How to deal with persistent neck pain

Neck pain can be caused by several different factors, and depending on the intensity of the pain, can prove to be debilitating for some patients. Luckily, there are many different treatment options. In his latest article, renowned spinal surgeon Mr Amarjit Anand explains the different cases and treatments for neck pain.

What might be causing my neck pain?

There are several possible causes of neck pain. One of the most common causes is an injury to the intervertebral discs of the neck, which can cause sharp pain.

The disc can also prolapse, which can cause neck pain and nerve symptoms in the arm. This is called radiculopathy, and can cause pain, numbness or tingling in the arm.

The facet joint is also associated with neck pain. These are little joints in the neck which can become irritated or arthritic.

When should I seek medical assistance for my neck pain?

If your neck pain persists for six weeks or longer it's worth getting an expert opinion to determine why the pain is not going away. Neck pain is very common, usually associated with the joints becoming irritated or a muscular strain. If the pain persists while taking simple painkillers, anti-inflammatories and avoiding aggravating factors then you should also consult a specialist.

You should also seek medical assistance if any associated nerve symptoms are radiating into the arm. This could be pain in the arm, or tingling, numbness or weakness.

Might my neck pain be a sign of an underlying condition?

Yes. There are simple causes of neck pain, such as muscular strain, but there is often a different underlying cause. In young people, it’s usually disc injuries or disc prolapses, and as we age, arthritis or facet joint could also be causes.

In some instances, the disc can hit or impact the spinal cord, which can cause several symptoms including loss of power in the upper limbs, tingling, numbness, loss of dexterity, and a loss of coordination. If these symptoms were to arise you should seek medical attention more urgently.

When is surgery recommended for neck pain?

The major indication for surgery in the neck would be if there are symptoms of spinal cord dysfunction because of something such as a disc pressing on the spinal cord, causing some sort of dysfunction. This is called cervical myelopathy. There’s no role for conservative management when patients are developing symptoms of spinal cord dysfunction.

Surgery may also be required is if there is nerve pain that is not settling with conservative management or simple interventions such as injections.

Surgery may be required for nerve pain that's radiating down the arm, or where there is nerve pain associated with weakness of the upper limb.

The other interventions that may be required, which I would classify more as procedures rather than operations, could be injections and radiofrequency denervation. These are minor procedures performed for axial neck pain, usually as a result of arthritis that comes with persistent pain despite a prolonged period of two to three months of conservative management.

What are the most effective home remedies when it comes to managing neck pain?

The first thing to do is avoid any aggravating factors. One aggravating factor is too much screen time. You should limit your screen time, whether that be the computer, iPhone or iPad, to about an hour to an hour and a half before a break is required. You should also ensure that the setup of your desk brings your computer screen up to eye level. Avoid multiple screens, particularly at different heights.

Long-distance driving should also be avoided. You can try adjusting your pillow to make it, less painful. The next intervention will be simple painkillers and anti-inflammatories.

You could also work on strengthening the muscles supporting the neck, primarily the trapezius and the upper back muscles. This can take some pressure off the cervical spine. This can be achieved through self-directed exercises, physiotherapy, or osteopathic and chiropractic treatments.

Mr Amarjit Anand is a leading spinal surgeon based in London and Caterham, with over 15 years of experience. If you have any neck or spinal pain, you can book a consultation with Mr Anand today via his Top Doctors profile.