According to a recent presentation by Dr. Thomas Puschak, a spine surgeon with Panorama Orthopedics & Spine Center in metro Denver, 90 percent of patients with neck pain don’t require surgery.
That’s good news! It’s also good news that surgical options are available for the remaining 10 percent of patients who do need it.
So when do patients know it’s time to start considering surgery?
“Typically, if there’s no neurologic or motor deficit, we’d like to see a good six- or eight-week span to see that this isn’t something that is going to pass relatively quickly with some simple non-operative treatment,” Dr. Puschak said. “Certainly, if somebody has significant weakness, that is something that could kick us up to a more aggressive route.”
In cases of spinal cord dysfunction where there is a neurologic or motor deficit, Dr. Puschak said that holding off on surgery might not be an option.
“We would move toward something surgical quicker because waiting on that could lead to permanent problems that could become nonreversible,” he said. “In worst-case scenarios, spinal cord dysfunction can lead up to paralysis.”
The vast majority of patients over time are able to achieve pain relief through some combination of medication, injections and manual therapies such as physical therapy. However, patients must work with their doctors to achieve the best results for their individual circumstances.
“Nerve pain can be quite intense. And it varies, it’s different for every person,” Dr. Puschak said. “Sometimes it can be annoying and a nuisance, sometimes it can be debilitating. You may have a normal motor exam, but your pain is so out of control that you can’t do things on a daily basis. The concept of going through all of those other things for six or eight weeks might not be realistic for someone.”