Neck pain is probably the second commonest pain after low back pain seen in a Pain Management Clinic; roughly 1 in 6 people could have neck pain. The neck supports the weight of the head and brain and all the vital communications from the brain to the rest of the body is carried by nerves passing the neck. The neck has a complex arrangement around the spine with nerves, ligaments, muscles, tendons as well as the blood supply to the brain. Additionally, the neck is very mobile to enable us to turn our head to all directions. Neck pains can severely impact on sleep, mobility, headaches and reduced quality of life.
Most people’s neck pain settle down in a few days and is usually due to poor posture, (excessive use of computers and mobile phones is a common cause these days) or sleeping in an awkward position or after an episode of cough or sneezing or during contact sports. Most people would find it very uncomfortable if the pain is not settling down after a few days. In these instances it is advisable to discuss with the GP to rule out any significant underlying conditions. Pain can be referred to the neck from the shoulder, upper chest-wall or even the head.
Degenerative disease of spine
Disc prolapse/ Herniated discs
Neck pains can vary from dull ache and stiffness to sharp pain radiating down the arm (similar to sciatica in the leg) with numbness and tingling; it can be associated with headache and pain between the shoulder blades. Some people will get dizziness, vertigo and is never comfortable in one position. Most neck pains on investigating will have normal scan results other than age-related degenerative changes. Severe neck pain following trauma with weakness in the arms and/or hands or associated with infection and fever or chest pains should be investigated without delay by seeking urgent medical attention.
Neck pain can be debilitating and any pain lasting for more than three months, it should be reviewed by your doctor. If referred to the Pain Consultant, they will carry out a history and clinical examination and if required, will arrange for suitable investigations. A clinical diagnosis would be arrived and then various treatment options would be discussed with you and the most suitable treatment plan would be offered.
Each injection can have different side-effects. Please refer to appropriate injections information leaflet in the section of treatments.
In situations where the pain is disabling severe and not allowing you to do the day-to-day chores, medications have proven inadequate to reduce the pain; injections are targeted to be given either under x-ray guidance or ultrasound guidance at the presumed sources of pain. Injections mainly consist of local anaesthetic with or without steroid. This works as anti-inflammatory at the source of pain.
Injections are not a permanent cure. Injections help by reducing the intensity of pain. The aim is to reduce pain and break the cycle of pain, allow you to carry out rigourous physiotherapy and help and healing. We may have to repeat injections in order to achieve the goals.
There are other injections available when nerves can be ablated (burnt) or we can apply what is called a radio-frequency lesioning at lower temperatures. These treatments have intermediate to long-term benefits and also work to reduce inflammation. These can be offered if the initial injection does not last long enough to follow on with strengthening Physiotherapy. These injections are not operations or permanent treatments. They are used to improve your condition of pain in order for you to carry out rehabilitative strengthening physiotherapy and come out of the vicious cycle of pain.
We can offer you Non-injection interventions such as acupuncture. We can introduce you to other means of self management of pain such as using a TENS machine . We have a modalities to offer at our clinic for example Medical yoga therapy, deep electrical muscle stimulation, TENS treatment. If the pain is unbearable, not responding to medications, or you do not want to try the non-invasive modalities ; we could offer you injection therapies.
You will have a detailed consultation, examination and then be given information and advice about your condition. We may also organise investigations. We may be able to prescribe you medication and give you details about how to manage pain and other interventional options can be discussed.
You will be reviewed only by MACS clinic senior Pain Consultants for your condition.
If your pain is very severe, not responding to over-the-counter painkillers you should contact your GP and get an appointment for review. If you are in severe disabling pain, unable to carry out any routine tasks, you could book an emergency appointment with your GP or go to the local A&E for a review.
Most acute pain problems settle down following some analgesics and benzodiazepines for muscle relaxation and improving sleep. Additionally, use of cold and heat packs, TENS machine, physiotherapy and neck strengthening exercises would help alleviate the symptoms.
Chronic neck pain needs proper assessment by a Pain Consultan for achieving meaningful pain relief and functional restoration. Your Consultant would reassure you about your condition and recommend the best course of action. A multi-modal multi-disciplinary approach is required based on the condition as well as the patient preference. Most therapies involve physical therapy and to achieve the best results, good analgesia needs to be ensured.
TYPES OF TREATMENT
Free video/face to face consultation
with consultant plastic surgeon
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