Neck Pain and Arm Pain

The conditions can be related but are distinct. Neck pain is so common it is almost normal. The incidence generally increases with age, as does the degenerative process. Just as the skin on a face changes with age, the x-ray appearance of a neck alters with age. This condition is called “cervical spondylosis”. Cervical spondylosis can exist and the patient is entirely unaware – in other words, it can be painless.

Generally, degeneration of the discs and facet joints can cause neck pain but when a disc or related tissue compresses a nerve, arm pain ensues. Pain in the arm due to nerve compression in the neck is called “brachalgia” and is analogous to “sciatica” which is pain in the leg due to nerve compression in the lower back.

Neck pain is generally harmless even though the pain can be severe. Usually it is characterized by fluctuating symptoms. Treatment is therefore supportive with painkillers and anti-inflammatory medication. Increasing doses or changes in medication are prescribed by the General Practitioner until the symptoms are controlled and natural resolution can then occur. If symptoms persist for more than 6 weeks, more serious causes need to be ruled out by x-rays and blood tests. A scan may be necessary at this stage. If an abnormality is identified, your GP will then refer you to an appropriate specialist.

Brachalgia (arm pain due to nerve compression in the neck) can be accompanied by a sensation of pins and needles or numbness. Weakness of the muscles may arise. If there is significant deterioration or persistent severe pain, a specialist opinion should be sought and an MRI scan should be obtained. A CT scan may also be helpful. These tests will usually identify the cause of the pain.

Treatment of neck pain:

  • Medication
  • Physiotherapy
  • Surgery is not necessary unless more serious disease is identified.

Treatment of brachalgia:

  • Initial period of rest
  • Medication
  • If pain is severe or neurological deterioration occurs, surgery may be indicated.

Cervical Spinal Cord Compression:

This serious condition can be caused by injuries, such as diving into a shallow pool or car accidents. More often, cord compression occurs silently due to age related degeneration. This causes a condition called cervical spondylytic myelopathy and is characterized by the patient developing clumsiness of the hands and difficulty walking.

MRI scan showing a serious problem at C4/5 and C5/6 with compression of the spinal cord
Fig. 04: MRI scan showing a serious problem at C4/5 and C5/6 with compression of the spinal cord. The patient had developed signs of cervical myelopathy. This patient required surgery.
X-ray after surgery
Fig. 05: This X-ray shows the situation after surgery to release the spinal cord by removing the discs causing the compression.

We specialise in assessment and diagnosis of spinal complaints with appropriate conservative treatment, planning surgery only when all other options have been exhausted.