Pain In The Neck? Non-Surgical Relief Is On The Way

Neck pain is second only to lower back pain as the most common musculoskeletal disorder. Recent surveys indicate that as much as 18% of the general population experience chronic neck pain. Fortunately, there is strong new evidence that more aggressive non-surgical therapies, in particular, radiographically guided injections using ultrasound and fluoroscopic imaging, can effectively treat many forms of severe neck pain.

Many individuals with neck pain will develop "cervical radiculopathy." A nerve branch or "root" is compressed or pinched as it exits the cervical vertebral column.

"The cause can be either a sudden protrusion or pimple of a cervical disc, or simply inflammation and swelling of the nerve root in a narrowed exit hole of the spine called the intervertebral foramen", says Dr. Alex Simotas, department of physiatry at the Hospital for Special Surgery in New York City who specializes in neck pain.

He further adds that "in both situations the individual may experience neck pain extending down the arm, often into the hand, along with numbness and often weakness of the arm." Sometimes the symptoms will resolve rapidly using a combination of anti-inflammatory medications and immobilization of the neck with a cervical brace or collar. Other patients may respond to gentle intermittent traction on the neck by a medical professional or self-administered traction with a take home device.

New studies suggest that even patients who have not responded to initial therapies may respond to the use of x-ray (fluoroscopically or ultrasound guided) transforaminal epidural steroid injections. Simotas further comments that "some investigators believe initial treatments often fail in patients with cervical radiculopathy because adequate doses of anti-inflammatory medications cannot reach the compressed area of inflammation around the nerve." Under careful monitoring and x-ray imaging a needle is directed into the troubled narrow spot of the spine. Radiographic contrast can be used to verify a safe and effective placement of medication. A concentrated steroid solution serving as a powerful anti-inflammatory is injected and the patient is sent home within hours of the procedure. Most patients will experience a sudden dramatic relief and improvement of their condition. As many as 80% seem to respond with one or two treatments and avoid unnecessary surgery.

Many neck pain sufferers do not have "radiculopathy." The cause of their pain may be attributed to strained muscles, ligaments, or simply "cervical arthritis." "When these patients fail to respond to initial therapies, surgical treatment is rarely advised since successful outcomes are difficult to predict", says Dr. Simotas. Guided cervical facet injections can provide significant relief of recalcitrant neck pain. The physician will place needles into small joints between the vertebrae known as facet joints. Relief is provided by administering small doses of a corticosteroid solution in carefully selected facet joints. For some patients, such therapy is adequate to bring about complete recovery.

Some more severe presentations may not respond to initial therapies and surgical treatments will be advised. Dr. Simotas remarks that "while a variety of techniques and approaches are available, the goal of surgical therapies is to alleviate the condition by decompressing the nerve at the site of impingement".

Comments

[QFE]

Just to put in my two cents - at 53 I had arthritis in my neck (verified by x-ray) so bad I thought the good part of my life was over. Faithfully doing the prescribed physical therapy and home exercises reduced the problem to a stiff neck on one side that I'm rarely concious of.

I also take glucosamin­e/chondotr­in (cheapest we can find convenienty), though whether that makes a difference or not I don't know. I'm not giving it up to find out.

Obviously there are more serious problems these approaches won't fix, but they worked for me and I'm sure would work for a lot more people. It's hard to do the physical therapy when it doesn't seem to be working, but it pays off enormously in the long run. Even when things seem hopeless, it always pays to try and make them better. In my case, I got nearly everything back just by hanging in.

I moved on from physical therapy to jump rope to my own exercises and approach designed to make exercise fun - and I know the difference. I'm trying to promote my ideas in a grass-roots effort to help with the obesity problem. Everything on the site is free and there are no lessons or special equipment or anything like that. I'm just trying to get exposure for my ideas.

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Thanks
Richard Waddell

[LEF]

I have found the use of Emotional Freedom Technique.­..emofree.­com. most powerful. Many people I have worked with have had tremendous back pain and have cleared it, even while on an airplane. It is probably one of the most empowering healing modalities that I have ever encountered.

[rini]

I have not had radiculopathy or much neck pain since I have been doing yoga over the past five years. Since I have a lordosis (curvature) of the neck, which is common I gradually relax the muscles and stretch the ligaments by doing a shoulder stand and the plow. This reverses the curve and prevents further stiffening and tightening of the ligaments that naturally increases through the years. It also strengthens my back, which is more than a chiropractor can do.

Of course, you have to listen to your body. If you are actually having spasms and severe pain when trying to do a position, brain flash, don't do it. Increase your flexability gradually.

[alignandrelax]

Modern American humans are the same species as those legendary women in the world who can successfully carry enormously heavy loads of rocks or water on their heads, sometimes day in and day out for decades without problems. (While some people suffer serious damage from this, it is because of HOW they are doing this). Even without muscle power (actually because they are not restricted by muscle power) these women are able almost effortlessly carry these loads because aligned bones are actually doing the work of carrying the rocks. What are aligned bones? A skeleton that aligns along the central axis of gravity that every healthy baby in the world must be able to find in order to be able to stand up and walk without falling down.

Chiropractic, acupuncture, massage are certainly preferable to invasive treatments, but best yet is learning how to align ones bones. It really works, and in learning how to sit, stand, bend, walk, and sleep in all the ways that support this alignment, almost anyone can, over time, remap the body's habitual patterns of use. This is the remedy that lasts a lifetime and withstands gravity, the same way that foundation pillars on a house support the house. The human body is governed by the same laws of nature that apply to physics, engineering and architecture —and everything else in the universe. In any given moment, one is either lengthening or shortening the spine, and a habit of perpetual shortening anywhere along the spine is the cause of probably most of the back and neck pain that people experience.

An examination of the skeletal alignment of toddlers, women who carry heavy loads on their heads and people who have aged into their 80s and 90s with extended spines and flexible joints reveals that they all share this common natural alignment. If you want to see many photos of this, Ageless Spine, Lasting Health is a book that shows this in great detail. This represents the biggest blind spot in our thinking of what contributes to healthy living today and comfortable aging tomorrow.

[Where is Jesus?]

I'm getting some advanced chiropractic treatments (not bone-cracking!)that is making a big difference. Steroid or cortisone injections are not the ultimate answer. But hey, when someone is in enough pain, it doesn't not seem like a bad idea at the time.

[pupuguru]

High,
Not new techniques at all---I had cortizone injections along with novacaine for a pinched nerve from 1965 to 1974. I now use yoga and cannabis, works far better than any invasive procedure for me. I have both lower back and cervical damage.

[rabun666]

cool

[pagangrandma]

I have had these injections twice. After the first one I woke up in twice as much pain as before treatment. The second time I woke up paralyzed from the neck down not even able to breathe. Fortunately that was temporary, but scared the hell out of me . Never again, I'll just put up with the pain, thank-you.

[DianeDfromPhoenix]

There are two problems with using steroids to relieve back/neck pain. First of all, the relief they may bring may encourage patients to do tasks that worsen the original injury -- (Gee, I feel so great, I'm going to move that roomful of furniture!)

Secondly, when the steroid wears off, there is frequently a rebound effect, which causes the pain to worsen. This is how the merry-go-round of drug dependency begins.

Steroids should be used as a last resort. Physical therapy, chiropractic, massage and other non-invasive techniques usually work just as well.

[signalman]

Again, no mention of Orthopedic or medical neuromuscular massage therapy as a non-invasive very effective modality for musculo-skeletal pain syndromes.
After a proper screening and exam,conscientious physicians will refer to competent Licensed Medical Massage Therapists
to eliminate the possibility of Myofascial Trigger Points,spa­sms,conges­tion,overu­se.
Headaches,­parasthesi­a,referred pain,restricted Range of Motion can often be successfully addressed by good,carin­g,knowledg­eable hands.

[rabun666]

I experience some shoulder pain that radiates into my neck. I get some relief from massage but the best result I get are Chiropractic treatments. It has a Chiropractic device, a device which attaches to the head and stretches the neck, traction of the neck. For me it takes 6 treatments and I get relief for several month's.This is the most effective way, although acupuncture works well also but may not be available as readily as Chiropractic is.

[aigeanta]

The last time I had severe neck pain, I took my butt over to an acupuncture clinic and they cured me in one session.

[karmafriend]

and who can afford this?

how much?