The spine program at MedStar Orthopaedic Institute is well-respected in the central Maryland and Washington regions for the diagnosis, treatment, and rehabilitation of neck pain and spine disorders. Our program brings together a variety of skilled specialists with experience in a wide range of spinal conditions, including some of the most complex conditions seen in orthopedic medicine. Our multidisciplinary team includes orthopedic spine surgeons, neurosurgeons, physiatrists (rehabilitative medicine physicians), nursing staff, physical and occupational therapists, radiologists, and an interventional pain management team—and we put all our expertise to work for you, to relieve your neck pain and get you back to your active life.
What is Neck Pain?
The spine consists of bones (vertebrae) separated by soft cushions (discs). Nerves that travel from the brain to the rest of the body all pass through the spine. When pressure from spinal vertebrae is applied to nerves, pain, numbness, tingling, or weakness can occur. These sensations are not always relegated to the back or spine as back pain; rather, they can occur in many areas of the body, depending on what nerves are pressed, where they originate in the spine, and where they travel to.
No matter how sharp, or how long it lasts, neck pain often limits our ability to feel active and productive. The top priority for anyone suffering from back pain is simply to eliminate the pain. Common causes of back pain include
- Poor posture, especially while using a computer or watching television
- Quickly twisting or moving your head
- Sleeping in a bad position
Arm and leg pain can arise from neck issues or injuries. Experiencing serious pain in our arms and legs can make even the simplest tasks feel very difficult.
Pain is identified two different ways: acute and chronic. Most people with back or neck injuries suffer from acute pain, which lasts four to six weeks and can stop without medical treatment. Chronic pain lasts for more than three months and requires medical treatment.
Neck Pain Diagnosis
When you arrive at a MedStar Orthopaedic Institute's facility with neck pain, our orthopedic teams will thoroughly review your medical history and symptoms and may perform a range of physical and laboratory examinations—all with the goal of making the most accurate diagnosis so we can give you the best treatment. The most common screenings to pinpoint the source of your neck pain or associated pain includes the following:
- X-rays show the alignment of your bones and whether you have a degenerative joint disease or possible tumors.
- Magnetic resonance imaging (MRI) or computerized tomography (CT) scans can reveal herniated discs or problems with muscles, cartilage, ligaments, tendons, or blood vessels.
- Myelography uses dye to show areas where your spinal cord may be getting pinched by the vertebrae in your back.
- Bone scans detect bone tumors or compression fractures caused by osteoporosis.
- Electrodiagnostic studies can confirm nerve compression caused by herniated discs or spinal stenosis.
- Discograms determine any damage to discs.
- Electromyography (EMG) assesses nerve or muscle damage
Understanding your neck pain is the first step in relieving it. Once an accurate diagnosis is reached, your MedStar orthopedic physician can discuss with you the specifics of your condition and determine a treatment plan that will meet your individual needs.
Conditions That Cause Neck Pain
Brachial Plexus Injury
The brachial plexus is a group of nerves that transmit messages from the spine to the hand, shoulder and arm. Inflammation, a tumor, or a serious shoulder injury can damage the brachial plexus and cause arm and shoulder and neck pain as well as numbness, weakness, or paralysis in the arm
Cervical stenosis is a condition in which the bones that make up the cervical spine tighten around the spinal cord, narrowing the cushioning space between them and putting too much pressure on the spinal cord. It can be caused by:
- The natural wear and tear of aging
- Narrowing since birth
Cervical stenosis causes a variety of uncomfortable symptoms, including:
- Pain in the back, neck, legs, or bottom
- Weakness, tingling or numbness in the shoulders, arm, and legs
Treatment for cervical stenosis generally depends on the severity of the neck pain. If non-surgical treatments, including anti-inflammatory or pain medications, steroid injections, or physical therapy, do not relieve the pain, surgery may be an option. The orthopedic surgeons at MedStar Orthopaedic Institute are extensively trained in the most advanced and innovative surgical procedures to treat cervical stenosis.
- Laminectomy, or decompression, removes the bones or ligaments that press on the nerves or spinal cord.
- Cervical fusion - unites vertebrae together to help stabilize the spine.
Degenerative Disc Disease
Flattening of the discs in between the vertebrae as a natural part of the aging process, causing the spaces separating the vertebrae to become smaller, which can affect the stability of the spine.
Facet Syndrome is inflammation of one or more of the facet joints. Facet joints are pairs joints running on either side and in between each of the vertebrae along the entire length of the spine. These structures allow for movement of the spine and provide stability. These joints can become inflamed and cause pain in that area. Physical therapy and other non-surgical treatments such as spinal injections are often used to rehabilitate the spine.
Between your spinal bones (vertebrae) are pads of cartilage called discs. Natural use or strain can cause a disc to rupture (leak) or slip out of place (herniate). When a disc weakens, parts of it can shift and put pressure on a nerve or even the spinal cord. It may result in neck pain, numbness, tingling, or weakness. A variety of factors reduces the amount of water in the discs, making them weaker and more likely to get injured. These include:
- Natural aging process
- Being overweight
- Picking up heavy objects
- Pain in the back or neck
- Burning sensation
- Arm and/or leg weakness
- Tingling, like your arm or leg "fell asleep"
- Bladder control problems
Most people suffering from neck pain from a herniated disc respond well to non-surgical treatment, which includes:
- Taking prescription or over-the-counter anti-inflammatory or pain medications
- Doing physical therapy, including applying heat or ice, massage, and exercises to strengthen the neck
If non-surgical treatment does not relieve your pain, you may need surgery. MedStar Health orthopedic surgeons will work with you to determine the least invasive and most effective surgical option, which include traditional open, minimally invasive, and endoscopic discectomy.
Muscle Strain or Spasm
Pulled muscle or overworked muscle.
Cartilage surrounding the spinal vertebrae gradually erodes, causing the bone to contact with the nerve.
Bone density is lost, causing vertebrae to weaken, fracture, or collapse, putting pressure on spinal nerves causing pain.
Tumors that grow on or near the bones of the spine or around the spinal cord can disrupt the line of communication between the spinal cord and the brain. Spinal tumors can originate in the spine, or spread to the spine from another part of the body. A spinal tumor can cause different kinds of symptoms, depending on where it is located and what type of tumor it is. Generally, spinal tumor symptoms can include:
- Back pain
- Strange feeling, either of coldness or numbness, in the legs or hands
- Muscle discomfort, including weakness and cramping
Treatment for a spinal tumor aims to remove or shrink the tumor and prevent it from damaging the spinal cord. The spinal surgeons at MedStar Health will work with you and your family to determine the most effective treatment options for you. In many cases, we recommend surgery to remove the as much of the tumor as possible. Our orthopedic surgeons have training and expertise in the most advanced microscopic and minimally invasive spinal surgeries. In other cases, we may recommend non-surgical treatment options, including:
- Monitoring tumor growth
- Medication, such as corticosteroids, to ease any swelling and inflammation
Treatment of Neck Pain
Neck pain treatment generally depends on how severe your pain is and the underlying cause. Common non-surgical treatment options may include:
- Prescription and over-the-counter anti-inflammatory or pain medications
- Injections of steroids or anti-inflammatory medications
- Physical therapy, including applying heat or ice, massage, and strengthening exercises
If non-surgical treatment does not relieve your neck pain, you may need surgery. The orthopedic surgeons at MedStar Orthopaedic Institute have extensive training in the most advanced and innovative surgical procedures to treat neck pain, including minimally invasive neck surgery and motion sparing surgery.