OrthoNeuroSpine & Pain Institute

Conservative care can be very effective in treating most symptoms related to disorders of the neck and cervical spine. Flare-ups of mechanical neck pain from muscle strains,as well as arm pain from a herniated disc causing a "pinched nerve" typically respond very successfully to nonoperative care. The most basic and simplest is a brief period of activity modification or rest. This can involve taking a break from routine daily activities or work to allow an acute or recent problem to resolve. On occasion, a cervical collar can be helpful for a short period of time to help the neck muscles relax or to act as a reminder to minimize neck motion or activity. Medications such as anti-inflammatories, pain relievers, steroids, muscle relaxants or narcotic pain relievers may be used.

Physical therapy (PT) is commonly used in the conservative care of cervical spine disorders. PT includes pain relieving modalities such as ultrasound, heat, electric stimulation and massage. In order for PT to be effective in the long term, it should involve not only these modalities but also stretching, therapeutic strengthening exercises for the neck and surrounding muscles, postural retraining, education and progression to a home exercise program. Traction may also be used if approved by your physician.

Chiropractic care or adjustments to the neck can be successful in many cases. You should discuss this with your doctor if you choose this method of treatment, as certain conditions should not be manipulated. You should maintain a treatment strategy that is consistent with your physician's experience.

Injection procedures can be used to help relieve painful symptoms arising from disorders of the neck and cervical spine. These fall into two categories: those done into muscular regions and those around neurologic structures. Muscular injections, or trigger point injections, can be use to relieve painful spasm and tightness in the neck muscles. They typically involve the injection of an anesthetic medication similar to Novocain, and an anti-inflammatory steroid. Injections around the neurologic structures include epidural injections and nerve root blocks. Epidural injections involve placing medication around the region and tissue the covers the spinal cord. Nerve root blocks involve placing medication around the spinal nerves after they have split off the spinal cord and are just exiting the spinal column. Medication that is injected around neurologic structures includes an anti-inflammatory steroid and frequently a local anesthetic. Physicians who perform epidural or nerve root blocks may require x-ray guidance to perform these procedures. Injections are not for everybody: usefulness and long-term benefit need to be evaluated on a case-by-case basis and are also dependent on your actual diagnosis.

Conservative care for cervical spine problems can be very effective in the vast majority of patients. The exact mode of treatment is dependent on your actual symptoms, history of prior treatment, structural problems, and diagnosis. Many patients can also benefit from combining one or more treatment options. Your particular treatment strategy will arise from a combination of these principles, your specific needs, and your physician's experience and assessment of your particular condition.