Is this you?

Why it happens

The cervical spine carries the head through a wide range of movement, so its discs and facet joints wear early. Muscles of the neck and upper back tighten to protect a painful segment and become a second source of pain. Arm symptoms mean a nerve root is irritated; clumsiness of the hands or unsteadiness on walking means the spinal cord may be involved and needs urgent assessment.

How Dr. Kiruthika assesses it

Examination of movement, strength and reflexes first. Ultrasound for the muscles and for guiding injections; MRI when arm symptoms or cord signs are present. Diagnostic facet blocks when the joints are suspected.

Conditions treated

Cervical spondylosis

Age-related wear of the discs and joints of the neck. Stiffness, aching, and reduced turning. Most is managed with posture work, strengthening and medication; facet injections or radiofrequency for joint pain that persists.

Cervical disc prolapse with arm pain (cervical radiculopathy)

A disc presses on a nerve root, sending pain, tingling or weakness into the arm or hand. Most settle over weeks. A cervical epidural or selective nerve root block under X-ray guidance reduces nerve inflammation when symptoms are severe or slow to improve. Surgery is considered for progressive weakness or cord compression.

Cervical facet pain

Pain from the small joints at the back of the neck, worse on looking up or turning, often referring to the shoulder blade. Diagnostic medial branch blocks followed by radiofrequency ablation give durable relief.

Whiplash and neck strain

Muscle and ligament injury after a sudden jolt, often a road accident. Early movement and physiotherapy; facet or trigger point injections when pain persists beyond six to eight weeks.

Trapezius and myofascial pain

Tight, tender bands in the trapezius and neck muscles — trigger points — that refer pain to the head, shoulder or arm. Ultrasound-guided trigger point injections and a stretching programme.

Cervicogenic headache

Headache arising from the upper neck joints, felt at the back of the head and behind one eye, worse with neck movement. Blocks of the upper cervical facet joints or the third occipital nerve confirm the source; radiofrequency for lasting relief. [Also covered on the Headache page.]

Treatment options, least to most invasive

  1. Posture correction, strengthening and medication
  2. Ultrasound-guided trigger point injections
  3. Cervical facet joint injection or medial branch block
  4. Cervical epidural or selective nerve root block under X-ray guidance for arm pain
  5. Radiofrequency ablation for confirmed facet pain
  6. Surgery — for spinal cord compression or progressive weakness. Referred directly.

On the day

Fifteen to thirty minutes, local anaesthesia, day-care. Neck procedures are done with X-ray or ultrasound guidance throughout. Home the same day.

Red flags

Seek urgent medical attention today if you have loss of bladder or bowel control, numbness in the area you sit on, weakness that is getting worse, fever with the pain, a recent fall or major injury, or unexplained weight loss. These are not conditions for an outpatient injection.

Also seek urgent assessment for clumsiness of the hands or unsteadiness on walking.

Questions patients ask

Is my neck pain from my phone?

Sustained forward head posture loads the lower cervical joints and the trapezius. It is a common contributor; it is rarely the only cause after six weeks.

Can neck injections cause paralysis?

Injections are done under image guidance by a trained pain physician precisely to avoid the spinal cord and vessels. Serious complications are very rare.

How long does radiofrequency last?

Typically six to twelve months, sometimes longer. The nerve regrows and the procedure can be repeated.

Will I need a collar?

No. Prolonged collar use weakens the neck. Early, guided movement is the rule.

When is neck surgery necessary?

Progressive arm weakness, hand clumsiness, or gait change — signs of cord or severe root compression.