Neck ache - Don't just ignore it

Neck ache - Don't just ignore it



IF you suffer from neck aches, don't ignore them or just stick on a medicated plaster and hope it works. Take note particularly if your arms start getting weak, numb or tingly. Of if you experience loss of bladder and bowel control. 'Weakness in the upper limbs indicates that there is actual nerve compression with damage to the nerve fibres. If left untreated, paralysis may occur and be permanent,' says James Tan Siah Heng, consultant spine neurosurgeon at Island Brain and Cervical Spine.

The neck (or cervical spine) consists of seven individual bones (vertebra) with a soft cushion (disc) between each of them. Muscles of your upper back and your shoulders are attached to these neck bones, he explains.

As one ages, wear and tear (looking down rather than straight ahead at your laptop for instance) is one of the causes that contribute to neck pain. Discs can protrude outwards (herniate) and bone spurs can grow on the neck as well, both conditions which cause compression of nerves. The neck is also prone to rheumatoid arthritis which usually results in instability and pain, says Dr Tan.

What are the treatment options? 'Treatment is always conservative first before resorting to surgery, such as the use of a collar for a few days to reduce motion, simple analgesia or the newer COX2 inhibitors, exercises, hot packs, and then modification of lifestyle and physiotherapy,' says Dr Tan, who's one of the first surgeons here to use facet and medial branch injections in the treatment of neck and back pain.

Surgical options are namely fusion, where the damaged disc is removed and bone is inserted between the vertebras to fuse the vertebras; arthroplasty (artificial disc replacement) is a newer approach; and laminoplasty is an operation on the neck from behind to lift up part of the bone to expand and decompress the spinal canal.

Another latest technique is nucleoplasty, where a small needle is inserted into the disc to 'burn' off part of the disc material. This is used to treat those who have disc disease causing neck pain but no nerve or spinal cord compression. 'Once degeneration starts, it is not reversible. If you take proper care, the degeneration can be slowed down and it may be years before any intervention may be needed. Proper posture is important in the way we sit, work and play,' concludes Dr Tan.

This story was first published in The Business Times on Jan 10, 2009.