A pain in the neck maybe something more.
So, what exactly is a pinched nerve in the neck?
A “pinched nerve” is what we commonly refer to as a source of pain in the neck which radiates to the arm. This is known as cervical radiculopathy. This can happen from a herniated (or slipped) disc, or from bone spurs, which are due to arthritis.
How does this happen?
Injuries can happen to people of all ages, but it’s most common in people in their 30s to 50s. It’s more common in women and those who work with machines. It can happen for a variety of reasons, including trauma, such as motor vehicle accidents, as well as repetitive strain injuries.
What do you mean by that?
Our posture is such an important part of strain on our bodies. Prolonged work with poor posture, and even sleeping habits can have an impact on neck injuries, resulting in pinched nerves. The work does not have to be physical. It can be from just working at the computer!
What are the symptoms?
Typically, someone first feels neck pain, followed by radiating burning or aching pain to the back of the shoulder, and down the arm. It’s also common to get numbness, tingling, and weakness in the arm, hand and fingers.
What’s the prognosis for this? Is there a cure?
The prognosis for a pinched nerve, and for neck pain in general, is generally good. For neck pain from a pinched nerve, up to 90% of patients recover without surgery.
What is the treatment for this?
Let’s talk about the treatment options in steps:
First, you can take medications that reduce inflammation, such as NSAIDs, drugs like Ibuprofen. Second, we usually prescribe physical therapy. This is often performed with gentle cervical traction, pulling the joints and discs back into better alignment. Finally, there is surgery.
What happens if nonsurgical treatments don’t work?
If symptoms last beyond a few weeks, it’s a good idea to see a surgeon to discuss surgical treatment options. Surgery is always the last option, but often times, it’s better to consider surgery a little earlier in the process, so that you don’t risk experiencing chronic pain or relying on pain medications for a long period of time.
So, what are the types of surgery that you typically perform for this?
Well, for a pinched nerve in the neck, the number one goal is to alleviate the pressure on the nerve, to decompress the nerve and allow it to heal.
There are multiple ways to accomplish this. Whenever possible, we try to target the nerve and disc or bone spurs from the front of the neck and spine, rather than the back. We remove most of the disc and place a spacer, which restores the normal height of the disc space, and takes the pressure off the nerve, allowing for healing. A plate allows the 2 bones above and below the disc to fuse together. That’s called a fusion.
In some cases, depending on the anatomy, we can perform a disc replacement, and place a moving implant between the bones, to preserve motion at that level of the spine. That’s called disc replacement.
Either way, these procedures are very safe and well tolerated, and many patients go home the same day. Many patients are back to work or resuming most of their normal activities within 2-4 weeks, some even sooner, but everyone is different.
So, what should a patient do if they have symptoms of a pinched nerve?
The best thing to do is to see a medical professional, typically starting with your primary care provider. Rarely, these symptoms can mimic other serious conditions, and a medical evaluation is the best place to start. Again, the vast majority of patients with a pinched nerve do get better without surgery, but early treatment with medication and physical therapy can help in the recovery process. And referral to a surgical specialist can be a good option if symptoms are persistent.
For more information log onto https://hartfordhealthcaremedicalgroup.org/specialties/specialty-care/neurosurgery