Neck pain and discomfort is one of the most common reasons patients seek medical attention. Most of them are not serious, and may be attributed to muscle stiffness due to poor posture, poor sleeping position, or tension. But it is also partly due to cervical spondylosis, intervertebral disc herniation, and even cancer that causes cervical pain, so it should not be taken lightly.

Because of soreness caused by spasm or strain, patients can improve the condition significantly through various conservative methods, such as improving posture, changing sleep position, pillows, avoiding sitting or standing for extended periods of time, doing gentle exercise, applying hot compresses, taking warm showers, etc.

Conditions requiring medical attention

Patients should seek medical attention as soon as possible if:

• Neck pain is caused by car accidents, falls and other injuries.
• After a week's rest, neck pain still does not improve significantly.
• The neck is so stiff that the chin can't touch the chest.
• Neck pain is accompanied by symptoms such as fever or headache.
• There are symptoms of nerve compression, such as tingling soreness in the arms and palms, and stiffness in the feet.

Cervical disk disorders

Long-term improper use or external injury are the causes of "cervical disk disorders," and arthritis can also lead to degenerative disc diseases and osteophyte. Once the nerve is compressed, it causes pain.

The most common manifestations of cervical disk disorders are intermittent neck pain, followed by increased numbness in the neck and arms, weakness, lower limb stiffness, coordination problems, and even paralysis if left untreated.

Cervical stenosis

After years of use, the intervertebral disc gradually becomes dehydrated, degenerated and inelastic, and its function as a shock absorber is also gradually lost. At this time, in order to maintain the stability of the spine, osteophytes begin to grow, and the ligament begins to become hypertrophic or even calcified.

In contrast, the "spinal cavity" where the spinal cord is located and the "spinal neural foramen" through which the cervical nerve root passes become narrow. Therefore, patients with cervical stenosis may have several symptoms: the neck begins to ache, and they will have numbness along the shoulders, arms and fingers; they have no strength, and they can't do fine movements; their walking steps become more and more rigid, weak, paralyzed, and sometimes they don't even realize that their slippers are off.

Osteoarthritis

The cervical vertebrae also deteriorate gradually. Its symptom is that the neck pain often spreads between the shoulder and the two scapulae. This kind of pain is often severe after getting up in the morning, then alleviated, and severe again in the evening. People who have had cervical sprains are more likely to suffer from it

Diagnosis

• Ask for medical history, symptoms, conduct detailed neurological examination, including muscle strength, reflexes, etc.
• X-ray and CT of the cervical spine: can clear see whether there are hard bone spurs and ossification of the posterior longitudinal ligament and whether the spine alignment is abnormal.
• Magnetic resonance imaging (MRI): can clearly show the tissue structure.
• Nerve conduction velocity/electromyography (NCV/EMG).

Treatment

• Conservative treatment is the first choice.
• Generally speaking, it is the time to use surgical treatment if the disease is serious, affecting the quality of life or work, and conservative treatment is ineffective or the symptoms recur.
• Methods of operation include decompression, fusion and fixation.
• Decompression surgery: discectomy and vertebrectomy, or laminectomy may be performed anteriorly or posteriorly respectively, depending on the position of nerve compression.
• Fusion: cervical spine stents are inserted between two vertebrae to produce osseous fusion and maintain long-term stability of the spine.
• The procedure is performed under a delicate surgical microscope under general anesthesia to ensure no nerve damage.