Neck pain or Neck ache
This is pain felt in the neck that originates from bones, joints, muscles, nerves and other structures. Neck pain can be described as sharp or sudden, dull or aching, burning and shooting pain. Neck pain often originates from the spine, also called the cervical area, hence it is also called cervicalgia. Episodes of neck pain may be acute lasting only a few weeks, to chronic lasting more than three months.
Other symptoms that may accompany neck pain and relating to disease of the spine include:
- Weakness to arms and legs as well as loss of coordination to hands and feet as a result of compression to motor nerve fibres
- Numbness or tingling that spread or radiate to the hands and feet as a result of compression to sensory nerve fibres (cervical radiculopathy or pinched nerve)
- Constipation or difficulty passing urine due to compression of nerve tracts that innervate rectum and bladder.
In order to properly diagnose you, if you are experiencing any of the above symptoms, your doctor will take a detailed history and do a thorough physical examination. Your doctor will also do investigations such as Blood tests, X-rays, CT scan, MRI, etc. to confirm the diagnosis or underlying cause for your symptoms.
Causes of neck pain include degenerative disc disease or arthritis affecting the spine; this is commonly seen in the adult or elderly population or those persons who have sustained trauma or injury to their neck previously, fractured or broken bone to the neck or cervical spine, spinal stenosis (seen in the elderly population), herniated or slipped disc causing compression of nerve roots, spondylolisthesis or loss of alignment of one vertebral body in relation to its adjacent vertebral body. Athletes in contact sports, such as boxing and football, to name a few, and persons whose job requires repeated heavy lifting (>25 pounds), or operating vibrating equipment, are at risk of one or more of the above mentioned causes of neck pain due to overuse injuries and direct trauma.
There are numerous treatments for the above causes however surgery is recommended in persons who have backache or back pain not relieved by medications or physiotherapy, persons who are experiencing weakness, numbness and tingling and bowel and bladder symptoms, and persons who have significant findings on imaging where the spine is deemed unstable and the risk of spinal cord compression is very high. It is important to note that the conditions listed above, if left untreated, may progress to spinal cord compression in the neck and may result in complete paralysis, or respiratory failure and death.
Spine surgery can be minimally invasive vs open and fusion vs non fusion (motion preserving). Spine surgery usually involves the use of implants and bone allograft to give structural stability as well as promote healing. Fusion surgery include Anterior Cervical Decompression and Fusion (ACDF) and is one of the most common procedures done to treat the cervical spine. Non-fusion spine surgery involves placement of an artificial disc prosthesis (Disc Replacement Surgery).
Complications in neck surgery such as this are infrequent and usually minor. However, as with any spine surgery, there are risks, including the possibility of general complications of any surgery such as bleeding, infection, venothromboembolism (blood clot in the legs that can break-off and go to the lungs) and reaction to anesthesia. Specific to ACDF, patients may experience hoarseness or difficulty swallowing but this usually improves within hours to days after surgery, wound hematoma, failed fusion, CSF leak and adjacent vertebrae degeneration. You are advised to discuss the potential risks and complications with your surgeon prior to having ACDF surgery. However, risks from any surgery can be reduced by following the surgeon's instructions before and after the neck surgery.