Unraveling the Mysteries of Neck Pain
Do you experience tingling or burning sensations in one or more of your arms or wrists? Is it sometimes challenging to button your clothes or hold coins in your hand? Do you feel numbness or shooting pains in a leg or even experience trouble walking? You may be surprised to learn that any one of these symptoms could be caused by a problem in your neck.
According to Thomas Puschak, MD, an orthopedic surgeon at Panorama Orthopedics, people with neck conditions can experience a wide variety of strange sensations in addition to pain. Some patients report feeling as if ants are crawling on their skin or as if someone is pouring hot or cold water over an arm or a leg. Others describe a profound sense of weakness in one isolated muscle.
Because your neck is connected to your spine, it can send signals down your spinal column to other parts of your body. Pain that originates in one part of your body but is felt in another is called “referred pain.” According to Dr. Puschak, the top two neck conditions that trigger referred pain are cervical herniated discs and cervical spinal stenosis (cervical means neck):
- Cervical Herniated Disc (also called a slipped or ruptured disc): a condition in which one of the discs in your spine bulges beyond its hard outer coating, irritating nearby nerves. Herniated discs are usually caused by injury, arthritis or aging. Patients with a herniated disc often experience pain, tightness or cramping in the neck and shoulder areas or tingling, burning or numbness in their arms, wrists or hands.
- Cervical Stenosis(also called cervical spinal cord compression): a condition in which the spinal canal in your neck is narrowed due to injury, arthritis or aging. This narrowing causes pressure on your spinal cord or on a nerve root, which can result in a combination of numbness, tingling, weakness or pain in one or both arms, hands or legs.Treatment:herniated discs and cervical stenosis are diagnosed and treated similarly.At your first appointment, Puschak will order an X-ray to rule out a fracture. He will also recommend physical therapy (PT) and medications designed to reduce inflammation or to calm nerve hyperactivity. Approximately 60 to 70 percent of patients respond to this treatment within six to twelve weeks.
If you don’t respond to PT or medications, Dr. Puschak often recommends a corticosteroid epidural injection to relieve pain and reduce inflammation. He may also order an MRI (magnetic resonance imaging) to learn more about the condition.
If corticosteroid shots don’t work within five to six weeks, Dr. Puschak will consider surgery to relieve the pressure on your nerves. Surgery for both a herniated disc and for stenosis is minimally invasive and involves inserting a small wedge of bone through a tiny incision in the front of your neck. The bone is then fused into place to permanently decompress the area. (In the case of a herniated disc, the damaged disc is removed first.) Both procedures require an overnight stay in the hospital and recovery can take from two to twelve weeks.
Whether you suffer from a herniated disc, stenosis or another orthopedic condition, Dr. Puschak wants patients to know they have his undivided attention when they come to him. “I take the time to listen and answer all of my patients’ questions carefully,” he says. “It’s very important to me that they understand their condition and all of their treatment options.”