Cervicalgia

Conditions

At ShimSpine we feel knowledge is power. The more you know about your spinal condition, the more likely you are to make good healthcare decisions. We have explained the conditions, the symptoms and the likely treatments available.

Cervicalgia

Cervicalgia

Cervicalgia is neck pain usually associated with trauma or aging. It is also referred to as none-specific neck pain. The cause is usually multifactorial and includes poor posture, neck strain, sports and occupational activities, anxiety and depression.

Symptoms vary with different physical activities and over time. It is aggravated by particular movements, posture, and activities, and relieved by others. Pain is often, but not always, aggravated by exercise and relieved by rest. It radiates in a non-segmental distribution into the shoulder, upper back, arm(s) and head.

With Cervicalgia, there may be associated neck stiffness and muscle spasm, decreased range of motion and tenderness of muscles. There is usually no objective loss of sensation or muscle strength.

Cervical Sprain-Strain (Whiplash)

Cervical Sprain-Strain (Whiplash)

Whiplash is a neck injury due to forceful, rapid back-and-forth movement of the neck, that most often occurs during a rear-end auto accident, but can also result from a sports accident, physical abuse or other trauma.  The muscles,  ligaments and tendons of the neck can be stretched,  and even torn.

Common signs and symptoms of whiplash include neck pain, stiffness and headaches. When not associated with an auto accident,  it is called a neck sprain or strain.

Symptoms can include neck pain and stiffness, loss of range of motion in the neck, headaches (most often starting at the base of the skull) and tenderness in the shoulders, upper back and arms.

The vast majority of cervical sprains gets better with conservative care.  Sometimes,  with a significant disruption of the muscles,  tendons and ligaments,  it can lead to chronic pain.

Cervical Facet Syndrome

Cervical Facet Syndrome

Cervical Facet Syndrome occurs when the joints of the neck become inflamed and pain develops. It is associated with aging and joint degeneration. The pain occurs when the facet joint has lost the ability to glide and move smoothly.

The facet joints are located between the disc and the body of the vertebra in front and the spinous process or the bumps you feel on the back of the neck. The joints glide when the neck is rotated, flexed or extended.

Cervical facet syndrome is caused by the cervical spine disc degenerative cascade.  As the disc narrows,  the facet joints are required to carry more physical load,  and the joints move in a different manner.  In some cases,  “whiplash” injury or other similar sudden back and forth rapid unguarded movements to the neck can cause these facet joints to become symptomatic. A strain to the facet joint capsular ligaments can create inflammation, which may result in neck pain, shoulder pain and trapezius tenderness. There is generally a decrease in range of motion in the neck.

Patients often have more pain and stiffness in the morning or after they have been in one position for an extended period of time. Movement generally improves symptoms.  Fortunately,  Cervical Facet Syndrome is self limiting,  but some medical interventions can accelerate the return to the normal baseline.

Cervical Spondylosis

Cervical Spondylosis

Cervical spondylosis, also known as cervical osteoarthritis or neck arthritis, is a common age related condition that affects the joints and discs and the neck. It develops from wear and tear of the cartilage and bone found in the cervical spine. Though it is largely due to age it could be caused, or accelerated by, many other factors.

Bone spurs, (overgrowth of bone that are the result of the body trying to protect an injury), dehydrated cervical discs, or traumatic injury tend to speed up the process of cervical spondylosis.

Though it is widely accepted that many people over the age of 60 have some spondylosis, they often have no symptoms. However some people who have cervical spondylosis can have chronic severe neck pain and stiffness. This disease of the spine is usually treated conservatively before surgery is considered.

Treatment

Depending on the specific nature and location of the problem, possible conservative treatments include:

  • Physical therapy
  • Injections
  • Behavior modifications (weight loss, quit smoking, no heavy lifting)
  • Environmental modifications (ergonomic chair, elevated desk).

If conservative measures are unsuccessful, surgeries could include:

  • Anterior Cervical Discectomy with Fusion (ACDF)
  • Posterior Cervical Foraminotomy.
Cervical Disc Herniation

Cervical Disc Herniation

A cervical herniated disc is when the inside core of the disc leaks out of the disc and presses on an adjacent nerve root. A cervical herniated disc may occur due to trauma or be spontaneous. Something as simple as a sneeze can herniate a disc.

Because there is not a lot of space available in the cervical spinal canal, even a small cervical disc herniation can press on one of the nerves and cause significant pain. Though neck pain is usually present, the most common pain is in the trapezius, arm and hand of the affected side. This will generally follow the normal distribution of the nerve affected. Some numbness and tingling may also be reported. This is called cervical radiculopathy.

If the disc is herniated back onto the spinal cord, the patient may not feel any pain at all. Their symptoms can be numbness and weakness in all extremities, clumsiness, or loss of balance. This is called cervical myelopathy.

Most herniated discs tend to shrink back into the disc space or dissolve over time. Conservative care is recommended first, unless the patient has signs of paralysis. Once the disc has been herniated, disc degeneration will often be accelerated due to the loss of fluid in the disc space.

Treatment

Depending on the specific nature and location of the problem, possible conservative treatments include:

  • Physical therapy
  • Injections
  • Behavior modifications (weight loss, quit smoking, no heavy lifting)
  • Environmental modifications (ergonomic chair, elevated desk).

If conservative measures are unsuccessful, surgeries could include:

  • Anterior Cervical Discectomy with Fusion (ACDF)
  • Posterior Cervical Foraminotomy.
  • Cervical Disc replacement
Cervical Radiculopathy

Cervical Radiculopathy

A cervical radiculopathy is a problem that results when a nerve in the neck is irritated as it leaves the spinal canal. This condition usually occurs when a nerve root is being pinched by a bone spur or a herniated disc.

When a nerve root leaves the spinal cord and the cervical spine, it travels down into the arm. Along the way each nerve supplies sensation (feeling) to a part of the skin of the shoulder and arm. It also supplies electrical signals to certain muscles to move part of the arm or hand. When a nerve is irritated or pinched, by either a bone spur or a part of the herniated disc, it causes problems in the nerve.

A cervical radiculopathy causes symptoms that radiate out away from the neck. What this means is that although the problem is in the spine, the symptoms may be felt in the shoulder, the arm, or the hand. The symptoms will be felt in the area where the nerve that is irritated travels. By looking at where the symptoms are, the spine specialist can usually tell which nerve is involved. The symptoms include pain, numbness and weakness. The reflexes in the upper arm can be affected.

It is always wise to try conservative measures for this problem before considering the surgical route.

Cervical Spinal Myelopathy

Cervical Myelopathy

When there is a narrowing of the spinal canal, the whole spinal cord may be effective. Pressure on the spinal cord, be it from spinal stenosis or herniated disc, as it runs through the cervical spine is called cervical myelopathy.

This pressure can cause weakness and spasticity in the legs where the patient may have some difficulty walking due to a loss of control of where their feet are placed. There may be numbness in both the upper extremities and lower extremities and reflexes may be increased in the legs. A loss of strength in the legs is common and they may lose their “position sense”. This is where the patient does not know where his arms and legs are if they have their eyes closed. It is important to note that the patient may have no pain if the nerve roots are not affected.

The treatment is quite different depending on the cause of the myelopathy but a surgical discussion is very important. This sooner pressure is removed from the cord, the better the chance of the patient improving.

It is important not to have any cervical injections or chiropractic adjustments with the diagnosis of cervical myelopathy. Certain movements, or an increase in volume around the cord, can cause paralysis.

Treatment

Depending on the specific nature and location of the problem, possible conservative treatments include:

  • Physical therapy
  • Behavior modifications (weight loss, quit smoking, no heavy lifting)
  • Environmental modifications (ergonomic chair, elevated desk).

If conservative measures are unsuccessful, surgeries could include:

  • Anterior Cervical Discectomy with Fusion (ACDF)
  • Cervical Disc Replacement

http://www.spineopedia.com/article/radiculopathy-and-myelopathy-at-segments-adjacent-to-the-site-of-a-previous-anterior-cervical-arthrodesis/

Cervical Spinal Stenosis

Cervical Stenosis

Most neck pain is due to degenerative changes that occur in the intervertebral disc of the cervical spine or the joints between each vertebra. Perhaps the most serious of the problems caused by degeneration of the cervical spine is the condition of spinal stenosis.

As we age, the disc loses some of its water content and as a result, some of its shock absorbing ability. It also decreases the opening in the spinal column where the nerve nerves exit (foramen). It is thought that too much motion on the spinal segment causes the bone spurs to form. Eventually the bone spurs can form around the nerves of the spine and also decrease the size of the foramen.

The narrowing of the foramen can lead to neck pain and upper extremity pain, numbness, tingling or weakness. The tighter the opening for the nerve, the more symptomatic the patient will be. This is called cervical radiculopathy.

When there is a narrowing of the spinal canal, the whole spinal cord may be affected. This could have the symptoms already mentioned but also, in the lower extremities, there could be numbness and weakness reported. This is called cervical myelopathy. Reflexes may be increased in the legs and strength may be lost. Walking could be compromised and the patient may refer to tripping over things and being “clumsy”.

The treatment is quite different depending on the symptoms of the patient. There are several conservative measures for radiculopathy. With myelopathy, the patient should have a surgical consult due to the pressure on the spinal cord.

Treatment

Depending on the specific nature and location of the problem, possible conservative treatments include:

  • Physical therapy
  • Injections
  • Behavior modifications (weight loss, quit smoking, no heavy lifting)
  • Environmental modifications (ergonomic chair, elevated desk).

If conservative measures are unsuccessful, surgeries could include:

  • Anterior Cervical Discectomy with Fusion (ACDF)
  • Posterior Cervical Foraminotomy
  • Posterior Cervical Decompression

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The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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