Neck Pain (Cervical Spine)

Degenerative disk disease occurs when the cushioning in your spine begins to wear away. After age 40, most people experience some spinal degeneration. But the condition doesn’t always cause symptoms. When it does, neck and back pain can be intense. The right treatment can lead to pain relief and increased mobility.

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Board Certified

Neurosurgeon

15+ Years

Experience

5000+

Procedures Performed

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What Is Neck Pain (Cervical Spine)?

The cervical spine runs from the base of the skull to the top of the thoracic region with seven vertebrae (C1–C7) that support the head, protect the spinal cord, and allow a wide range of motion. That mobility comes at a cost: the cervical spine is highly susceptible to both acute injury and age-related degeneration.

Neck pain becomes a specialist concern when it radiates, when it's accompanied by neurological symptoms (numbness, tingling, or weakness), or when it persists beyond 6 weeks without improvement. The source disc, nerve root, facet joint, or cord determines the treatment path.

30 Minutes

Same Day Procedure

General Anesthesia

2-6 Weeks Recovery

Common Types of Neck Pain Conditions

Cervical Herniated Disc

Also called "cervical disc prolapse" or "slipped disc."

The soft inner material of a cervical disc pushes through its outer wall and compresses a nearby nerve root or the spinal cord. Herniated discs at C5–C6 and C6–C7 are most common. Symptoms depend on which nerve root is affected — typically pain, numbness, or weakness following a specific arm or hand pattern.
Nerve root compression (radiculopathy) Can resolve with conservative care

Cervical Spinal Stenosis

Also called "cervical canal narrowing"

Narrowing of the spinal canal in the cervical region, typically due to bone spurs, thickened ligaments, or disc bulging. When severe, it compresses the spinal cord itself (myelopathy) rather than just a nerve root. Myelopathy is progressive and often requires surgical decompression before it becomes irreversible.
Cord compression risk May require surgery, age-related

Cervical Radiculopathy

Also called "pinched nerve in the neck"

Compression or irritation of a nerve root as it exits the cervical spine. Produces a distinct pattern of pain, numbness, or weakness in the shoulder, arm, or hand corresponding to the affected nerve level. The most common levels are C6 (thumb/index finger) and C7 (middle finger). Often responds to non-surgical treatment, but injection therapy or surgery is needed when symptoms are severe or persistent.

Cervicogenic Headaches

Also called "neck-related headaches"

Headaches that originate in the cervical spine rather than the brain. Caused by irritation of the upper cervical joints (C1–C3) or occipital nerves. Distinguished from migraines by their unilateral neck-to-head pattern and aggravation with neck movement. Often misdiagnosed. Respond well to targeted cervical injections or radiofrequency ablation of the medial branch nerves.

Cervical Degenerative Disc Disease

Also called "cervical spondylosis" and "cervical DDD."

Age-related wear of the cervical discs — loss of disc height, reduced water content, and eventual bone spur formation. Not all degeneration is symptomatic, but when it is, it typically causes axial neck pain and stiffness and can progress to nerve or cord compression. Treatment targets the source of pain, not the radiological finding.
Degenerative facet and disc origin: progressive

Neck Muscle Strain / Whiplash

Also called "cervical sprain" or "acceleration-deceleration injury"

Injury to the muscles, ligaments, or tendons of the cervical spine — most commonly from motor vehicle accidents. Whiplash is a mechanism of injury, not a diagnosis. Symptoms include neck pain, stiffness, and sometimes headache or arm symptoms if nerve structures are involved. Most cases resolve with conservative management; persistent symptoms warrant imaging to rule out structural damage.

Common symptoms

Radiating arm pain

Pain, burning, or aching that travels from the neck into the shoulder, arm, or hand

Numbness or tingling

Often in specific fingers or hand areas, a sign of nerve root involvement

Muscle weakness

Grip weakness or difficulty raising the arm indicates significant nerve compression

Limited range of motion

Stiffness or pain with turning, tilting, or extending the head

Headaches

Pain originating at the base of the skull and radiating forward cervicogenic in origin

Balance or gait problems

Unsteadiness or clumsiness may indicate cervical myelopathy cord compression

How we diagnose cervical spine conditions

Diagnosis starts with a detailed clinical exam and history. Imaging confirms what the exam suggests. We don't treat MRI findings; we treat patients.

Clinical examination

Neurological testing—reflexes, strength, sensation, Spurling's test to localize the level and identify nerve involvement

MRI (cervical spine)

Primary imaging for soft tissue disc, nerve roots, cord compression, and ligament integrity

CT scan

Better detail on bone foraminal narrowing, bone spurs, and surgical planning

EMG / Nerve conduction

Measures nerve function confirms radiculopathy vs. peripheral nerve issue

Diagnostic injection

Image-guided injection to a specific joint or nerve root confirms the pain generator before committing to a procedure

X-ray (flexion/extension)

Identifies instability, alignment issues, or disc height loss not visible on standard films

Seek urgent evaluation for these symptoms

Progressive arm or hand weakness

Difficulty with fine motor tasks (buttoning, writing)

Neck pain after trauma

Loss of coordination or balance

Bowel or bladder dysfunction

Bilateral arm symptoms

Treatment Options

We follow a structured, stepwise approach starting with the least invasive option that addresses the specific diagnosis. Surgery is offered when conservative measures have failed, symptoms are severe, or neurological function is at risk.

Non-surgical

Cervical epidural steroid injection

Targeted injection to reduce inflammation around compressed nerve roots

Cervical facet joint injection

Diagnosis and treatment for facet-mediated neck pain

Radiofrequency ablation (RFA)

Long-term relief for cervical facet pain and cervicogenic headaches disables the pain signal at the nerve level

Physical therapy / cervical traction

Supervised rehab to restore function and reduce mechanical load on the spine

Surgical

ACDF (anterior cervical discectomy and fusion)

Removal of the damaged disc through the front of the neck, followed by fusion of adjacent vertebrae. Gold standard for cervical radiculopathy and myelopathy.

Cervical disc replacement (arthroplasty)

Replaces the disc with a motion-preserving implant instead of fusion preserves neck flexibility and reduces adjacent segment stress

Posterior cervical decompression

Laminectomy or laminoplasty from the back of the neck used for multi-level stenosis or myelopathy

Neck pain with arm symptoms needs a diagnosis, not a massage.

We'll identify the source and give you a clear treatment plan, surgical or not.

Request Appointment

(571) 399 6340

What to expect week by week

Recovery varies, but here's how most patients progress.

Same Day

Go home. Rest.

Procedure done. Mild soreness at the injection site is normal. Skip driving — you'll need a ride.

24–48 Hours

Soreness fades.

Site soreness clears in a day or two. Some patients notice early pain improvement starting here.

1 Week

You should feel a difference.

Most patients see a meaningful reduction in neck and arm pain as the steroid reaches full effect.

Weeks–Months

Continued improvement.

Relief can last weeks to months. A second injection or PT can extend it further if needed.

Expert Spine Surgeon

Dr. Avery L. Buchholz is a board-certified neurosurgeon with fellowship training in complex spine surgery. With over 15 years of experience and 5,000+ procedures performed, he specializes in both minimally invasive and complex surgical techniques.

His expertise spans the full spectrum of spine care, from non-surgical interventions to advanced reconstructive procedures, always prioritizing patient safety and optimal outcomes.

Download the CV

About Dr. Buchholz

Frequently Asked Questions

Get answers to common questions about our practice and procedures

What makes neck pain different from a simple stiff neck?

When pain involves the arms, hands, or head, it usually points to a structural cause. Structural problems need structural solutions, not just rest.

What does the cervical spine do?

It runs from the skull to the upper back, supporting the head and protecting the spinal cord. Its wide range of motion makes it prone to both injury and age-related wear.

When does neck pain need a specialist?

When it radiates into the arm or hand, comes with numbness, tingling, or weakness, or lasts more than 6 weeks. The exact source, disc, nerve, joint, or cord determines treatment.

What symptoms point to nerve involvement?

Radiating arm pain, numbness or tingling in specific fingers, and muscle weakness are key signs. Limited range of motion and headaches can also be related.

Can neck problems cause headaches or balance issues?

Yes, some headaches originate in the neck itself, and unsteadiness or clumsiness can signal spinal cord compression. Both warrant evaluation.

How is neck pain diagnosed?

With a clinical exam (reflexes, strength, sensation) plus imaging like MRI, CT, or X-ray as needed. Diagnostic injections can confirm the exact source before treatment.

What conditions does Capital Spine and Pain Institute treat?

We treat herniated discs, sciatica, spine trauma, degenerative spine conditions, complex spine disorders, scoliosis, cervicogenic headaches, and carpal tunnel syndrome. We also treat neck, mid back, and lower back pain..

When is neck pain a medical emergency?

Progressive arm or hand weakness, loss of coordination, or bowel/bladder dysfunction needs urgent care. Neck pain after trauma or symptoms in both arms also warrant same-day evaluation.