Cervical conditions are spinal conditions that show up in the neck region though they can transfer pain through the upper back and down your arms.
Cervical Degenerative Conditions
Degenerative (arthritic) changes in your cervical spine can cause localised neck pain, nerve pain in the arm, or spinal cord compression. Symptoms localised to your neck include stiffness, grinding, or pain (sharp or aching) that is felt in the back of the neck and across the shoulders. Sometimes pure muscle fatigue or strain can give rise to a similar pain in the neck.
The issue with arthritis of the cervical spine is the thickening of ligaments and bone spurs around the joints and discs of your spine. The discs dry out, lose height and in some cases become unstable. These changes can result in nerve pinching or spinal cord compression. If a nerve is affected, then there will be shooting pain in your arm associated with weakness, numbness or tingling.
Spinal cord compression itself does not cause pain, but leads to numbness in your hands, clumsy fingers and unsteadiness of the legs.
Symptoms of degeneration of the spine usually develop over time.
Early treatment of neck pain is based on: changing activity to avoid triggers for pain, anti-inflammatory medication (such as Nurofen, Indocid, Mobic or Celebrex), applying heat packs and physiotherapy. Often pain will settle in a few weeks but may recur and be episodic, in which case it is important to try and remain active anyway.
Longer term, if your spine continues to degenerate cervical surgery is used to treat unrelenting nerve pain in the arm, or for loss of control in the hands or legs due to damage to the spinal cord. Procedures used to alleviate nerve pinching or spinal cord compression vary from simple to complex and the choice is based on X-rays, CT and MRI scans.
Cervical Disc Herniation and Radiculopathy
Also commonly referred to as a disc protrusion, ruptured disc, or a slipped disc.
Whatever name is used it still refers to a common and painful spinal condition.
Disc herniation occurs when the tough, outer rim of the disc tears, allowing the soft, central part to squeeze out and contact the nerve which lies adjacent to the disc.
Symptoms include pain in your neck and shoulder and can extend to shooting pains down your arms. This is often associated with weakness, numbness or tingling of the arm or hand. The onset is usually sudden and is typically felt as a cricked neck in the morning followed by pain, which can be severe.
For most people symptoms resolve over a few weeks with reduced activity, physiotherapy and medications.
Surgery can relieve unrelenting pain or severe weakness of the arm. There are a few different options and the choice is based on a rigorous diagnosis of your condition.
These procedures may be performed through incisions on the front or the back of the neck. Most people having this type of surgery on the neck return home after a couple of nights in hospital.
Cervical Myelopathy (spinal cord compression)
Cervical myelopathy causes numbness in your hands, clumsiness of the fingers and unsteadiness of the legs. It often develops slowly, without pain and may not be noticed until symptoms are quite advanced. Typically, there are difficulties writing, turning a key, holding a knife and fork, unsteadiness on the feet and falls. At times bladder and bowel function may be impaired as well.
The most common cause is degenerative change of the cervical spine with compression of the spinal cord in the spinal canal. Pain in the arms may accompany cervical myelopathy if the exiting nerve roots are also compressed and inflamed (cervical radiculopathy).
A conservative non-surgical treatment plan is always the default preference. However, if neurological deterioration is significant, then decompression surgery is recommended. Here the goal is to decompress or relieve the pressure on the spinal cord.