New England Spine Care

Cervical Spondylosis - Neck Pain

DEFINITION

DEFINITION

Spinal spondylosis means arthritis of the spine.  In the cervical spine, this is called cervical spondylosis.   Every two adjacent vertebrae will connect with pair of Facet joints.  There is one facet to the left of the center and one facet is to the right of the center at each segment of your spine.  When you bend and twist, your facet joint allows for that motion.  Approximately 15 to 20% of all back pain is related to the facet joint.  Either due to trauma or simple aging, the facet joints can become arthritic, and become painful.  As a result, you may develop neck pain, mid-back pain, and lower back pain.  Most individuals report worsening pain by twisting and turning the spine to the affected side or extending the spine such as looking up to the ceiling or arching her back.  Facet pain is often steady, and moderately painful and symptoms may fluctuate during the day and with changes in temperature or humidity.

In the neck, facet pain could create just neck pain (often one-sided), neck pain with headaches, or neck pain with pain in the shoulder blade area.  It is a moderately painful condition, that worsens with activities such as looking up or down, turning side to side or tilting your head. you may find computer work, or looking up to sealing (extension) painful. Tight muscles around the shoulder blade, pain that radiates to your shoulder area is common.

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WORKUP:

If your pain persists, further workups such as X-rays and MRIs will be indicated.  Procedural treatment can be helpful in treating the pain 

TREATMENTS

Neck pain from the facets is treated conservatively and not surgically.  Your doctor will combine physical therapy and medications such as Advil/Motrin for several weeks. In most cases, applying heat /Ice, soft tissue treatments such as massage and acupuncture, and in selected cases, chiropractic/osteopathic adjustments can be tried. 

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Physical Therapy for Stable Spondylosis (Arthritis)

Common exercises for cervical spine complaints include a range of motion restoration, stretching exercises, strengthening exercises, and stabilization programs.  Relaxation techniques, postural corrections, and workplace ergonomic advice will be incorporated in the program. During the course of physical therapy, the additional treatment offered can include ultrasound treatment, muscle stimulator, TENS unit application, manual treatments, massage treatments, and application of ice and heat. Once your pain is controlled, your range of motion is improved, and your strength is returning, you will be progressed to a final home program. Patients participate in physical therapy 2-3 times per week for a total of 10-12 times before being reevaluated by their physiatrist. 

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​Procedures: 

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Cervical Facet Injection:

Steroid injection into the facet joints will reduce the inflammation and pain and it may last for several months. It takes 10 minutes to perform and no sedation or anesthesia is needed for cervical facet injection 

Cervical RF ablation

another pain management procedure that is designed to create a miscommunication between the painful facet joint(s) and your brain. Your physician will ablate the nerve ending next to the facet joint that is painful. Before this procedure is performed, your doctor will numb those nerves to make sure it works, before committing to the ablation (numbing is done twice before ablation). This procedure takes 20 minutes, and results may last up to a year. 

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PRP Facet injection

Platelet Rich Plasma is a natural product from your blood. PRP injections are considered regenerative treatments. PRP contains growth factors that help "heal" an injured tissue or to treat a degenerating structure such as joints.  Arthritic or inflamed facet joints can be treated by PRP. When effective, you may only have to treat the facets once with prolonged effect. It takes 30 minutes to draw the block and perform the injection and no sedation is needed.  PRP preparation varies and it is very important to receive the highest concentration of platelets. Our practice utilizes a system that produces higher platelet concentrations in the current market.