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TOP 11 NON-OPERATIVE TREATMENTS FOR THAT PAIN IN YOUR NECK

Did you know most spinal conditions do NOT require surgical intervention? In fact, of the 50,000 patients we have treated in the past 20 years neck pain is one of the most frequent conditions. The positive news is that we manage the majority of these patients with “non-operative” care that’s often called “conservative” care.

Prior to treating any type of pain it is critical to first understand the root of the pain. The most common cause of neck pain is often poor cervical posture. Essentially, the neck tends to be in a forward flexed position, placing excessive strain on the supporting neck and shoulder musculature. By restoring posture to its normal position, the head essentially is in balance over the spine, causing significantly less muscular tension.

Although each patient is treated with an individualized approach to their diagnosis, below I have outlined some very basic principles which we use in prescribing treatment.

1. Ultrasound: An ultrasound machine sends high frequency waves through the tissues and can reach pain, which is often deep in the muscle. These ultrasonic waves essentially increase blood flow to these areas and are thought to essentially promote healing and pain relief.
2. Heat vs. Ice: A common question I get asked is, “should I put ice on my neck or should I put heat on my neck?”  In general, when it comes to injury and severe pain, (ie: ankle sprain) go with ice. If you experience a more chronic injury or stiffness, many times heat will feel better and alleviate some of the stiffness. For pain we find that cold decreases pain and swelling, while heat increases circulation to an injured area. In some cases, contrast therapy is used, employing both ice and then heat in an alternating fashion.
3. Transcutaneous Electrical Nerve Stimulation (TENS): This mild electrical current is thought to be beneficial in controlling pain, and according to patients, is often quite effective. This modality consists of electrodes which are placed directly on the skin. A current of electricity is passed between those electrodes over an area of discomfort.
4. Massage: Massage can be helpful in alleviating muscle tension in the neck; however, in the setting of injury, massage therapy is highly therapeutic in alleviating muscle spasm associated with injury. Typically, this modality is performed by a massage therapist or a physical therapist.
5. Trigger Point Injections: Specific focal points of muscular tension are known as trigger points.  They can be quite painful when pressed upon; however, it is often difficult using manual techniques to alleviate these trigger points. Some specialists believe that by injecting local anesthetic or cortisone into a trigger point, pain can be relieved.
6. Dry Needling: This new technique for pain management and sports related injuries applies the use of acupuncture needles to deactivate the trigger point (muscle knot), reduce pain and restore normal function to the involved muscle. The needle stimulates the trigger point to resolve, causing significant alleviation of pain. The term dry needling refers to the fact that a needle is placed, but nothing is actually injected through the needle.
7. Traction: Either using manual techniques, in which a physical therapist pulls gently on the head and neck to stretch across the discs and facet joints or using a home device which accomplishes the same task, traction is extremely useful in alleviating muscle spasm and compression of the spine. Actually, we find it particularly effective when patients are complaining of nerve root compression and arm symptoms. By stretching the neck, each of the nerve root openings (foramina) is slightly enlarged.  This enlargement promotes resolution of the inflammation around the nerve root, hopefully allowing the nerve to heal.
8. Bracing: Techniques used to brace the cervical spine include soft collars and hard collars.  Any time bracing is applied to the neck, there is some sense of stability.  Many times, by simply limiting range of motion, inflammation tends to diminish resulting in less pain and greater range of motion. One concern about the long-term use of a neck brace is loss of flexibility of the neck, as well as loss of strength of the postural muscles.  We often say that bracing can be used short-term for pain control but long-term we prefer to enhance the strength and flexibility of the cervical spinal supporting musculature.
9. Exercise / Physical Therapy: Nearly every patient who presents to our office with neck pain is prescribed physical therapy, which eventually transitions into a home exercise regimen. Physical therapists work to increase range of motion and strength while restoring posture.
10. Home Exercises: Home exercises take the exercises taught by the physical therapist and make them into a useful home regimen that can be completed on a near-daily basis in a reasonable period of time.
11. Medications: There are a variety of medications that will reduce inflammation, decrease muscle spasms and swelling, and reduce pain or the sensation of pain. Examples of such medications include corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), analgesics (“Pain Killers”), muscle relaxants, and antidepressants. Unfortunately, these medications are often ineffective in dealing with post surgical or severe neck pain. *Please note that there are several side effects with any medication you take. For your safety consult with your doctor to understand which medication is most appropriate for you.

I trust you found this explanation helpful and will serve as a resource as you navigate through treatment for your neck pain. Please understand this post was not meant to serve as a comprehensive guide to the treatment of neck pain. If you have a specific condition we can help you with please leave us a comment or email us at contact@spinemd.com.

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