ROBERT MCLAIN, M.D. - NECK AND BACK SURGERY

BAck Pain? Neck Pain? Ask Dr. McLain  

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9/5/2022

Five Not-so-Obvious signs You’ve got a Neck Problem:

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Not-so-obvious signs you’ve got a Neck Problem

​If you’ve woken up with a painful stiff neck after a hard day’s work or a slip and fall, you know it’s not hard to figure out where the problem is coming from. Fortunately, most episodes of acute neck pain are muscle-related and will get better with time, stretching, and some anti-inflammatory medications.  You’ll usually be feeling better before you can even get around to seeing a specialist.
Symptoms of more serious cervical disease may not be so obvious: Here are five symptoms you might not even recognize as coming from your’ neck, that suggest you may need to see a spine doctor sooner rather than later!   

Charcoal drawing of hands threading a needle (McLain 2013)
1  Numbness and tingling in the hand or arm – often confused with carpal tunnel syndrome.  Numbness, tingling or weakness in one hand or the other may be caused by a nerve being pinched in the arm or in the neck.  Sometimes misdiagnosed as neuropathy, if symptoms occurs in one arm and not the other, and if they persist or progress, this needs to be checked out!
2 Frequent headaches – usually at the end of a long day, and localized to the base or back of the skull.   Headaches are very common, usually benign, and not given much consideration unless they become frequent or are associated with other neurological problems. Muscular tension caused by cervical disc disease can be a cause of recurrent headaches as well as neck pain.
3 Pain in the thoracic spine – right down between the shoulder blades.  This often confuses patients and doctors alike, because the pain and tenderness are focal to the thoracic spine, between the shoulder blades.  This is where the muscles that support your neck (the shoulder girdle) tie in to the spine, and this is often a spot where neck muscle irritation or strain is felt.
4 Loss of balance and difficulty walking a straight line – “I walk like a drunken sailor”. When we lose our fine sensory feed-back from feet and hands, we lose our sense of where our feet are in space.  Without that fine neural feed-back we tend to stagger about, particularly in the dark when we don’t have our normal visual cues to help us navigate. This is called ataxia, and it’s often the first noticeable symptom of spinal cord compression.
5 Difficulty buttoning buttons – loss of manual dexterity. Even before numbness or pain becomes noticeable, some patients see a change in their hand-writing or their manual dexterity.  In one Japanese grading scale of spinal cord function, patients are graded by skill using chop-sticks.  If you’ve been using chop sticks all your life, and you suddenly start having trouble handling them – you need to find out what the problem is.  It could be arthritis in the hands, and it could be carpal tunnel syndrome, but if it’s not one of those it’s time to examine the cervical spine.  The same goes for handwriting and normal daily activities. 
Fortunately, the question of whether your neck plays a role in these symptoms can usually be settled with a directed physical exam and a set of plain x-rays, things your family doctor or physician’s assistant can accomplish easily. If there’s still concern after that, an MRI will most often establish the diagnosis and tell us whether this is something that can be managed simply, or whether there needs to be a discussion about surgery.
And, that’s where I come in!
Thanks
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    I'm Dr. Rob McLain. I've been taking care of back and neck pain patients for more than 30 years.  I'm a spine surgeon.  But one of my most important jobs is...
    answering questions!

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Robert F. McLain, M.D. 
Spine Surgery Cleveland
For appointment or questions, Please call: 800 670-0302
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  • Spine Surgery Cleveland Home
  • About My Practice
    • About Dr. McLain
    • My Research Background
  • Surgical Care Available
    • My Colleagues
    • Surgery at our Surgery Center
    • Disc Replacement Surgery
    • SI Joint Pain
    • Laser Spine Surgery
  • Insurance
  • Contact Us
  • Library
    • Robert McLain, MD, AAOS
    • North American Spine Society
    • American Academy of Orthopaedic Surgery Patient Information
    • MidAmerica Orthopaedic Association
    • American Orthopaedic Association
    • Disclaimer
  • Back Pain? Neck Pain? Ask Dr. McLain