Chronic neck pain can be caused by a variety of conditions such as muscle spasms, trauma, deformity, osteoarthritis, inflammatory conditions, spondylosis, stenosis, or pinched nerves. That’s why it’s important to see a doctor who can diagnose the source of your pain and symptoms and help you feel better. Duke spine specialists diligently work to provide the greatest relief with the least-invasive interventions. Together, you and your doctor can create a treatment plan that fits your goals and lifestyle.
About Neck Pain
Neck pain is often caused by problems in the top part (called the cervical region) of your spine. Acute pain comes on suddenly and usually heals on its own within days or weeks. Chronic pain lingers for months and can be constant or intermittent.
Many cases of neck pain are minor. However, you should seek immediate medical care if your pain is caused by an injury or is accompanied by any of the following symptoms:
- Severe headaches
- Tingling or numbness in the arms or legs
- Shooting arm pain
- Loss of bladder or bowel control
- Loss of balance or frequent falls
- Weakness or difficulty using your hands
Duke Health offers locations throughout the Triangle. Find one near you.
Conservative options are very effective in treating neck pain. Surgery may be a last resort if these solutions don’t provide the relief you need.
A trained physical therapist guides you in exercises and stretches designed to strengthen your neck, improve your balance and flexibility, and improve range of motion -- all benefits that can alleviate your symptoms. Your therapist may suggest cervical traction, which stretches your neck to reduce compression.
Medications include over-the-counter and prescription anti-inflammatory drugs, muscle relaxers, steroids, nerve-pain medicines, and more. Our doctors balance medication recommendations with risks of side effects, dependency, or other unwanted reactions.
Epidural steroid injections treat inflammation and pain right at the source -- your pinched spinal cord or nerve roots. Using X-ray imaging to guide them, doctors numb your skin and place a needle into the epidural space in your spine. You’ll feel pressure during this. The medicine usually begins working within a few days to a week. You’ll be able to return to normal activities the following day. We give these injections in a special, sterile fluoroscopy suite.
A TENS (transcutaneous electrical nerve stimulator) unit can be used in your doctor’s office or at home. A portable version is small enough to hold in your hand. When you are experiencing pain, you place reusable electrodes on your neck and attach them with wires to the TENS device. Then you turn on the device to deliver mild electricity (it should not hurt) through your skin for 15 to 30 minutes. This stimulates your nerves and stops pain receptors in the brain.
In some cases, including trauma and fractures or instability of the spine, your doctors may recommend wearing a rigid or semi-rigid neck brace for a short time. This stabilizes your spine, allowing it to heal and helping prevent additional injury.
A skilled chiropractor manipulates or adjusts your spine and other joints, reducing pain and improving function. Treatment may also include soft-tissue therapies and exercises.
Acupuncture uses fine needles placed strategically in the skin to relieve pain. We offer this treatment as a complement to your regular treatment plan, not as a substitute.
Massage manipulates muscles to relax them, ease tension, and improve blood flow and circulation.
By taking pictures of bones and joints in your neck, X-rays can help identify fractures, dislocations, bone spurs, instability, or other potential causes of pain. X-rays take about 15 minutes and are virtually painless.
MRI (Magnetic Resonance Imaging)
Magnet waves create the most detailed images of your spine, including your discs, spinal bones, spinal cord, and nerves. Images can help identify disc damage or pressure on your spinal cord or spinal nerves. This test takes about 30 to 60 minutes and is virtually painless.
CT (Computed Tomography)
A series of cross-sectional pictures produce detailed, 3-D images of your spine bones. This test takes about 10 minutes and is virtually painless.
Electrodes are inserted directly into muscle with a thin needle to record electrical activity. You will feel some discomfort. EMG, which can last from 30 to 90 minutes, measures how well muscles and nerves are working in a certain area of your body -- in this case, your neck and arms.
Rarely, neck stiffness or pain can be a symptom of an infection or another serious condition like meningitis. Blood tests can help identify these.
To confirm whether pain is coming from a specific area in your neck, doctors inject numbing medication into that spot. If the pain improves, doctors know more about the source of your pain.
Where you receive your care matters. Duke University Hospital’s nationally ranked orthopaedics, neurology, and neurosurgery programs were named best in North Carolina by U.S. News & World Report for 2019–2020.
Why Choose Duke
Team of Specialists
Our team includes physiatrists (physical medicine and rehabilitation doctors) who specialize in conservative spine care, orthopaedic and neurosurgery experts, physical therapists, pain management specialists, psychologists, a massage therapist, an acupuncturist, a chiropractor, and others. We work together to ensure you receive comprehensive, thorough care.
Safe, Effective Results
Our surgeons are motivated to constantly improve, so they pay close attention to outcomes and always strive to do better. As members of many national and international groups such as the North American Spine Society and the Cervical Spine Research Society, our spine surgeons stay up-to-date on the latest technologies and advances in treating your spinal injury or condition. This results in safer, more effective procedures and fewer complications.
We’re always looking for ways to advance spine care treatment. In addition to ongoing clinical trials, we also collect information about outcomes that we use for quality improvement.