| Non-Surgical
Treatment for Your Neck Pain
Medications
Medications are commonly used
to control pain, inflammation,
muscle spasm, and sleep disturbance.
Some general tips about treatment
with medication:
•
Medication should be used
wisely! Take all medications exactly
as prescribed and report any side
•
effects to your doctor.
•
Some pain medicines are
highly addictive!
•
No pain medicine will control
chronic pain if used over a long
period.
•
No medication will cure
neck pain of degenerative origin.
Cervical
Collar
A cervical collar is often
used to provide support and limit
motion while an injured neck is
healing. It also helps keep the
normal alignment. Cervical collars
can be soft (made of foam) or
hard (made of metal or plastic).
Because these collars can restrict
the movement of your head, you
may need help with eating and
other activities. The skin under
the collar needs to be checked
every day to prevent blisters
or sores.
Cervical
Pillow
A
cervical pillow is sometimes recommended
for people who have problems with
neck pain at night. The cervical
pillow is designed to hold the
neck in the best position to prevent
excess stress on the cervical
spine during sleep.
Physical
Therapy
Your
doctor may have a physical therapist
work on an exercise program developed
just for you. The physical therapist
will teach you ways to prevent
further injury to your neck.
For
a complete description of the
rehabilitation of neck pain, you
may wish to review the document:
Neck Rehabilitation
Epidural
Steroid Injection (Nerve Block)
If
other treatments do not relieve
your back pain, you may be given
an epidural steroid injection
(ESI), or a cervical nerve block.
An ESI places a small amount of
cortisone into the bony spinal
canal. Cortisone is a very b anti-inflammatory
medicine that may control the
inflammation surrounding the nerves
and may ease the pain caused by
irritated nerve roots. The ESI
is not always successful. This
injection is often used when other
conservative measures do not work,
or in an effort to postpone surgery.
Surgical
Treatment
Common
Operations Used for Neck Pain
Surgery
is only necessary for a few people.
However, no single type of surgery
works for every neck pain problem.
If your doctor thinks surgery
will improve your neck pain, he
will suggest the type of surgery
he thinks is the best for you.
Numerous surgical procedures have
been designed to treat each type
of neck pain. The following section
describes different surgical treatments
in a very general way, and gives
an overview of what each type
of procedure tries to accomplish.
Surgical procedures are generally
done for one of three reasons:
•
To remove pressure from
the nerve roots caused by bone
spurs or herniated disc material
(for cervical
•
radiculopathy)
•
To remove pressure from
the spinal cord (for cervical
myelopathy)
•
To stop the motion between
two vertebrae - or a spinal segment
(for degenerative disc disease)
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Discectomy
One
of the most common surgical procedures
for problems in the cervical spine
is an anterior cervical discectomy.
The term "discectomy" means
"remove the disc". A discectomy
relieves the pressure on a nerve root
by removing the herniated disc causing
the pressure. In
the cervical spine, the disc is
usually removed from the front.
An incision is made in the front
of your neck right beside your
trachea (windpipe). The muscles
are moved to the side. The arteries
and nerves in the neck are protected
as well.
Once
the spine is reached from the
front, each disc and vertebra
are identified using an X-ray
to make sure that the right disc
is being removed. Once this is
determined, the disc is removed
all the way back to the spinal
cord. Any bone spurs that are
found sticking off the back of
the vertebra are removed as well.
Great care is taken to not damage
the spinal cord and nerve roots.
In
the cervical spine, a discectomy
is usually combined with a anterior
spine fusion, where the two vertebrae
on either side of the removed
disc are allowed to heal together,
or fuse. The cervical fusion is
described in detail below.
Cervical
Fusion
Once
the disc has been removed between
the vertebrae, a cervical fusion
is performed. This procedure allows
the surgeon to fill the space
left by removing the disc with
a block of bone taken from the
pelvis. Placing a bone graft between
two or more vertebrae causes the
vertebrae to grow together, or
fuse. If your neck problem is
caused by segmental instability,
a spinal fusion may also be recommended
- even if you do not have a cervical
radiculopathy.
The
bone graft is usually taken from
the pelvis at the time of surgery,
but some surgeons prefer to use
bone graft obtained from a bone
bank. Bone graft from a bone bank
is taken from organ donors and
stored under sterile conditions
until it is needed for operations
such as spinal fusion. The bone
goes through a rigorous testing
procedure, similar to a blood
transfusion. This is in order
to reduce the risk of passing
on diseases, such as AIDS or hepatitis,
to the recipient.
There
are two basic types of spinal
fusion:
Anterior
Interbody Fusion
This
type of fusion is much more common
in the neck. This type of fusion
is described above. In the interbody
fusion, a bone graft is placed
between two vertebrae and replaces
the removed disc. During the healing
process, the vertebrae grow together,
creating a solid piece of bone
out of the two vertebrae.
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