“This pain is getting so bad that I cannot do my job anymore.”
Prolonged fixed positions of the neck, especially when looking up or down, cause strain and fatigue on the muscles of the cervical spine. When these muscles fatigue they cannot hold the normal curvature of the cervical spine and then the forces of stress start to impact the actual bones of the cervical spine. When you extend your neck (look up) there are joints in the back of the cervical spine (facet joints) that get compressed against each other. As the joints of the neck experience prolonged compression they eventually wear off the articular cartilage (shock absorbers) and bone on bone contact occurs. This is also called osteoarthritis of the cervical spine when the wear and tear leads to joint space narrowing, inflammation and bone spur formation.
The good news is that in most cases these symptoms of neck pain can be treated with conservative measures. Strengthening the neck musculature is a great way to not only alleviate cervical spine symptoms, but it also serves as a preventative intervention to reduce degeneration of the cervical spine over time. In comparison to other treatment options, neck core strengthening is cheap and non invasive.
Sometimes the pain has gotten so severe that any exercise or physical therapy would be to difficult to initiate. This is were a cervical spine injection would be a useful intervention to control or even eliminate the pain from the cervical spine. It can allow a patient to resume normal activities sooner and also provide the relief necessary to undergo a cervical core strengthening regimen. Injections can also serve as a specific diagnostic tool wherein they can localize an area of the cervical spine that is the primary pain generator. There are also treatments beyond cervical spine injections where a non invasive procedure can be performed to eliminate sensory nerves that are responsible for neck pain. By turning these nerves off one can also turn off the pain, but unfortunately these nerves can grow back.
Primum non nocere, or do no harm, is the primary goal of ethical medical provider and one way a patient can tease out the right provider is to not only get a second opinion but a third opinion. This increases the likelihood of finding a provider who has your best interests in mind. After all, it’s your body and while we should all be able to put our trust in medical professionals, it is the patient that has to live with the medical treatments they undergo.