Cervical Spine Pain (Pain in the neck and arms) Just as the back is mostly a mixture of many causes of pain, so it is true with the neck. Arthritis, disc injury, herniation, facet arthritis are all co-mingled just as with the back. Attention to the lower cervical disc narrowing with surgery is occasionally fraught with failure to relieve pain though surgery in the neck is safer and more effective than in the low back. When the neck is injured in an extension/flexion injury such as whiplash, the maximum disc injury is to the lower cervical area where movement is maximum. For this reason, most neck surgery occurs between C5, C6 or C6-C7. The maximum ligament injury occurs much higher at the attachment of the skull to the first two vertebrae. Since the nerves supplying the skin and muscle are at a minimum in this area, symptoms tend to be neck surgery and head heaviness rather than numbness and pain at a distance.
More important, the spinal cord and base of the brain lose protection and cause symptoms more suggestive of other diseases such as Multiple Sclerosis or migraines. This syndrome called Barre-Lieou syndrome is rarely diagnosed today. It is not possible to correct these delicate ligaments as they are surgically inaccessible and fail to show on MRI.
Cervical Disc Disease can cause herniation with nerve root pressure. The symptoms include numbness and tingling of the forearm or part of the hand. This is true because three separate nerves supply the arm. Pain from a C4-C5 disc refers to the outside of the shoulder. C5-C6 affects the forearm and thumb. C6-C7 refers to the hand. These symptoms can be relieved with surgery, which is surprisingly simple. An incision is made over the front of the neck just above the collarbone. No serious structures are cut, rather they are moved aside. The vertebrae are separated with a special clamp and the disc is removed. Donor bone is taken from the iliac bone just below the boney prominence above the hip with a device like a cookie cutter and placed in the gap. The bones then grow solid. The patient complains more of hip than neck pain post op. The biggest complication of the surgery is that the fusion makes for a long segment of immobile bone that now throws the movement into the next disc causing it to deteriorate over years resulting in more surgery. Prolotherapy has the advantage that it stabilizes the weak disc without limiting its movement. The disc is still herniated but because the motion is more naturally, there is less swelling and arthritis and subsequently less nerve pressure.