Understanding Neck Pain
Neck pain is the second most common musculoskeletal complaint after back pain, affecting approximately 50% of adults at some point in their lives. The cervical spine consists of 7 vertebrae (C1–C7) with intervertebral discs, facet joints, and ligaments. It houses the spinal cord and the nerve roots that supply the arms.
Neck pain ranges from simple muscle strain ("tech neck") to serious conditions like cervical disc herniation causing arm pain (radiculopathy), or cervical myelopathy (spinal cord compression) causing progressive weakness and loss of fine motor control.
Important: Cervical myelopathy — spinal cord compression in the neck — is a serious condition that can cause irreversible neurological damage if untreated. Early surgical intervention is often recommended.
Symptoms
Neck pain and stiffness, worse in morning
Pain radiating into the shoulder, arm, or hand
Numbness or tingling in the fingers
Weakness in the hand or arm
Headaches originating from the base of skull
Difficulty with fine motor tasks (myelopathy)
Balance problems or unsteady gait
Leg weakness or spasticity in severe myelopathy
Causes
- Cervical spondylosis — degenerative disc and joint disease
- Cervical disc herniation — herniated disc compressing nerve root
- Poor posture — "text neck" from prolonged screen use
- Muscle strain and tension — stress, poor ergonomics
- Whiplash injury after accident
- Cervical spinal stenosis — narrowing of the cervical canal
- Inflammatory arthritis — rheumatoid arthritis
Treatment Options
Conservative Care
Physiotherapy, cervical collar, NSAIDs, muscle relaxants, and postural correction. Effective for most mechanical neck pain within 4–6 weeks.
Cervical Epidural / Block
Targeted cervical epidural steroid injection or selective nerve root block for radiculopathy. Rapid, effective pain relief.
ACDF Surgery
Anterior Cervical Discectomy & Fusion — gold standard for cervical disc herniation and myelopathy with excellent long-term outcomes.
Cervical Disc Replacement
Artificial disc replacement preserving motion — an alternative to fusion for suitable candidates, particularly younger patients.
FAQs
What is the difference between cervical radiculopathy and myelopathy?
Radiculopathy involves compression of a cervical nerve root, causing pain, numbness, or weakness in the arm/hand. It is generally treatable conservatively. Myelopathy involves compression of the spinal cord itself, causing weakness, clumsiness, balance problems, and in severe cases, leg weakness. Myelopathy often requires surgical decompression to prevent further neurological deterioration.
