Neck Pain and Neck Surgery

Neck pain can make everything harder: sleeping, driving, working at a computer, even turning your head to look over your shoulder. When the pain spreads into your shoulder or arm, or your hands start to feel numb or clumsy, it’s natural to worry about what’s going on.

The good news is that most causes of neck pain can be found and treated. Dr. Betsy Grunch, a board-certified, Duke-trained neurosurgeon, has spent more than 13 years helping adults with neck problems, from pinched nerves to spinal cord compression. This guide explains the most common causes, the warning signs to watch for, and the treatment options available, including motion-preserving disc replacement.

Most neck problems come from changes in the discs, joints and bones of the cervical spine, the seven bones in your neck. These are the conditions Dr. Grunch treats most often:

• Cervical spondylosis: everyday wear and tear in the discs and joints of the neck. It’s very common with age and is often the root cause of other neck problems.
• Herniated disc: the soft center of a disc pushes out and presses on a nerve or the spinal cord.
• Cervical radiculopathy (pinched nerve): a squeezed nerve root that causes pain, numbness, tingling or weakness down the arm and into the hand.
• Spinal stenosis: narrowing of the spinal canal that leaves less room for the spinal cord and nerves.
• Cervical myelopathy: pressure on the spinal cord itself. It can cause clumsy hands, trouble with buttons or handwriting, and balance problems.
• OPLL: a ligament inside the spinal canal slowly turns to bone and presses on the spinal cord.
• Whiplash: neck injury from a sudden back-and-forth motion, often in a car accident.
• Chronic neck pain: neck pain that lasts longer than three months.

Many people with neck pain start with their primary care doctor or physical therapy. It’s time to see a spine surgeon if you have:

• Pain, numbness or tingling that travels into your shoulder, arm or hand
• Arm or hand weakness, such as dropping things or a weaker grip
• Clumsy hands, trouble with buttons, or changes in your handwriting
• Balance problems or feeling unsteady when you walk
• Pain that keeps you up at night or keeps getting worse
• Neck pain after a fall or car accident
• An MRI that shows a herniated disc, stenosis or spinal cord compression

Call 911 or go to the nearest emergency room if you have sudden weakness in your arms or legs, trouble walking, or new loss of bladder or bowel control.

Treatment starts with an exam and a careful look at your imaging. Many patients begin with physical therapy, medicine or injections, and Dr. Grunch will talk with you about what makes sense for you. When symptoms keep coming back, get worse, or affect your strength or the spinal cord, surgery can often correct the problem.

Dr. Grunch performs the full range of neck surgery:

• Anterior cervical discectomy and fusion (ACDF): removes a damaged disc through a small incision in the front of the neck and joins the bones together. It is one of the most successful operations in spine surgery.
• Cervical artificial disc replacement: removes the damaged disc and replaces it with a motion-preserving implant, so the neck keeps moving at that level.
• Cervical discectomy: removes a herniated disc that is pressing on a nerve or the spinal cord.
• Foraminotomy: widens the opening where a nerve leaves the spine, without a fusion.
• Cervical laminectomy and laminoplasty: make more room for the spinal cord when several levels are narrowed.
• Posterior cervical fusion: stabilizes the neck from the back to protect the spinal cord.

Many patients go home the same day after ACDF or disc replacement, and some stay one night in the hospital.

• Duke-trained and board-certified by the American Board of Neurological Surgery, and a Fellow of the AANS, ACS and CNS
• Experience: more than 5,000 procedures, with 400 to 600 surgeries a year
• Motion-preserving options: cervical artificial disc replacement for carefully selected patients who want to avoid a fusion
• Minimally invasive techniques whenever they are a safe choice
• Second opinions: Dr. Grunch often sees patients who were told they need neck surgery, or who still have pain after surgery somewhere else
• Close to home: offices in Gainesville, Sandy Springs and Riverdale

Learn more about Dr. Grunch’s training and credentials.

Is neck pain serious?

Most neck pain comes from strained muscles or wear and tear and improves with time and treatment. Neck pain becomes more serious when it comes with arm pain, numbness, weakness, clumsy hands or balance problems, because those can mean a pinched nerve or pressure on the spinal cord. Those symptoms deserve an exam by a spine specialist.

When should I see a surgeon for neck pain?

See a spine surgeon if your pain travels into your arm, if you have numbness or weakness, if your hands feel clumsy, or if pain keeps coming back despite physical therapy or other treatment. You should also be seen if an MRI shows a herniated disc, stenosis or spinal cord compression.

Do I need surgery for a pinched nerve in my neck?

Not always right away. Many pinched nerves are first treated with physical therapy, medicine or injections. If pain, numbness or weakness continues or gets worse, surgery such as ACDF or disc replacement can often correct the problem.

What is the difference between a neck fusion and a disc replacement?

Both remove the damaged disc to take pressure off the nerves or spinal cord. A fusion joins the two bones so they heal as one, while a disc replacement uses a moving implant so the neck keeps its natural motion at that level. Dr. Grunch will explain which option fits your spine and your goals.

How long is recovery from neck surgery?

Many patients go home the same day after ACDF or cervical disc replacement, and some stay one night. Most people can drive once they are off narcotic pain medicine, and return to work depends on the kind of job you have. Dr. Grunch or one of her physician assistants will give you a recovery plan for your surgery.

If neck pain, arm pain or numbness is getting in the way of your life, Dr. Grunch can help you understand what’s causing it and what your options are. Call 470-293-9800 or contact us to schedule a visit at our Gainesville, Sandy Springs or South Atlanta (Riverdale) office. You can also ask general questions any time through our “Ask Us Anything” chat.

Related: All neck conditions · All neck procedures · Lower back pain and back surgery · Pinched nerves and sciatica · Choosing a spine surgeon

This information is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. Please talk to your provider about your symptoms.