When a sudden impact from a car accident, sports injury, or fall damages your spine, the immediate pain is often just the beginning of a much longer journey. What many people don’t realize is that spinal injuries can trigger a cascade of changes in your neck that lead to chronic pain lasting months, years, or even decades. The delicate structures of your cervical spine (neck area) including discs, ligaments, nerves, and muscles can suffer damage that does not always heal properly. This creates an environment of ongoing inflammation, nerve irritation, and mobility problems that significantly impact your quality of life.
Dr. Todd Lanman, a renowned spinal neurosurgeon with over 30 years of experience, has dedicated his career to understanding and treating the complex spinal conditions that cause persistent neck pain. Having personally undergone eleven spine surgeries himself, Dr. Lanman brings both professional expertise and personal insight to help patients who struggle with chronic neck pain following spinal injuries. His innovative approaches, including artificial disc replacement and groundbreaking restorative motion surgery techniques, offer hope for patients whose spinal injuries have evolved into long-term pain conditions.
Understanding the Spinal Structure
The cervical spine is a complex structure that forms the uppermost portion of your spinal column (i.e., the neck). The cervical spine includes the seven vertebrae (spinal bones), five intervertebral discs, eight pairs of spinal nerves, and an extensive network of muscles, tendons, and ligaments. The vertebrae are the seven bony building blocks (C1 through C7) that form the structural framework of your neck, providing protection for the spinal cord while supporting the weight of your head. The five intervertebral discs act as shock-absorbing cushions positioned between the cervical vertebrae, allowing your neck to flex and rotate smoothly while preventing the bones from grinding against each other during movement. The eight pairs of spinal nerves (C1 through C8) exit through small openings between the vertebrae and control muscle movement in your neck, shoulders, arms, and hands while also providing sensation to these areas. The extensive network of muscles includes major groups like the trapezius, sternocleidomastoid, and deep cervical flexors that power neck movement, support proper posture, and provide dynamic stability during daily activities. The tendons connect these muscles to the bones, transmitting the force needed for neck movement and positioning. The ligaments are tough, fibrous bands that connect bone to bone throughout the cervical spine, with major ones like the anterior and posterior longitudinal ligaments, ligamentum flavum, and nuchal ligament working together to maintain spinal stability and control the range of motion within safe limits.
The cervical spine is unique because it must balance two seemingly contradictory demands: it needs to be strong enough to support your head (which weighs 10-13 pounds) while remaining flexible enough to allow your neck to move in all directions – forward, backward, side to side, and in rotation. Each component of the cervical spine plays a critical role in maintaining proper neck function and movement. The vertebrae provide the structural framework and protect the delicate spinal cord that runs through the center of each bone. The intervertebral discs make up about 40% of the cervical spine’s height and enable your neck’s remarkable range of motion. The facet joints (connections between the back portions of adjacent vertebrae) determine what type of movement is possible, allowing for the neck’s ability to flex, extend, rotate, and bend laterally. Meanwhile, the complex system of ligaments including the anterior and posterior longitudinal ligaments, ligamentum flavum, and the nuchal ligament work together to maintain spinal stability and prevent excessive movement that could damage the spinal cord. The surrounding muscles provide the power for movement while also acting as dynamic stabilizers, and the eight cervical nerve pairs ensure proper communication between your brain and the rest of your upper body.
Common Spinal Injuries That Cause Neck Pain
- Whiplash: Occurs when a sudden jolt or impact forces your neck to snap forward and backward rapidly, stretching or tearing the soft tissues including discs, muscles, ligaments, and tendons in your cervical spine. This injury commonly results from car accidents, falls, or sports activities and can cause neck pain ranging from mild to severe, along with stiffness, reduced range of motion, headaches, and sometimes radiating pain down into the shoulders and arms.
- Herniated Discs: Happens when the gel-like center of an intervertebral disc pushes through a crack in the outer wall, potentially pressing against nearby spinal nerves. Depending on which cervical level is affected, a herniated disc can cause weakness in specific muscle groups. For example, biceps weakness with numbness, tingling, and pain that radiates down the arm into the hand and fingers may indicate a problem at C5-C6.
- Spinal Stenosis: Develops when the spinal canal narrows due to bone degeneration, thickened ligaments, or bone spurs. These compress the spinal cord and nerve roots. This condition often presents as severe neck pain with stiffness that can be triggered by simple activities like sneezing or tipping the head back. Spinal stenosis may cause headaches that are sometimes misdiagnosed as migraines.
- Osteoarthritis: Osteoarthritis of the spine is a degenerative joint disease that occurs when the protective cartilage in the facet joints and discs between vertebrae wears down over time. This causes the bones to rub against each other, resulting in pain, stiffness, and reduced flexibility. Symptoms include pain that worsens with activity, morning stiffness, and sometimes weakness or numbness in the arms if bone spurs compress spinal nerves.
- Fractures: Fractures in the cervical vertebrae typically result from trauma. They cause significant localized neck pain, stiffness, visible swelling, and decreased range of motion. More severe fractures can create spinal instability and/or compress nerves in the arms and legs, which causes weakness and numbness. Some upper cervical injuries may even affect breathing control.
The Development of Chronic Neck Pain
Chronic neck pain usually starts with an injury but becomes long-lasting due to a mix of physical and emotional factors. What begins as temporary inflammation and nerve changes can turn into ongoing issues if your body’s healing process gets stuck. Over time, the way you move to protect your neck can actually make things worse.
Inflammation and Healing
After a neck injury, your body naturally releases inflammatory chemicals to heal damaged tissues. But in chronic pain, these chemicals (like IL-1β and TNFα) stay active too long—studies show IL-1β levels can be nearly 85% higher than normal in people with persistent neck pain. This constant low-level “fire” in your neck can interfere with healing, leading to stiff scar tissue and less flexibility in discs and ligaments.
Nerve Involvement
When nerves in your neck become pinched or compressed, they can cause a special kind of pain called neuropathic pain, which happens because the nerves are irritated and inflamed. About 28% of people with pinched nerves in the neck (a condition called cervical radiculopathy) experience burning or electric shock-like pain that may travel down the arm. Over time, if the nerve stays compressed, your body can become more sensitive to pain signals, and studies show that nearly 37% of people with a herniated disc in the neck have changes in how they feel and process pain.
Muscle Imbalances
Neck pain often makes your body tense up certain muscles to protect the area, leading to stiffness. For example, the upper trapezius can become almost 40% stiffer in people with chronic neck pain. At the same time, the deeper muscles that help support your neck may become weaker and even shrink. This imbalance means your neck is less stable and can make everyday movements like turning your head more painful.
Psychological Factors
Stress and depression amplify pain perception by altering central nervous system processing. Chronic neck pain patients have a 68.4% prevalence of anxiety and 55.7% prevalence of depression. Depressed mood triples the risk of developing chronic neck pain. Psychological distress also prolongs muscle tension, creating a feedback loop that worsens physical symptoms.
Symptoms of Chronic Neck Pain
Chronic neck pain is often described as a persistent ache that does not go away. It can sometimes feel stabbing, burning, or sensitive to even mild touch. Many people experience pain that radiates from the neck into the shoulders, arms, or even hands. This is often due to irritated or compressed nerves. Headaches are also a common symptom, especially when the pain is connected to problems in the upper part of the neck or to tension in the surrounding muscles. People with chronic neck pain frequently notice their neck feels stiff or that it is harder to turn, tilt, or move their head as freely. Muscle tightness and tension are typical; the muscles around the neck tend to stay contracted in response to ongoing pain, which can make the discomfort and stiffness even worse over time.
Diagnosis and Evaluation
Dr. Lanman first diagnosis chronic neck pain related to a spinal injury by performing a thorough medical history. He will ask about the onset, location, and nature of your pain, as well as any previous injuries. During the physical exam, Dr. Lanman will check for tenderness, muscle strength, reflexes, and how well you can move your neck in different directions. If serious conditions like fractures, infections, or tumors are suspected, or if there are signs of nerve involvement, Dr. Lanman may order imaging tests may be recommended.
X-rays and CT scans can reveal bone problems like fractures or bone spurs. MRI provide detailed images of both bones and soft tissues, and it particularly useful for the latter. MRI can help identify herniated discs or nerve compression. In some cases, electromyography (EMG) may be used to check if nerve signals are being properly transmitted to the muscles. Doctors also use validated questionnaires to assess your pain, function, and how neck pain affects your daily life. These help guide treatment and track progress over time. This comprehensive approach ensures that both the physical and potential psychological factors contributing to chronic neck pain are carefully evaluated.
Treatment Options
Non-Surgical Treatments:
Non-surgical treatments are often the first line of care for chronic neck pain caused by a spinal injury. These treatments are intended to reduce pain, improve function, and help you return to daily activities. Pain medications such as nonsteroidal anti-inflammatory drugs (like ibuprofen or naproxen) and, in some cases, muscle relaxants are ordered. These medications can help decrease inflammation and relieve muscle spasms, respectively.
Physical therapy is a cornerstone of treatment. PT generally focuses on stretching tight muscles, strengthening the neck and upper back, and correcting posture to support the spine and prevent future pain. Chiropractic care can also help realign the neck, relieve pressure on nerves, and restore mobility; however, manual adjustments should only be performed by a licensed professional familiar with your specific condition.
For some people, epidural steroid injections can provide targeted relief by reducing inflammation around irritated nerves. Finally, making ergonomic modifications—such as adjusting your computer screen to eye level, using supportive chairs, and practicing good posture—can prevent further strain and help manage chronic neck pain in daily life.
These non-surgical approaches are often combined and tailored to each individual for the best results.
Surgical Treatments:
Surgery is considered when chronic neck pain persists despite months of non-surgical treatments. Surgery is also needed when there are worsening neurological deficits such as numbness, weakness, or loss of coordination in the arms or legs. Imaging findings must align with symptoms to justify surgical intervention.
Common surgical options include decompression (e.g., laminectomy), artificial disc replacement and anterior cervical discectomy and fusion (ACDF). Decompression surgery involves removing parts of the vertebral bone or thickened tissue that are narrowing the spinal canal and putting pressure on the spinal cord or nerve roots. Artificial disc replacement is a procedure where a damaged or degenerated spinal disc is surgically removed and replaced with a metal-and-plastic mechanical device that preserves the spine’s natural movement and flexibility. ACDF is a surgical procedure that removes a damaged or herniated disc from the neck through an incision in the front of the neck, then fuses the adjacent vertebrae together using bone graft material to provide stability.
Dr. Lanman’s Approach to Neck Pain
Dr. Todd Lanman has been helping people with complex neck and spine problems for over 30 years. What makes him truly unique is that he’s experienced spine pain himself—he’s had eleven spine surgeries throughout his life. This personal experience, combined with his expertise as a world-renowned spine surgeon, means he truly understands what you are going through when dealing with chronic neck pain.
Dr. Lanman has been at the forefront of new treatments, including leading research studies that helped get artificial disc replacement devices approved by the FDA. His deep knowledge of both traditional and cutting-edge treatments allows him to accurately identify what is causing your neck pain and create solutions that many other doctors might not consider. Dr. Lanman’s innovative restorative motion surgery techniques such as artificial disc replacement offers hope for people whose neck pain has not improved with other treatments.
FAQs: Spinal Injuries and Chronic Neck Pain
Can whiplash lead to long-term problems?
Yes, whiplash can lead to long-term problems. While many people recover within a few weeks, some develop chronic neck pain, persistent headaches, and reduced range of motion that can last months or even years. The sudden stretching and tearing of soft tissues during whiplash can cause ongoing inflammation, muscle imbalances, and nerve irritation that doesn’t heal properly without appropriate treatment. Early diagnosis and proper care are crucial to prevent whiplash from becoming a chronic condition.
How is a herniated disc in the neck treated?
Herniated discs in the neck are initially treated with conservative methods, which successfully manage approximately 80% of cases. Treatment typically starts with anti-inflammatory medications, rest, and physical therapy that includes stretching, strengthening, and techniques like traction to relieve nerve pressure. If conservative treatment fails after 6-12 weeks or if there are severe neurological symptoms, surgery may be recommended. The most common surgical options include anterior cervical discectomy and fusion (ACDF), which removes the damaged disc and fuses the vertebrae, or artificial disc replacement, which preserves neck movement by replacing the disc with a mechanical implant.
What are the signs of spinal stenosis?
The main signs of spinal stenosis include neck or back pain that worsens with standing or walking and improves when you sit or lean forward. You may experience numbness, tingling, or weakness that radiates down your arms (if stenosis is in the neck) or into your legs and feet (if stenosis is in the lower back). Many people notice cramping in their legs, difficulty walking long distances, and a characteristic relief when bending forward. In severe cases, spinal stenosis can cause loss of bladder or bowel control, which requires immediate medical attention.
When should I see a specialist for neck pain?
You should see a specialist for neck pain if it persists for more than 6 weeks despite conservative treatment, or immediately if you experience any “red flag” symptoms. Red flag warning signs include pain radiating down your arms with numbness or weakness, loss of bowel or bladder control, severe pain after trauma (like a car accident), fever with neck stiffness, or sudden onset of coordination problems. If your neck pain doesn’t improve with rest, over-the-counter medications, and gentle stretching after one week, it’s time to see a healthcare provider.
