditions such as heart attack, meningitis, malignancy, tension headache, referred shoulder pain, thoracic outlet syndrome, carotid artery dissection, vertebral artery dissection, esophageal obstruction, etc.

• Treatment depends on the severity of your neck pain as well as the underlying cause. Most cases of neck pain usually respond to conservative measures such as rest, ice, over the counter anti-inflammatory medications (naproxen, ibuprofen, acetaminophen) and time. Sometimes muscle relaxants are also utilized for neck spasms or taut bands. 
• Physical therapy plays an important role in neck pain relief and can help you improve your strength, posture, and flexibility to reduce risk of future flare ups. 
• Nonsurgical treatment options are offered based on symptoms and underlying diagnosis. These include: 

Epidural Steroid (cortisone) injections

Trigger Point Injections

Medial Branch Nerve Blocks/Radiofrequency Ablations (RFA)

The team takes an integrative approach to patient care, so your doctor may combine several conservative treatments to relieve your back pain.

If no other treatments are working after at least six months, surgery may be necessary for your neck pain, providing the cause of the pain is identifiable.

Options include:

• Spinal fusion
• Disk replacement

Where suitable, your surgeon performs these procedures using minimally invasive techniques to reduce tissue damage and shorten recovery time.