Do you have chronic neck pain? Is a surgical consultation the next step? The neck can be injured in many ways. In the event of a traumatic accident or injury, emergency surgery may be necessary to stabilize a life threatening situation or to prevent paralysis. But what about the patient with chronic neck pain? The patient who lives day to day on pain medications or has frequented the chiropractor and physical therapist for years? Is surgery the only next step? What are the causes of chronic neck pain? Chronic neck pain usually centers around the nerves. A disc in the neck can become herniated or "bulge" because of the wear and tear of the tendons, ligaments, and muscles. One possible diagnosis out of many may be spondylolisthesis.
When the ligaments and tendons become weakened, the vertebrae can move out of place. This may cause pressure on the disc and in turn irritate a spinal nerve. Sometimes a pinched nerve occurs when the nerve becomes trapped between the vertebrae. What about disc degeneration? As we age the discs can also degenerate, wear out, get weak, flatten out, and lose the flexibility they need to act as shock absorbers. Sometimes in an attempt to stabilize the weakened area of the neck, bone spurs will form (osteoarthritis) to "hold things in place." It is at this point "conservative treatments" for alleviating the pain of the neck area are used. This can begin with a steady diet of anti-inflammatory medications to ease the nerve pain. Cortisone may be injected to reduce inflammation and swelling.
Chiropractics is often tried to push the vertebrae back into place and usually it does, but the vertebrae will slip back because of loose ligaments that chiropractors can cause, and the pain cycle starts again. As pain increases, the surgical consultation is considered. To prevent pain, either bone is chipped away from the nerves (laminectomy) or fusion to prevent the vertebrae from slipping out of place is recommended. Fusion Surgery Fusion surgery is of course a complicated surgery, metal and/or bone is attached to the vertebrae and "fused" together to prevent the vertebrae from moving and cause distress on the nerves. Fusion surgery has its draw backs. First, even if successful, the fusion will limit the patient's mobility in the neck region.
Second, the fusion can cause a "different pain," because new stress is placed on the non-fused area above and below the fusion. Third, new pain can be caused by the damage of the surgery to connective and supportive tissue, ie ligaments and tendons already in a weakened state. As a former surgeon in training, I believe that surgery should always be the last option (unless an emergency situation), especially when there are treatments such as Prolotherapy available that can ease the patient's pain, permanently. Prolotherapy Prolotherapy causes inflammation by irritation. How can this possibly be beneficial? Because the inflammation is controlled to those select areas of ligaments and tendons damaged by wear and tear and whose weakness causes bones to slip out of place. Is this effective for disc degeneration?
Disc degeneration is a diagnosis typically given when reading an MRI or x-ray. The problem is that the image on the film of a suspect disc or discs may not be a true picture of what is causing the pain. Degenerative disc disease may only be incidental to the real cause of the neck pain - ligament and tendon weakness. The big kicker is that many patients have disc "disease" and have no pain at all. By injection an irritant into the neck, Prolotherapy strengthens the ligaments and tendons and restores their natural state of elasticity and resiliency and helps keep the vertebrae where they belong.
Does Prolotherapy work for everyone? Studies have shown Prolotherapy to effectively reduce pain in 90% of patients studied. Its benefits are minimal side-effects, a much safer and less invasive procedure than surgery, and rare down time for recovery. It is also much cheaper than surgery without the need for rehab or time off from work. Are you a candidate for Prolotherapy? Finding the right doctor is the first step. If you're interested in seeing if you're a candidate for Prolotherapy, visit Dr. Marc Darrow.
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