P the poor neck a part of the body that's often f for less than positive idioms such as I'm not going to stick my neck out or I am up to my neck in bills I'm going to break your neck like having a ner on my neck it's my neck on the line and everybody's favorite pain in the neck have you ever woken up with a stiff neck and wondered if it's something more serious or maybe you've experienced chronic pain that just won't go away no matter what today we are going to highlight the symptoms discuss the treatments and answer any questions you may have on ask the dock send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the askthe do page on our website allhealth tv.com welcome to ask the dock the show where we encourage our viewers to send in their health questions I'm Dr gorgi branik a minimally invasive spine surgeon and today we're going to be talking about various causes of neck pain such as herniated discs spinal stenosis and osteoarthritis as well as explore the symptoms diagnostic method Surgical and non-surgical treatment options available to alleviate neck pain and improve your quality of life let's kick things off with a question from Aaron reached out to us on our very own website allhealth tv.com hi Dr branik my grandmother's neck has really been bothering her lately so she went to her primary care physician he diagnosed her with cervical spondy losis and suggested that she go to an orthopedic surgeon my question is what is cervical spendal losis and how is it diagnosed Aaron you're good grandson and I'm really glad that you asked that question question so cervical spilos is sort of a term that encompasses uh all degeneration of the cervical spine here you can see a nice biodigital of the bones of the cervical spine starting from C1 and C2 which kind of inserts into C1 and then the bones that more frequently develop spilos so if you rotate to the back of the neck you see these joints that two of each are between each level so cervical arthritis or spendal losis may involve these joints as you develop arthritis or degeneration and then discs are in front of the spine and dis degeneration can also be described as C cervical spilos unfortunately this diagnosis doesn't really tell me a lot of information it just tells me that there is degeneration and it would be important to really piece together what parts of the spine have degenerated and what are the symptoms so the common symptoms that perhaps your grandma may have are neck stiffness pain behind the jaw facial tingling then we're talking about things related to c56 pain involving the upper shoulder blade that can also be c56 versus the lower part of the shoulder blade somewhere where the Brad line would cross horizontally would be C 6 7 pain that's right in the middle versus Pain off midline makes a difference too so it'd be important to seek care from an orthopedic surgeon so you can examine your grandmother perform some exam Maneuvers to see if it makes her pain better if it makes it worse and then you would know exactly where the pain is coming from and then you would say that Her diagnosis would be more than just cervical spindalis you would say exactly what the problem is this dis or this particular joint I hope this helps our next question comes to us from Sandy who reached out to us on our Instagram page Sandy asks Dr B my husband was recently diagnosed with cervical herniated diss which necessitates surgery we're both terrified especially of surgery centered on the neck the orthopedic surgeon performing the surgery doesn't have a great bads side manner we've seen you on TV we both like you so would you mind telling us what are the risks and benefits of cervical spine surgery syny thank you for reaching out I'd be happy to explain what the surgery entails as well as to allay your fears um if your surgeon doesn't have badside manner I would get a second opinion first and foremost because surgery is like a marriage and you really want to make sure that after the surgery this person is still going to be there for you to walk you through the whole process so if you already see that there may be an issue with badside manner I would urge you to consider getting a second opinion now here is an interesting biodigital of cervical spinal Anatomy you can see that the sternomastoid muscle which begins right around your sternum and your clavicle ascends all the way to the back of the jaw hence development of some jaw pain in patients with a c56 disc problem when the neck is extended and flexed you can see that there is a lot of motion that is seen by the middle of your of your neck so the joints that bind the bones are involved as well as the Diss and all of the above can cause symptoms now the risks of surgery are many the surgery has become safer with time especially now that we've we've learned to do it in a mini invasive fashion but there are both short-term midterm and long-term risks of surgery of course paralysis is always a a problem or a risk with neck surgery but these days you rarely hear about a person being paralyzed by cervical spine surgery bleeding can be an issue which can cause a hematoma or blood collection in the neck and that can be a problem as well that's why I'm always weary about surgical uh interventions in a neck performed in a Surgical Center as opposed to a hospital with a good uh ability to save someone who is in trouble there are midterm and long-term complications fusion surgery is associated with problems above and below the surgical site so patients may come in after six months or even after 10 years and say that their neck pain has come perhaps at a different spot and finally another complication for which patients often come to see me is where the surgery failed to attempt it to to achieve its goal and patient continues to be be in pain and that can be due to graft migration or Hardware failure I would really encourage you to seek a second opinion and find a doctor who you feel like you can truly relate to somebody who doesn't have a problem with badside Manner and asking all the hard questions about risks our next question comes from Stephen Steph just reached out to us on our YouTube page and his question for me is dronic my neck's been giving me problems lately I've been taking a leave and it's helped but the pain comes back after the meds wear off a Budd of mine who is a chiropractor said it could be a herniated disc I've tried to self diagnose online but there are way too many potential disorders my question is how can I differentiate between neck pain caused by a herniated disc and other types of neck pain hi Stephen it's funny how many patients try and diagnose themselves at home nowadays there are a lot of websites that provide you sort of an allinclusive list of diagnosis which can scare the beeses out of anyone so it's important to mention diagnostic modalities I love an MRI that is a study where you lay inside a tube and pictures are taken of your neck that show both bones and soft tissues and nerves so an MRI would be an essential modality x-rays are a bit outdated but they can also provide you some very useful information CAT scan is just for bones so if you've already had a procedure involving either a dis replacement or a fusion then a CAT scan may be indicated now there's no substitute for a medical for a physical exam performed by your doctor neck motion is assessed and then your doctor looks at all these other elements like weight loss like Associated findings this herniations in the neck are often associated with neck stiffness neck pain headaches especially in the back of the head Facial Pain shoulder blade pain so all the way down to your thoracic spine could still be a cervical problem and finally when a disc herniates and starts to irritate a nerve you start to feel pain all the way down to the arm which may include numbness in an end stages even weakness sometimes this pain takes your breath away but please don't take my opinion over the television set get an opinion from a physician who has the ability to examine you and look at all your personal criteria in case you missed it the first time here's another opportunity to find how to send us your questions send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the askthe do page on our website allhealth tv.com Francesca just sent us another question through through YouTube Franchesca question is hi doctor I have neck pain my arms are becoming occasionally numb my hands are clumsy and I'm losing balance but what worries me the most is when I look up at the sky or touch my chin to my chest it feels like an electric shock going down my back Francesca I'm sorry to hear that you're in pain and feeling all these unpleasant Sensations but I don't want you to worry what you're describing is common clumsy hands numb hands stiff neck can be associated with spinal cord compression I know that that sounds scary but spinal cord compression without trauma is a very slow process and is usually um not something that should prompt you to go to the emergency room although once you start feeling those electrical Sensations going up and down your spine when you bring your CH Chin Chin to your chest bring your head back that's called a lmid phenomen on it would be important for you to get an evaluation and I'm not saying that spinal cord compression isn't important it can be an emergency but I don't want you to hear me say this and necessarily say oh my God I'm going to be paralyzed a lot of times I hear this uh from patients and I just want to say to you that it's important to get an evaluation if you are having these symptoms uh sometimes spinal cord compression can be something temporary that will go away but often times it's something that does uh need to be addressed and it will be important for you to seek care from either neurosurgeon who is comfortable dealing with spinal cord compression or an orthopedic spine specialist another question from allhealth tv.com you should really check out this website when you get a chance it is chalk full of great information Matel asks hi Dr branik I went to my primary care physician last week because I hurt my neck playing Hoops he said it's probably not a big deal and that I should take some alive and take it easy for a while doctor I know my body and this doesn't feel like it's a muscular it's it's muscular in nature should I request an MRI cat skan or x-rays how important is Imaging in diagnosing neck problems Matel I love to hear you advocating for yourself never be afraid to get a second opinion and nobody knows your body better than you and MRI is my favorite study because it really shows you both the soft tissues as well as the Bony Anatomy it shows you nerves that may be compressed and it can really lead you to a diagnosis but don't be surprised if your MRI has many findings so it's important to seek a physician who can examine you who can really listen to the details of your story and then connect the MRI findings with what you are feeling but if you are feeling like this is not just a muscular problem then please get a second opinion don't hesitate thank you for for reaching out Matel this next video is from the Mayo Clinic and it checks out the details on medical imaging please take a [Music] look medicine has come a long way since its humble beginnings and one of the key factors in its story transformation has been the science of Medical Imaging Medical Imaging allows healthcare workers to see inside patients bodies using minimally invasive techniques and procedures and these procedures are essential in the identification and treatment of all sorts of medical conditions at Mayo Clinic school of health sciences we offer several Medical Imaging programs radiologic technologists are experts in performing x-rays to create images of specific body parts nuclear medicine technologists prepare small doses of radioactive drugs and capture images used to diagnose infections and disorders diagnostic medical sonographers use Imaging equipment that relies on sound waves to form images of many parts of the body also known as ultrasounds and MRI technologists who use magnetic resonance imaging techniques to create detailed images of organs and tissues in your body this YouTube question comes to us from Felicia Felicia asked asks hi Dr branik my neck is a pain in the you know what I've had a lot of pain dash of weakness in my arms and a pinch of numbness in my hands my doctor says I have cervical radiculopathy and wants to try some non-surgical treatment before pulling the trigger on surgery my question is this how effective are non-surgical treatments for cervical radiculopathy Felicia I love your personality and wi that's a great question let me show you a picture of the cervical spine and specifically I want to point out the area where the nerves exit your spinal canal now this is a very small Channel you can kind of see one right there and right there and right there and you can see that Canal that channel that little window is anchored both by the always Border both by The Joint in the back of the spine as well as the dis that's in the front now both arthritis of this joint and a herniation or degeneration of this dis can cause this tiny little space to become tight which would inevitably irritate one of your nerves now nerve pain goes in a direction of wherever that nerve travels so if it's the sixth nerve nerve you'll see pain going down all the way down your arm to these two fingers if it's the seventh nerve it'll be more triceps pain back of the forarm and these three fingers eight nerve goes to the whole back of the wrist so again it's important Felicia to really talk to your doc and understand which nerve is involved because there are a lot of mimickers of nerve compression as well nerve irritation about your elbow may cause pain that looks like eight nerve but is actually part of cubital tunnel carpel tunnel which is numbness of these three fingers may come from the wrist and that's something very common where patients will wake up in the morning and say they have to sort of shake out their hand because of numbness so it would be important to get a physical exam and proper Imaging however if you are having neck pain that's associated with both pain numbness and weakness going down your arm it is difficult to say without examining you and seeing your MRI whether you have a good chance of recovery without surgery or whether it's a good idea to take the pressure off the nerve and the reason is because nerve irritation which can occur just from a nerve being touched by a dis can also presents with intermittent pain numbness and weakness similar to where there is true nerve compression so it would be important to get to the real bottom of your problem and I would really encourage you to seek care from a caring and experience or to IC spine surgeon if you've got questions we've got answers please um in case you missed it uh first couple of times here's yet another chance to find out how you can submit your questions to the show send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the ask theoc page on our website allhealth tv.com we've got a Facebook question from Gregory coming to us Gregory asks hi doctor I was just told that I have arthritis in my neck is that even possible I always thought arthritis only happened in the hands I guess my question is this what role does arthritis play in the neck pain and how can it be managed Gregory I know this may sound crazy but you can get arthritis in any part of your body that moves arthritis involves the generation of the joint so whether it's your spine your neck your back your hands your elbows your ankles or your knees all of that can become arthritic now neck arthritis isn't necessarily a medical term and when we hear neck arthritis that may include both discs which function like joints as well as joints in the back of the spine don't rush into surgery first try different kinds of injections to see if that can alleviate your pain because in general arthritis isn't dangerous so if you have no pain but you do have arthritis it doesn't mean you have to have it corrected in fact there are a great number of studies that show that elderly patients with no pain may have significant arthritis on their Imaging so it's important to let your doc really try to connect your symptoms and the findings of arthritis on your Imaging here is one more question this time it's from our website allhealth tv.com from Blain Blain's question for me is hey Doc what are the potential complications of untreated cervical spine injuries Blain that's not a game you want to play this is a very important question so there are both early and late consequences of untreated cervical spine injuries the positive note is that most patients who have neck pain will present to the office saying that they had a history of a fall or they have a history of neck pain in the past history of neck injury in the past with a long period of time after that injury when they were painfree so I would tell you that the search for the original causation is usually pretty fruitless and if you had an injury a long time ago it may show up later as arthritis but this isn't the kind of an injury really we really worry about now that being said on the complete opposite side of that Spectrum are patients who have just undergone a motor vehicle accident and are laying their immobilized the firefighters will frequently put a collar around their neck and they're worried about paralysis so it's important at that point to not move your neck don't test it let a doctor examine you to make sure that you don't have something called paralysis where you squeeze the spinal cord and may potentially have a something that's uh unfixable such as uh uh loss of upper lower extremity function inability to walk something called quadruple number two spinal cord injury which is essentially what we just mentioned where the canal gets pinched off in trauma this may happen after a bad accident so again it's important not to move let the firefighers do their thing the paramedics let the paramedics do their thing take it to the hospital get an evaluation and make sure that it's nothing that may cause a problem now midterm longterm we worry about number three which is chronic pain it's possible that if you herniate a disc it will hurt a nerve and then you'll start having pain going down the arm pain can become numbness numbness can become weakness you don't have to live in pain so it's important to seek care if you've developed chronic pain after an accident four respiratory problems with spinal cord injury that is severe enough you may have difficulty breathing but don't forget that a minor fender bender where you impacted your ribs may also cause difficulties breathing so don't panic let the docks and the paramedics do that thing and once you have a diagnosis you can then address it but don't catastrophize most of the time respiratory problems after a neck injury if you're moving your arms you're moving your legs I'm not because of spinal injury number five bowel and bladder dysfunction this can also happen with spinal cord injury so please be aware of spinal cord precautions such as a collar or immobilization after a bad carreck or after a fall number six long term patients can develop muscle atrophy and contractures that's where joints become real stiff and they have a loss of function of their hands now this is usually a problem that takes years to develop some it can be reversed so if you having neck pain don't let it get to that point talk to your doc if there is pain in your neck or pain going down arms which signifies nerve pain number seven are blood clots which is an unfortunate s of paralysis since a lot of these patients are sort of stuck and bear unable to move and finally infections due to immobilization can happen uh with paralysis and that can be both infections of the respiratory system as well as infections uh from ulcers from not being able to move you can never have too many questions so please keep them up speaking of questions here's one more on Instagram and this is from Maya Dr banik my surgeon saw my MRI and said if I don't have surgery soon I will end up paralyzed he also told me that if I drive over a speed bump too fast I may never walk again now I'm afraid to leave my house my I really appreciate you're asking this question so many patients travel to see me after they've been scared into surgery some like even some well-known people like Azie Osborne or Tony Robbins talk about having surgery when their doctor discovered something that they never felt please get a second opinion if you've walked into the office your arms are functioning okay you are able to to to go about your day and then a doctor discovers something that nobody else has seen and says you have to have surgery 99 out of 100 times if you seek a second opinion you will find that you could avoid surgery or at least have a lesser operation like dis replacement always seek opinion if you feel like your surgeon is pushing you into surgery measure three times before you cut once it's very unlikely that if you wait at least a few weeks to get a second opinion that you will truly be paralyzed and a study out of Yale uh where they looked at patients who were in accidents who had pre-existing spinal cord conditions by Jonathan grow showed that there was not an increased res risk of paralysis please remember get a second opinion and again I really appreciate all of the questions I want to encourage all of you to continue sending in your questions if you in pain if you're wondering what to do next get a second opinion you don't have to live in pain welcome again to ask the doc hope to talk to you next time through your wonderful questions thank you again send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the askthe do page on our website allhealth tv.com