Condition
Neck Pain
Neck pain is pain in the cervical spine, the seven vertebrae between your skull and your shoulders.
- Seen at
- All three offices
- Typical wait
- Within the same week
- Treated with
- 6 procedures
In short
What neck pain actually is.
Neck Pain
Neck pain is pain in the cervical spine, the seven vertebrae between your skull and your shoulders. It comes from the discs, the small facet joints at the back of the neck, the muscles across the top of the shoulders, or a nerve root being pinched as it leaves the spine. When it travels into an arm or hand, a nerve is involved and the evaluation changes.
Symptoms
How it shows up.
If several of these sound like your week, it is worth having the source looked at properly.
- A tight aching band across the back of the neck and the tops of the shoulders
- Pain that flares after a day at a screen and eases when you lie down
- Turning your head to check a blind spot hurts or will not go all the way
- Headaches that start at the base of the skull and wrap forward behind one eye
- Pins and needles or numbness running down into the arm, thumb or fingers
- Weakness gripping a coffee cup or dropping things without meaning to
- Grinding or crunching sounds when you roll your head
What causes it
- Disc degeneration and arthritis in the cervical spine, which is nearly universal after age fifty
- Whiplash from a rear end collision, which strains ligaments and irritates facet joints
- A herniated cervical disc pressing on a nerve root
- Hours of forward head posture over a phone, laptop or workstation
- Muscle trigger points in the trapezius and levator scapulae that refer pain up into the head
- Old sports injuries or heavy overhead work
When to act
Stop waiting when this happens.
Do not sit on these
Any one of the following is a reason to be seen rather than to wait it out.
- Pain has lasted more than six weeks or keeps coming back every few months
- Numbness, tingling or weakness has appeared anywhere in the arm or hand
- Headaches from the neck are happening several times a week
- You have trouble with fine tasks such as buttons or keys, or your walking has become unsteady, both of which need prompt evaluation
- The pain started with a car accident or a fall and has not settled within a few weeks
Diagnosis
Finding the actual source.
A diagnosis is not a guess from an image. It comes from the exam, the history and, where nerves are involved, electrodiagnostic testing.
- A careful history separating neck pain that stays local from pain that travels, since the two have different sources and different treatments
- Range of motion testing plus Spurling maneuver, which reproduces nerve root pain when the neck is extended and turned toward the painful side
- A neurological exam of the arms mapping strength, sensation and reflexes to specific nerve roots from C5 through T1
- EMG and nerve conduction studies to confirm whether the arm symptoms come from a pinched nerve in the neck, from carpal tunnel at the wrist, or from both at once, which is common and frequently missed
- X-ray or MRI when the exam suggests disc herniation, stenosis or instability
- Diagnostic medial branch blocks to confirm the facet joints as the source before considering radiofrequency ablation
Nerve testing happens here, not elsewhere
EMG and nerve conduction studies are done in the office and read by Dr. Sheikh the same day, rather than sent out and waited on.
Treatment
How neck pain is treated.
Ordered from the most common first step to the options reserved for pain that has not responded.
15–30 minEpidural Steroid InjectionAn epidural steroid injection puts anti-inflammatory medication into the epidural space, the area just outsid…Read more →
Facet Joint InjectionA facet joint injection treats the small paired joints at the back of the spine that let you bend and twist.Read more →
30–90 minRadiofrequency AblationRadiofrequency ablation uses heat from a radio wave to interrupt the small nerves that carry pain from an art…Read more →
Trigger Point InjectionA trigger point injection treats a knot in a muscle, a tight band that will not release and that often refers…Read more →
15–45 minNerve BlockA nerve block is an injection of local anesthetic, often with a steroid, placed next to a specific nerve or c…Read more →
45 minJoint InjectionsA joint injection places medication directly into a painful joint, either a corticosteroid to reduce inflamma…Read more →Questions
Neck Pain, answered.
Why does my neck pain cause headaches?
The top three nerves of the neck share a pathway with the nerve that supplies the face and scalp. When the upper cervical joints or muscles are irritated, the brain reads part of that signal as head pain. That is why these headaches start at the base of the skull and travel forward.
Is it safe to get an injection in my neck?
Cervical injections are done under live X-ray with contrast dye to confirm placement before any medication goes in, and we use the approach with the best safety profile for your anatomy. The procedure takes about fifteen minutes and you go home the same day. Risks are real but uncommon, and we review each one with you beforehand.
Do I need an MRI for neck pain?
Only if the exam calls for it. Neck pain without arm symptoms usually does not need an MRI up front. If you have numbness, weakness or pain running into the arm, imaging plus an EMG together give a much clearer picture than either one alone.
Will a chiropractor help my neck pain?
Manual treatment helps some people with mechanical neck pain and does nothing for a compressed nerve root. If you have been adjusted repeatedly without lasting change, or you have numbness or weakness in an arm, that is the point to get an actual diagnosis before continuing.
How long should neck pain last before I see someone?
Six weeks is a reasonable line for pain alone. If there is numbness, tingling or weakness in the arm, do not wait six weeks. Nerves that stay compressed for months recover less completely than nerves treated early.
Can my neck cause numbness in my hand?
Yes. A pinched nerve root in the neck can produce numbness in the hand that feels exactly like carpal tunnel syndrome. Nerve conduction studies tell the two apart, and sometimes show both, which is called double crush. Treating only one of the two leaves you still numb.
What is radiofrequency ablation for neck pain?
It uses heat to interrupt the tiny nerves that carry pain from arthritic facet joints. We only offer it after diagnostic blocks have proven those joints are the source. Relief typically lasts six to eighteen months, and the procedure can be repeated when the nerves regrow.
Get a real diagnosis for neck pain.
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