What it is
Neck pain can come from muscle strain, degenerative changes in the cervical discs and joints, or compression of nerves and — less commonly but more seriously — the spinal cord itself. Distinguishing simple mechanical neck pain from nerve or cord involvement is the central job of the evaluation.
Common symptoms
- Stiffness or aching in the neck, shoulders, or upper back
- Pain radiating into the shoulder blade or down the arm
- Numbness or tingling in the hands or fingers
- Headaches originating at the base of the skull
- Warning signs: hand clumsiness, balance trouble, or weakness — these deserve prompt evaluation
Why it happens
Most neck pain is mechanical — strain and age-related change in the discs and facet joints. When a disc herniates or bone spurs narrow the nerve exits, arm symptoms (cervical radiculopathy) can follow. If the spinal canal itself narrows and compresses the cord, cervical myelopathy can develop, affecting hand coordination and balance — a condition where timing matters.
How Dr. Pompliano evaluates it
Every evaluation starts with listening — a detailed history of your symptoms, how they behave, and how they limit your life — followed by a focused physical and neurological examination and a careful review of your imaging. The diagnosis drives the plan, not the other way around.
Treatment: conservative first
Most patients with this condition improve without surgery. Depending on your specific situation, a plan may include:
- Physical therapy: posture, strengthening, and mobility work targeted at the cervical spine and shoulder girdle
- Activity & ergonomic adjustments: workstation, sleep position, and habit changes that reduce daily strain
- Medication: short, purposeful courses of anti-inflammatories when appropriate
- Injections: epidural or selective nerve root injections when a specific nerve is implicated
Surgery is recommended only when symptoms persist despite a genuine course of conservative care, or when there are signs of progressive nerve or spinal cord compromise.
When surgery makes sense
Surgery is considered for persistent nerve compression that fails conservative care, progressive weakness, or cervical myelopathy. Options range from ACDF to motion-sparing artificial disc replacement — a particular focus of Dr. Pompliano's practice — matched to your anatomy and goals.
Related procedures: ACDF · Cervical Disc Replacement · Posterior Decompression