Countless Americans live with neck pain with research showing that 27 out of every 1,000 people experience neck pain that prevents them from turning their heads, nodding, or even resting comfortably. Many cases of neck pain go undiagnosed, even though they persist for several weeks or months.
Patients who seek help for neck pain may receive injections as part of their treatment plan. These injections can alleviate discomfort, allowing patients to focus on physical therapy exercises that restore their range of motion.
As a leading spinal neurosurgeon, researcher, principal investigator for artificial disc clinical trials, and founder of Lanman Spinal Neurosurgery and the Advanced Disc Replacement Spinal Restoration Center, I treat patients with neck pain every day. My biggest regret is that my patients didn’t seek treatment sooner before their discomfort reached unbearable levels. Here is the information I pass on to patients about neck injections for back pain so they know why some are recommended as part of their treatment plans.
Before you can explore the best injections for neck pain, it helps to have a deeper understanding of how the cervical spine works and where your discomfort comes from.
The spine is made of 33 vertebrae that run from your skull to your tailbone. The top seven vertebrae that run from your head to your upper back are known as your cervical spine. Each vertebra is protected by intervertebral discs that work as shock absorbers and prevent the bones from wearing down against each other. The vertebrae are also connected by facet joints.
Each of these elements (the vertebrae, the spinal discs, and the facet joints) plays a collective role in supporting your head and protecting your spinal cord, the latter of which sends information through your nerves to and from your brain. Your ability to navigate the world around you is a result of the support your spine provides to your neck.
However, the complex nature of the cervical spine also allows for multiple opportunities for pain. Not only could you experience problems with your intervertebral discs, but you could also develop pain as a result of damage to your muscles, tendons, ligaments, and other soft tissue. Any neck discomfort will make it difficult to move around comfortably, to the point where the pain can interfere with your day-to-day life. This is why diagnosing neck pain can be a challenge, and why it’s critical to work with a leading spinal neurosurgeon who can accurately determine the source of the issue as well as put together a plan to help.
Neck pain can feel different depending on the cause of the issue. You may feel a dull, persistent throbbing that doesn’t go away or sharp stabs that shoot through your arms. You also may develop symptoms like numbness or tingling, stiffness, or a loss of motion. Your doctor will ask about your specific symptoms to come to a clear diagnosis. Here are a few common causes of neck pain:
Along with asking about your symptoms, your doctor will also ask about your lifestyle factors to identify the potential cause of neck pain. They want to know if they are dealing with a sports injury or long-term strain from office work.
Once your doctor has a diagnosis and understands the source of your neck pain, they can develop a treatment plan. Many doctors start with pain and inflammation medications while advising the patient to refrain from activities that cause their neck pain. They may also recommend physical therapy exercises to support range of motion. However, sometimes the body needs more to heal. This is when your doctor may turn to injections.
If your neck pain is serious enough that it requires injections, you may benefit from meeting with a spinal surgeon. They can evaluate your cervical spine and confirm that injections are the best course of treatment. They also may recommend additional support options that can make you more comfortable.
Here are a few commonly recommended injections and why spinal surgeons recommend them.
Epidural steroid injections (ESIs) are used to treat inflammation in the cervical spine. These injections are designed to provide pain relief so the patient can work on their physical therapy exercises and the neck can heal. ESIs can either be steroids or corticosteroids and are injected directly into the neck.
The name epidural stems from the epidural space around your spinal cord. This is a sleeve that surrounds your spine and is made of fat, nerves, and connective tissue. The injection covers the nerves in the epidural space and numbs them, giving them space to heal. This also relieves your discomfort.
ESIs may be recommended to patients who have herniated discs, degenerative disc disease, osteoarthritis, or spinal stenosis. They can treat symptoms like pain, numbness, weakness, and tingling.
If your doctor identifies the facet joints as the main source of your pain, they may recommend facet joint injections. These are either anesthetics or corticosteroids that can reduce joint pain or inflammation. Facet joint injections can be done in a doctor’s office in only a few minutes.
Your doctor may recommend facet joint injections if you have osteoarthritis or rheumatoid arthritis, along with spondylolisthesis or scoliosis. These injections should reduce inflammation and provide pain relief so your facet joints can heal.
An Alpha 2 Macroglobulin (A2M) injection uses a human plasma protein to support regeneration. It is a way to boost healing in areas that are struggling to recover from trauma and other injuries. Not only do A2M injections have anti-inflammatory properties, but they also use naturally found proteins to support recovery. Some patients say they feel less pain within a few hours of the A2M injections.
These injections may be recommended for osteoarthritis, joint injuries, spinal injuries, sciatica, herniated discs, and degenerative disc disease. Injection-based treatments that are part of early intervention can prevent the body from degenerating further, causing even more pain. This is why getting a neck pain diagnosis early is important – early detection and intervention increase your chances of a full recovery.
Corticosteroids are used to treat inflammation and reduce discomfort in your neck. They are different from anabolic steroids that are used to increase muscle mass. If your doctor recommends steroid injections, they are most likely using corticosteroids. This also applies to ESIs.
The steroids will be injected near the source of the pain to target nerves in that area. You may need to rest after the injection to give the medication time to work. During this time, your body will start to heal. Your doctor may recommend light exercises you can do to support the healing process and protect your range of motion.
The reduced pain and inflammation from steroid injections can last for several weeks and even months. You may only need a single injection to start the healing process or you may need multiple to fully recover.
One of the benefits of seeking treatment from an experienced spinal surgeon is that you don’t have to be a medical expert if you develop neck pain. Your doctor should carefully identify the source of your discomfort and decide on the best treatment options. This may include injections if they think starting a course of steroids or A2Ms is the right call.
Your doctor will evaluate several criteria before recommending injections. These criteria will also determine which injections have the highest chances of success. They will evaluate the severity of pain, any underlying conditions you may have, and previous treatments that you attempted. Even if you are a good candidate for injections, your doctor may recommend other treatments first to see how your body responds. They may also recommend treatments on top of injections to support healing.
Recovery is a journey. Working with a doctor you trust can help you explore different options and find the best treatments that work for you.
There are several different sources of neck pain, but also multiple treatment options to address it. From physical therapy exercises to heat therapy and anti-inflammatory injections, an experienced spinal health professional can create a treatment plan specific to your needs. They will try to reduce your pain levels while maintaining your mobility and range of motion.
If you live with neck pain, take steps to seek treatment. The sooner you receive a diagnosis, the sooner your doctor can start you on a treatment plan. Take the first steps by requesting a consultation with Dr. Todd H. Lanman, an award-winning spinal neurosurgeon. Dr. Lanman is committed to helping patients determine the best approach for their specific conditions and following their healing journies. Contact Dr. Lanman today and envision a future without neck pain.
Steroid injections in the neck are considered safe, especially when administered by an experienced medical professional. They can respond quickly if you show any unwanted side effects to the injections. These injections are also outpatient procedures that only take a few minutes.
The longevity of the injections depends on the type of medication and the patient. Some people experience relief for a few weeks following the injection while others enjoy reduced pain and inflammation for several months. The goal of these injections is to support the neck so it can heal.
Your doctor should provide aftercare guidelines for neck injections, but the most important thing to do is rest. Do not exercise, lift heavy objects, or put a strain on your neck. You may be able to start light, low-impact workouts within a few days following the injections.
A cortisone shot is designed to reduce inflammation so the body can heal. Nerve blockers prevent the body from sending pain signals to the brain. Nerve blockers can provide immediate pain relief while cortisone shots provide long-term pain relief. Your doctor may recommend one or both injection types depending on your diagnosis.
Success rates vary depending on the cause of the pain and the type of injection. However, 57% of patients report reduced pain levels because of nerve blockers. This is considered a high success rate compared to similar neck pain treatments.
Every patient is different so the best pain reliever for one person will not be ideal for another. However, most treatment plans build a mixture of anti-inflammatory treatments (like medication, injections, or cold therapy) with pain reduction care. Reducing both pain and inflammation will make patients more comfortable.
You can’t immediately cure a stiff neck. However, you can treat your discomfort with pain and anti-inflammatory medication, heat and cold therapy, and even gentle massages. If your pain persists, talk to a doctor to discuss more in-depth treatment options.
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