Hi Dr. Corenman
I’ve sent a few messages before. Thanks for your response. I’m now realizing that my neck pain is most def focused at the C3-4 level. It radiates down the neck into my shoulder, although the shoulder pain is not nearly as bad as the neck pain. I’ve been doing PT but it usually results in acute neck pain and having to take NSAIDs and a muscle relaxer to be able to sleep.
My question, is since the majority of this pain is focused in my neck, how common is it to perform surgery solely for neck pain. Thanks
Surgery for neck pain is possible. The level has to be quite degenerative or unstable and a diagnostic block has to yield significant relief. Two positive diagnostic blocks should be considered. The patient understands in this case, surgery (ACDF) can help but has an approximate success rate for relief of about 70%.
Neck pain is generated by motion of the segment. An ADR can work but at a much lower success rate (unless the segment is not too degenerative which would be an indication not to do surgery). If the pain was facet mediated, an ADR will increase pain as increased ROM will increase motion of the painful joint.
When you say diagnostic block, is that a facet block?
My physiatrist recommends an steroid epidural. Which should I be pursuing in your opinion? I do have some full pain going down my shoulder into upper arm