General Management of Neck Pain
We have a path for managing neck pain that goes through steps to the next treatment. We start with things like physical therapy, and medicines that you can buy at your pharmacy. If that does not work then we start to look at prescription medications that are not opioids (narcotics). If that does not work then we start to look at opioid (narcotic) medications and injections.
Trigger Point Injections
We use these injections when your pain is mostly coming from the muscles or when there is a combination of pain from the muscle and the spine. A trigger point injection is a shot into muscles that have “knots” and are causing pain and less ability to move. We use numbing medicine and sometimes steroids. They help by breaking up the knots and allowing the muscle to rebuild. The work best in combination with stretching and massage.
Facet Injections
We use this when your pain is mostly in your neck, and you are not a candidate for a Radiofrequency Ablation. These injections go into the joints at the side of the spine that cause pain. You might see “facet arthropathy” on your MRI report and that means that there is arthritis at the facet joint. Putting some numbing medicine and steroid medicine in the joint can potentially relieve pain for 3-6 months.
Medial Branch Blocks
We use this to test which nerves are sending your pain, this is done when your pain is mostly in your neck. A medial branch block is when we put medicine along the nerves next to the spine that might be causing the pain. This is a test that can tell us if these are the nerves that are causing your pain. If your pain is relieved after two different tests then we can schedule your for a Radio-frequency Ablation
Radiofrequency Ablation
We do this if you had an 80% decrease in your pain after testing with medial branch blocks and your pain is mostly in your neck and not really going down your arms. A Radiofrequency Ablation or RFA is a procedure in which we apply energy to the top layer of a nerve that sends pain signals. This energy makes it so the nerve stops sending the pain signals and your pain levels go down. This can help for 6 months to a year. Before we do an RFA we would do testing (see above) to make sure that the nerve is the one causing the pain.
Cervical Epidural
We use this when you have pain in your neck that goes down your arms . An epidural injection is when we put numbing medicine and steroids at the epidural space. Which is the area right before the place where your spinal cord and spinal fluid are. This means that the medicine can cover the nerves as they are coming out and stop/decrease the amount of pain that you have.
