Neck Pain: An Introduction

Young businessman with neck pain

While not as common as low back pain, neck pain is often more difficult to accurately diagnose and effectively treat. Many clinics simply lack the experience to feel comfortable in this area. At Schlesinger Pain Centers, neck pain has always been a major part of our practice as well as a particular interest of mine.

While not as common as low back pain, neck pain is a condition, which is increasing rapidly in prevalence due to the effects of previous trauma (especially motor vehicle accidents), various types of arthritis and the effects of aging on the American population. In fact it is the second most common condition that we treat here at Schlesinger Pain Centers. The various types of neck pain account for over 30% of our patients and have always been a particular interest of mine.


As with low back pain making an accurate diagnosis is essential in finding effective treatment. Again as with low back pain causes tend to fall into two basic groups, axial neck pain (where the pain is confined primarily to the neck and radicular neck pain (where the pain radiates or travels from the neck to another part of the body, usually the shoulder or arm). In addition there is a third variety of neck pain for which there is no analogue in the lower back, namely cervicogenic headaches. In this condition problems in the upper neck can manifest themselves as pain in the back of the head, which with increasing severity can spread upwards and forwards to involve the whole head.


Treatment depends on the type of neck pain and can include traction, physical therapy, yoga therapy, medical management, epidural steroid injections, neuroablative procedures (most commonly radio-frequency ablations) wherein certain nerves are either destroyed or disabled for prolonged periods of time and neuromodulation (most commonly spinal cord and peripheral nerve stimulators). The choice of treatment modality is determined not only by the disease process, but also the location of the problem.


In some cases where conservative measures prove ineffective the best option is surgery. Knowing when to advise surgery and helping patients decide between different surgical techniques requires many years of experience. Patients rarely want to hear the “S” word, but I always remind them that while you never want to have too much surgery, you don’t want to have too little surgery either. We at Schlesinger Pain Centers have been fortunate over the years to work with some of the best spine surgeons in Los Angeles and have seen very favorable results.


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