Cervical radiculopathy
A nerve root in the neck is irritated or compressed, so the pain, pins and needles or weakness is felt down the arm rather than only in the neck. Often settles without surgery.
Read about radiculopathy ›Conditions of the neck and cervical spine
Most neck problems are not dangerous and settle with time. A few are worth acting on early. This page explains the common cervical spine conditions in plain language, starting with how they actually feel, so you can work out where your own symptoms fit and when a specialist opinion is worth seeking.
Most settle
The large majority of neck pain improves with time, movement and simple treatment, and never needs surgery.
The exception
Pressure on the spinal cord is the one pattern worth acting on early. The signs are on this page.
Symptoms first
Every condition below leads with how it feels, not just its clinical name.
One region
This site covers the cervical spine, the seven vertebrae of the neck.
START WITH HOW IT FEELS
Find the pattern that sounds like yours
Patients rarely arrive with a diagnosis. They arrive with a feeling. Start from the description that fits, and read what usually causes it and what tends to help.
Cervical myelopathy
Pressure on the spinal cord itself, not just a nerve. The signs can be subtle at first. This is the one pattern on this page worth acting on early rather than watching.
Read about myelopathy ›Cervical disc herniation
Part of a disc bulges beyond its normal edge and presses on nearby structures. Discs do not actually slip. Many herniations shrink back on their own over months.
Read about disc herniation ›Neck pain
The broad, common one. Most neck pain has no sinister cause and eases within weeks. This covers what helps, and the handful of signs that mean it is worth getting checked.
Read about neck pain ›Cervical spondylosis
Age-related change in the discs and joints of the neck. Extremely common on imaging, and most people who have it will never need treatment for it. What the report really means.
Read about spondylosis ›Cervical spinal stenosis
The spinal canal narrows and the space around the cord shrinks. Often silent, but it is what can turn a minor problem into myelopathy, so it is worth understanding.
Read about stenosis ›HOW THESE ARE TREATED
Surgery is the last rung, not the first
For almost every condition above, treatment climbs a ladder. Most people get better long before the top of it. An operation is only considered when the rungs below have not worked, or when the cord is at risk.
FIRST
Time and movement
Many cervical problems, including a lot of nerve pain, improve on their own over weeks to a few months. Staying gently active usually beats resting.
NEXT
Physiotherapy and medication
Targeted physiotherapy, anti-inflammatory or nerve-pain medication and good pain control carry most patients through without anything more.
SOMETIMES
Targeted injections
A carefully placed injection can settle a specific inflamed nerve or joint, and can help confirm exactly where the problem is coming from.
ONLY IF NEEDED
Surgery
Considered when symptoms are severe or not improving, or when the spinal cord is being compressed. The operations are explained here.
Not sure where you sit on this ladder? That is exactly what a consultation is for. Non-surgical treatment and whether you need surgery at all are covered separately.
WHEN TO ACT SOONER
The signs not to sit on
Most neck symptoms can safely be watched for a while. These cannot. They suggest the spinal cord or a nerve is under real pressure, and they are worth a prompt opinion rather than a wait-and-see.
1
Hands becoming clumsy
Dropping things, fumbling buttons, keys or coins, or handwriting getting worse, especially if both hands are affected.
2
Unsteadiness on your feet
Feeling less balanced walking, or as though your legs are not quite doing what you ask, without another obvious cause.
3
Weakness that is getting worse
Progressive weakness in an arm or hand, rather than pain alone, particularly if it is worsening week to week.
4
Changes below the neck
New numbness spreading in the legs, or any change in bladder or bowel control, needs urgent assessment, not a website.
If it is sudden or severe
Sudden weakness, rapidly worsening coordination, or loss of bladder or bowel control can signal serious cord compression. Do not wait for an appointment: call 000 or go to your nearest emergency department. GPs with an urgent concern can phone the rooms directly on (07) 3870 3708.
WHY IT MATTERS WHO YOU SEE
The same scan can mean different things
A finding is not always the cause
Bulging discs and wear show up on the scans of plenty of people with no symptoms at all. The skill is matching what the images show to what you actually feel, and knowing which finding explains your problem and which is just noise.
Why the cervical spine is different ›The neck has less margin for error
The spinal cord runs through the middle of the cervical spine, and there is little spare room around it. That is why the cervical spine is often treated as its own area within spine surgery.
About Dr Tollesson ›Dr Tollesson is a fully qualified neurosurgeon whose practice covers brain and spinal surgery for adults and children through Brain and Spine Surgery Queensland. This site covers the cervical spine side of it.
Found the pattern that fits, or still not sure? Both are a good reason to get it looked at.
A consultation will tell you what is actually causing your symptoms, whether it needs treatment, and what the options are. You will need a referral from your GP or another specialist for a Medicare rebate.