Most people have experienced neck pain at some point in their lives. The most common cervical condition is cervical disc degeneration, which affects 95 percent of men and 75 percent of women by age 65.
The neck is part of a long flexible column, known as the spinal column or backbone, which extends through the length of the body. The cervical spine (neck region) consists of seven bones (C1-C7 vertebrae), which are separated from one another by intervertebral discs. These discs, composed of a jelly-like substance, allow the spine to move freely and act as shock absorbers during activity.
The most common type of cervical or neck disorder, such as disc degeneration and cervical spinal stenosis, emerge as a result of age-related degeneration of the spine. However, cervical problems can emerge not only due to age, but from injury (a common example is whiplash), poor posture, or diseases such as arthritis. Even simple muscle strains can result in a painful neck. In more serious cases, neck pain can be a presenting symptom of meningitis, an infection of the brain and spinal cord linings. Meningitis can have many causes and may be contagious (meningitis would include other symptoms, however). Other types of infections can also occur in the neck, such as infections in the bone or intervertebral disc.
Although the primary symptom of cervical conditions is neck pain or stiffness, the discomfort can extend beyond that. A degenerative process can cause compression on one or more of the many nerves in the spinal cord, causing radiating pain, as well as numbness and weakness in your shoulders, arm and hand. Other symptoms include the possibility of headaches. A spinal cord injury can also result in balance problems, bladder control issues and weakness, as well as fatigue with walking.
To assess cervical disc disease, your doctor will review your symptoms as well as your medical history. Your doctor may need to perform a physical exam to test your strength and reflexes if the sensation in your arm and hand are affected.
Diagnostic imaging may include a CT scan, EMG/NCS (electromyogram and nerve conduction study), MRI, myleogram (combines the use of dye with x-rays or CT scans) or X-rays.
Depending on the diagnosis, a patient may consider rest and over-the-counter medication. Physical therapy can also be effective, via use of cervical traction or gentle manipulation of muscles and joints with the goal of reducing pain and stiffness. A physical therapist can also provide range of motion exercises and good posture techniques.
Spine specialists can provide more targeted assistance, with the use of prescription medications or injections to relieve pain. When all therapeutic measures fail, however, surgery is also an option.
When considering treatments of any kind, be aware that degenerative disc disease is also influenced by lifestyle. It is wise to eat a balanced diet, engage in exercise (particularly for general muscular strength and flexibility), as well as avoid smoking, which is a risk factor for cervical disc disease. Posture is key: maintain a straight neck and a straight, supported back.
Each year more than 200,000 cervical spine surgeries are performed in the United States to treat conditions ranging from cervical spinal deformities to degenerative disc disease. Great care and expertise must be taken to provide relief for what can be a seriously debilitating condition. Surgical techniques include:
Those concerned with surgical rehabilitation should be aware that the latest advances in this surgery have greatly improved both recovery time and results. Dr. Lewin routinely explains the rehabilitation process to his patients. Resumption of patients’ normal routine depends on the type of procedure they have undergone. Following surgery, you will be given specific instructions on movement restriction and whether a brace is recommended. Occupational and physical therapy provide patients with the proper exercises while they are healing and facilitate long-term recovery. You will likely need a few weeks of recovery time before returning to work or any activities that require extensive movement or lifting heavy objects.