| 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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