If you’re having pain in your neck, shoulder, or arm—or if you’ve experienced progressive numbness, tingling, or loss of coordination in your hands—these may be signs of an issue involving your cervical spine.
Your neck, or cervical spine, includes the vertebrae that support your head and connect to your upper back. Your cervical vertebrae (C1 through C7) protect your spinal cord and the nerve roots that branch off of it, as well as the vertebral arteries that carry blood to your brain. Your cervical spine supports the weight of your head—no mean feat since the average head weighs 10 to 12 pounds—so it’s strong by necessity, but also quite flexible.
The most common cervical spine issues fall into two main categories. The first is spinal compression, where you may experience numbness, tingling, weakness, or loss of fine motor coordination in your hands. The second is a pinched nerve root (more formally called nerve impingement). This frequently results in pain, most often near your shoulder blades or radiating down your arm.
“If you’re diagnosed with spinal cord compression, and you have numbness and tingling in your hands or poor fine motor movement, then surgery is probably the best course of treatment,” said Goodman Campbell Brain and Spine neurosurgeon, Dr. Eric Potts.
It’s important to note that cervical degenerative spine problems can be complex, involving more than one disease process. According to Dr. Potts, the care taken in the diagnosis and testing phase of treatment helps to identify these cases well ahead of surgery.
“There are more complex cases, but we almost always know that ahead of time. What I like to do is talk to the patient, review all the imaging studies, come up with our diagnosis, and then treat that diagnosis.”
For some complex cases involving removal of tumors or the fusion of long sections of the spine, a technological assist can be helpful. “A device from Medtronic, called the O-arm, allows us to perform intraoperative image-guided surgery to make sure we do everything very accurately,” Potts said. “That’s been a part of our cervical and lumbar practice for around 20 years, and we’re experts at using that technology in treating all kinds of spinal conditions.”
Nerve impingement issues, on the other hand, often respond well to conservative, non-surgical treatments, according to Dr. Eric Potts.
“In general, neck pain is not well treated with surgery; it’s better treated with conservative treatment,” Potts said. “With pressure on a nerve or a nerve root impingement, we’re more likely to try pain medicine, oral steroids, epidural steroid injections, or selected nerve root injections. Physical therapy or traction may also help. And with these options, there’s about a 50% chance that you’ll get better without needing surgery.”
Dr. Potts states “It is always better to be evaluated. Many people dismiss their symptoms as ‘It’s just me getting old’ or ‘it’s just my arthritis,’ and it’s not until things get worse that they end up going to a neurosurgeon. So if you can’t fasten your buttons or pick up small objects, have it checked out sooner rather than later.”