Neck pain that has lasted more than a few months is rarely just muscular, and treating it as though it were is why it has lasted months.
What it is
The cervical spine has three plausible pain generators: the discs, the facet joints, and the nerve roots. They produce different patterns and need different treatment.
Facet joint pain is typically one-sided, worse on extension and rotation, and refers to the shoulder blade. Discogenic pain is more central and worse with flexion. Nerve root pain travels into the arm.
How it usually presents
- Pain at the base of the neck, often with a band across the shoulders.
- Stiffness that is worst in the morning or after sitting.
- Referred pain to the shoulder blade — commonly mistaken for a shoulder problem.
- Headache from the upper neck.
- Arm symptoms, which point to cervical radiculopathy rather than simple neck pain.
How we treat it
- A proper examination first, because the pattern narrows the diagnosis considerably before any imaging.
- Diagnostic blocks where the source is genuinely uncertain.
- Facet injections or radiofrequency ablation for confirmed facet pain.
- Epidural steroid injection where a nerve root is inflamed.
To be assessed, call (314) 310-5577 or request an appointment. If this began with a crash or a fall, see accident and injury care.
Common questions
Is my phone causing this?
Sustained flexion loads the neck, so posture is a contributor, but it is rarely the whole story in someone with months of pain.
Do I need an MRI?
Only if the result would change what we do. Many people with severe neck pain have unremarkable scans, and many with dramatic scans have no pain at all. See understanding your MRI report.
Hurt in an accident? Start here.
You do not need a lawyer, a police report or a referral to be seen. Bring your symptoms and we will work out the rest.
Or text (314) 886-5902 · Monday–Friday, 8:00 a.m. – 4:00 p.m.