Dr. Ashish Kumar Shrivastav
New Delhi: Pain is the commonest medical complaint and one in the neck troubles quite a few of us. No wonder, the idiom, “Pain in the neck”!
While there can be a myriad reasons for the neck to cause trouble, by far the commonest would be the so called cervical- the term cervical actually refers to the neck region in medical terminology and does not mean any illness.
What is meant is cervical spondylosis a fancy term for normal wear and tear of the spine in the neck (or cervical) region. This includes age related degenerative changes in the spines bones and joints and the shock absorbers in between the bones called discs. Each and every one of us will suffer these changes to varying degrees and a minority will require treatment.
It becomes important when it affects the bunch of nerves from the brain travelling through this part of the spine to supply the body parts. Once these are affected, pain may become agonizing and neurological deficits in the form of weakness, numbness, and incoordination may follow. Definitive treatment then is mandatory to prevent irreversible damage.
The bright side is that the vast majority will need only some care and exercises for the cervical (and the rest of the) spine. However, about a fifth will need some surgical intervention primarily for the nerve related problems.
Cervical spine surgery for this problem, in principle, involves removing the pressure off the big bunch of nerves (the spinal cord) or the individual nerves, with or without some metal insertion for stabilising the bony structures. Nowadays we are able to even replace the cervical disc by artificial implants.
These surgical procedures, performed under image guidance and by microscopic techniques, in the present context are elegant, safe, effective and of proven benefit. Fewer days spent in the hospital, and rapid convalescence gets the patient going faster. If required and advised by your neurosurgeon, do not be scared by the mere mention of surgery.
Investigation by MRI is well nigh essential for diagnosis the nerves cannot be seen on a plain X-Ray image. And please do not start physiotherapy on your own neck pain has other more dangerous causes, which can worsen by this approach.
In fact, if not operated in time when indicated, can and will lead to neurological deficits.
While medicines and physiotherapy can reduce pain, they cannot relieve the nerve under pressure.
The natural wear and tear of the body is not being helped by the stresses and strains of twenty first century lifestyle. Simple precautionary steps while driving, working long hours on the computer will delay and reduce the severity if not completely stop this ailment.
(The writer is Neurosurgeon, Brain Tumour, Spine, Epilepsy, Bear Cyber Knife Surgeon,Dharmshila Narayana Superspeciality Hospital, New Delhi)