Justin Field, MDJustin Field, MD

12 Treatment Options for Neck Pain

By Justin Field, MD

Dr. Field is a board-certified, fellowship-trained orthopedic spine surgeon. Dr. Field has specialized training in minimally invasive spine surgery and motion sparing technologies, such as cervical and lumbar Artificial Disc Replacement, as well as non-fusion stabilization.

June 17, 2022

Neck pain is a common condition that can hinder a person’s ability to perform daily tasks and routines. While some instances of neck pain are temporary and heal fairly quickly, chronic neck pain can persist for months or years without treatment. Some people find relief with simple solutions, such as rest, physical therapy, medications or hot and cold therapy, while others need more intensive treatment to relieve their discomfort.

Treatment for neck pain ranges from non-surgical treatment to surgical procedures. Steroid injections or radio-frequency energy can sometimes help manage chronic neck pain, but more serious conditions causing neck pain may require surgery.

It’s important to consider surgery as an option only if necessary. If you struggle with persistent neck pain, an experienced physician can evaluate your situation and determine if you’re a candidate for surgery. There are many ways to treat and manage temporary and chronic neck pain, so it’s important to understand what causes neck pain and what your options are if you experience it.

What Causes Neck Pain?

To understand neck pain, its causes and potential treatment options, it’s important to understand the neck’s unique anatomy. The neck is also referred to as the cervical spine, and it consists of the spine’s first seven vertebrae. Spinal nerve roots are connected to the rest of the body through several holes in each of the cervical spine’s vertebra. 

Each vertebra in the spine is connected to the next via facet joints and a connective tissue disc containing a gelatinous substance known as nucleus pulposus. Discs support proper spine alignment, and they provide spacing and cushioning for the vertebrae.

The cervical spine supports the head and allows for the neck’s range in motion. Any damage or strain to the components that make up the cervical spine can cause temporary or chronic neck pain. Neck pain can occur for a variety of reasons. Temporary neck sprains and strains caused by minor injuries and poor posture usually subside fairly quickly. Nonpermanent pain typically has the following causes:

  • Holding your head in an abnormal position for a long time
  • Sleeping with your head in an unnatural position
  • Sports injuries
  • Repetitive motion
  • Slouching or slumping when you sit

Chronic neck pain persists for longer than a few weeks. Sometimes, chronic neck pain comes with additional symptoms such as difficulty walking, numbness and weakness, which can indicate a serious underlying condition. Chronic neck pain can occur due to the following:

  • Aging
  • Injuries
  • Overuse of neck muscles
  • Continuous poor posture
  • Degenerative diseases such as arthritis
  • Damage to the neck bones
  • Abnormal structures within the neck bones
  • Damage to the discs that are located between each cervical vertebrae
  • Facet joint damage
  • Severe muscle strains
  • Tumors
  • Severe ligament damage
  • Cervical bone fractures and cracks

Whiplash can also cause neck pain, occurring after an incident when the neck moves back and forth rapidly. Whiplash can occur due to several traumas such as falls, car accidents and sports accidents. 

Chronic neck pain is most commonly caused by disc and facet joint damage. Discs are flexible and elastic, but they can tear due to overuse, injury or aging. If the center of a disc tears, it can leak the nucleus pulposus and cause the nerves surrounding it to become irritated and inflamed. If the nucleus pulposus causes the disc to swell or distort, it is known as a herniated disc, which presses against cervical nerves and pinches them.

Over time, discs can naturally lose cushioning, thickness and hydration. This is known as cervical degenerative disc disease, and it can cause the same complications as a herniated disc such as arthritis and pinched nerves. 

How to Prevent Neck Pain

Neck pain is one of the most common disorders that affect the musculoskeletal system. However, there are some steps you can take to prevent neck pain. If you work at a desk in front of a computer all day, try to do some gentle neck stretches every hour and sit in a chair with an adjustable straight back, swivel seat and armrests. 

You can also prevent neck pain by wearing shoes with cushioned soles and avoiding standing for long periods. If you are able to, you should sleep on a firm mattress and use a supportive pillow. Massages and yoga can also help prevent neck pain. 

12 Treatment Options for Neck Pain

There are many cervical neck pain treatment options available if your pain is making it difficult to perform daily routines and live your life comfortably. Treatment for chronic neck pain can be as simple as resting, or it may require more intensive treatment options such as physical therapy or, in some cases, surgery. 

The best treatment for neck pain varies by person, so what helps you will depend on your level of pain, how long it persists and what is causing it. 

Non-surgical Options

Individuals can sometimes manage neck pain without surgery. In some cases, simple therapy, medications and nonsurgical procedures can deliver chronic neck pain relief so people can continue performing their normal routines.

Nonsurgical solutions for neck pain are typically helpful if the pain is due to a minor strain or poor posture. However, if pain continues for a few weeks or more and pain relief efforts are unsuccessful, you may need to consider surgical options. 

1. Rest and Proper Posture

Sometimes, simply resting an injured neck can reduce pain. Spend some time with your neck in the most comfortable position that brings the least amount of pain. You can also roll up a towel and place it under your neck to keep your neck and head in a straight, neutral position. 

Try to keep your neck and head upright and straight to maintain the correct posture while sitting. This can help relieve neck pain, and it also helps to prevent it. Avoid slouching or slumping when you sit on your couch or on chairs, and try to only sit on chairs that provide proper back support. If you work in front of a computer, keep it at eye level and avoid leaning backward or forward at your desk. 

2. Hot and Cold Therapy

You can use hot and cold therapy to relieve neck pain if you experience a ligament sprain or muscle strain. For the first one or two days, you can apply ice to reduce swelling in your neck. Once the swelling subsides, you can use heat wraps to help your muscles relax and loosen. You should only use hot and cold therapy if it provides comfort. Use heat or ice at 20-minute intervals each.

If you experience pain for a few weeks or longer, there may be damage to your bones, facet joints or cervical discs. In this situation, hot and cold therapy will typically be ineffective because your condition requires more aggressive treatment. 

3. Stretches and Exercise

You can use hot and cold therapy to relieve neck pain if you experience a ligament sprain or muscle strain. For the first one or two days, you can apply ice to reduce swelling in your neck. Once the swelling subsides, you can use heat wraps to help your muscles relax and loosen. You should only use hot and cold therapy if it provides comfort. Use heat or ice at 20-minute intervals each.

If you experience pain for a few weeks or longer, there may be damage to your bones, facet joints or cervical discs. In this situation, hot and cold therapy will typically be ineffective because your condition requires more aggressive treatment. 

4. Water Therapy

Water therapy can involve exercising in water, receiving an underwater massage or a hydro-massage that uses various levels of water pressure to target certain muscles. Water therapy can help to relieve neck pain because it does the following:

  • Increases blood flow to muscles
  • Reduces stress and tension
  • Relaxes the body

5. Medications

You can also manage chronic neck pain with over-the-counter medications. Pain relievers such as acetaminophen and aspirin or non-steroidal anti-inflammatory medications (NSAIDs) such as naproxen and ibuprofen can help alleviate neck pain. The best medicine for neck pain can vary by person, so the key is to find the medication that works best for you. Keep in mind any other medications you take and potential reactions, and speak to your doctor to determine what medications are safe to take.

6. Steroid Injections

Epidural steroid injections deliver an anesthetic and a steroid to the epidural space around your spinal cord where the nerves are irritated and inflamed. The steroid reduces inflammation, and the anesthetic relieves pain by temporarily blocking the nerves from transmitting pain signals to the brain. Epidural steroid injections can relieve pain when the cervical spine’s nerves are compressed.  

Facet joint injections are similar to epidural steroid injections because they help to manage pain and reduce inflammation. Facet joints allow you to move, twist and bend your neck without moving it too far in any direction, and injections to the area can help you control pain and tolerate rehabilitation after a neck injury. 

7. Radiofrequency Ablation

Cervical Radiofrequency Ablation (RFA) is a nonsurgical and fairly painless treatment that blocks nerves. During this treatment for neck pain, radiofrequency energy produces heat that creates a lesion on the nerves that disrupts and blocks pain signals from reaching the brain. RFA typically lasts longer than anesthetic nerve blocks and blocks pain for approximately nine months to one year

Surgical Options

In some cases of neck pain, you may need to seek surgical options. Surgery may be necessary if you experience persistent pain or if you also experience numbness, weakness or pain in your hands, arms or shoulders. In these situations, your doctor may recommend any of the following surgeries:

1. Anterior Cervical Discectomy and Fusion

During an anterior cervical discectomy and fusion (ACDF) surgery, a surgeon will remove an entire damaged disc through the front of the neck. They will then surgically fuse the two vertebrae together so the spine remains stable after surgery. This is the most common type of neck surgery.

2. Artificial Disc Replacement

When a surgeon performs cervical artificial disc replacement surgery (ADR), they remove an affected disc and replace it with an artificial disc. The main goals of ADR surgery are to relieve nerve compression and maintain motion. This procedure can help qualified patients preserve more of their natural spine motion than a traditional fusion could.

An ADR procedure can help treat pain if a disc degenerates or herniates and begins to collapse. A damaged disc has very little room for the spinal cord and nerve roots to function, which can cause numbness, tingling, weakness and chronic pain. When a surgeon replaces a degenerating disc with an artificial one, the artificial disc relieves pressure and creates space for nerves to heal so they can function normally.

While it does not improve the range of motion in the neck, the ADR procedure can help a patient maintain their cervical spine’s natural motion and biomechanics. This helps them move their neck with the regular range of motion they had before the disc began to degenerate.

This type of procedure is best for patients who experience symptoms beyond their neck area. This is because it relieves symptoms that are caused by spinal cord compression and nerve root inflammation.

3. Laminectomy

A laminectomy can ease neck pain that interferes with daily life after other medical treatments are unsuccessful. During a laminectomy, a surgeon will remove all or part of the lamina, which is the part of the vertebra over the spinal canal. Removing the lamina relieves pressure on the nerve roots or spinal cord to reduce pain caused by a herniated disc, a tumor, a narrow canal or an injury.

A laminectomy can help you keep more of the regular flexibility in your neck. However, you may have reduced flexibility if you also require a spinal fusion procedure.

4. Laminoplasty

A laminoplasty procedure creates space and enlarges the spinal canal. During laminoplasty surgery, a surgeon doesn’t remove an entire lamina but instead cuts it. The surgeon creates a hinge on a side of the lamina and wedges the other side open with a small metallic plate or a bone strut. This restructures the bone to create more space.

5. Foraminotomy

If nerve openings, known as foramina, in the spine are narrowing, nerve cords are compressed as a result, and doctors may recommend a foraminotomy. During a cervical foraminotomy procedure, a surgeon will remove a small section of facet joint bone in the neural foramen, as well as soft tissue that is compressing one or more exiting spinal nerves. This procedure most commonly helps patients who have a degenerative disorder or a bulging disc, and it can relieve both arm and neck pain. 

Find Chronic Neck Pain Relief at the Desert Institute for Spine Care

The Desert Institute for Spine Care (DISC) offers cutting-edge treatment options to help patients find relief from chronic neck pain. Our surgeons treat a wide variety of spine conditions including degenerative disc disease, herniated disc and other cervical spine complications. 

We offer advanced nonsurgical spine treatments and minimally invasive spine surgeries, and our board-certified surgeons hold 50 years of collective patient care experience. DISC is a worldwide leader in endoscopic spine surgery, and we provide patients with consistent results so they can enjoy life without pain. We will carefully choose the least invasive treatment method or surgical option to help you restore your lifestyle with minimal side effects.

Take control over your pain and get back to living your life comfortably. Contact us to learn more about how we can help you relieve your chronic neck pain. 

LEADERS IN MINIMALLY INVASIVE SPINE CARE
1635 E. Myrtle • Suite 400 • Phoenix, AZ 85020
Ph: 602-944-2900 • Fax: 602-944-0064

DISC - Desert Institute for Spine Care
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