Neck pain is very common in people older than 50 years, and may be a natural consequence of aging. Like the rest of the body, the bones in the neck (cervical spine) progressively degenerate with increasing age. Cervical arthritis, or cervical spondylosis, typically occurs in 50% of people over the age of 50. As we age the discs in our spine begin to degenerate and alter the overall biomechanics of our spine. Some levels become stiffer, while other levels in response become hypermobile.
Over time, arthritis of the neck (cervical spondylosis) may result from bony spurs and problems with the nearby ligaments and discs. Because of the arthritic overgrowth the spinal canal may narrow, this is called spinal stenosis. This narrowing compresses the spinal cord and the nerves to the arms. As a result patients may develop a combination of neck pain, arm/hand pain, numbness, weakness, or spinal cord compression. The pain that results may range from mild discomfort to severe, crippling dysfunction.
Cervical arthritis, or spondylosis, can lead to chronic pain and stiffness in the neck that may radiate into to the upper arms, hands, or even legs. Patients may experience some or all of the following symptoms…
- Neck pain (Which may be worse with upright activity)
- Neck stiffness (Which may be worse with certain work activities)
- Numbness in the arms, hands, and fingers
- Weakness in the arms, hands, and fingers
- Trouble walking because of weakness in the legs or loss of balance
- Grinding or popping sounds or sensations in the neck
- Muscle spasms (Which may originate from the neck)
- The condition can cause irritability, fatigue, and sleep disturbances
- This may impair the ability to work or your daily activities.
During your consultation, Dr. Pablo Pazmino will take a complete medical history to rule out other conditions that can cause symptoms similar to cervical herniations. Dr. Pablo Pazmino will also perform a complete and thorough physical examination. Radiography (X-rays) and other diagnostic imaging tests (MRI) will then be reviewed so that Dr. Pablo Pazmino can evaluate your bony quality, any instabilities, herniations causing any neural compression, bony spurs or other abnormalities to reveal the extent of damage to your cervical spine.
At Santa Monica Spine we pride ourselves in our duty to educate our patients. Dr. Pablo Pazmino uses his background as a teacher to ensure that you understand your pathology, imaging and treatment options completely during each visit. Our patients often comment on their amazement at the amount of time and effort we take to review their studies, often in a manner which they have never seen before. We want our patients to be involved in every step of the process and we feel that education is the first step towards achieving that goal together.
At Santa Monica Spine / Beverly Spine we are very thorough. Dr. Pablo Pazmino will rely on you to provide us with a complete history of any and all medical illnesses, hospitalizations, surgeries, or chronic conditions which you may have had in the past, or for which you have seen other physicians in the past.
More specifically we will require a history of your neck and arm pain itself. What is the exact location of the neck pain? Arm pain? When did the problem begin? What does the pain feel like? Has your neck been injured before? Have you previously been treated for neck pain?
Symptoms of cervical spondylosis may last for several months or become chronic. Most patients with Cervical Arthritis or Spondylosis can be treated non-operatively. Dr. Pablo Pazmino may recommend a course of physician guided conservative management.
- Rest. A soft cervical collar or neck brace may be used to limit neck motion and relieve irritation.
- Medication. Dr. Pablo Pazmino may prescribe nonsteroidal anti-inflammatory medications (NSAIDs) or other non-narcotic pain relievers to relieve your pain and reduce swelling. Muscle relaxers, analgesics, and anti-inflammatory medications are also helpful.
- Acupuncture. Dr. Pablo Pazmino works with a team of Acupuncture specialists and may recommend this if indicated for your symptoms
- Physical therapy. A cervical traction device, hot and cold therapy, ultrasound or active exercise program may help relieve symptoms. Exercises may include neck strengthening, neck and shoulder stretching, and aerobic exercises. Patients may also receive gentle massage and perform activities to improve posture.
- Injections: A series of selective nerve root blocks or epidural injections of a cortisone-like drug may lessen nerve irritation and allow more effective participation in physical therapy. These injections are given on an outpatient basis over a period of weeks. Dr. Pablo Pazmino only works with a small group of physicians who he trusts to perform these injections. Click here to see some of the recommendations Dr. Pablo Pazmino makes in regards to injections and pain management physicians.
Nonsurgical treatment may take away most of the symptoms, but it does not treat the underlying structural cause. Follow-up visits are necessary so Dr. Pablo Pazmino can check if symptoms have gotten better, worse, or have stayed the same.
For some patients with significant pain and weakness, after failure of conservative management, Dr. Pablo Pazmino may recommend a surgical treatment option. The surgical treatment options may vary and depend on the individual patient and their pathology. Surgery may be necessary for patients with progressive neurologic symptoms or severe pain that does not improve with other treatments. Surgery may remove bone spurs or disc material (Decompression) and provide lasting pain relief. For more on surgical treatment options view the presentations below. For more surgical options click the images below.
When Should You Seek Medical Care?
If severe pain occurs following an injury (motor vehicle accident, diving accident, or fall), a trained professional, such as a paramedic, should immobilize you to avoid the risk of further injury and possible paralysis. Emergent medical care should be sought immediately.
Immediate medical care should also be sought when an injury causes pain in the neck that radiates down the arms and legs.
Radiating pain, or numbness in your arms or legs which causes weakness in the arms or legs without significant neck pain should also be evaluated.
If there has not been an injury, you should seek a Spinal Evaluation with Dr. Pablo Pazmino when pain is:
- Continuous and persistent
- Accompanied by pain that radiates down the arms or legs
- Accompanied by headaches
- Accompanied by numbness, or tingling
- Accompanied by weakness!
Many patients seek care for Cervical Arthritis pain by Dr. Pablo Pazmino because as an Orthopaedic surgeon he is specifically trained to diagnose, treat, and help prevent problems involving the muscles, bones, joints, ligaments, and tendons. Although Dr. Pablo Pazmino confines his practices to Spinal pathology he also treats a wide variety of diseases, injuries, and other conditions, including Artificial Disc Replacement.