Many people have occasional neck pain or stiffness. In many cases, it's due to poor posture, normal wear and tear, or overuse.
If you suffer from neck pain, you know how difficult everyday movements and activities can be. It can cause an increase in work absenteeism and keep you from enjoying the life you want to live.
Listen in as Dr. Babak Khamsi discusses neck pain and how you can get help for this condition that can affect the quality of your life.
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What You Can Do to Help Your Neck Pain
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Learn more about Babak Khamsi, MD
Babak Khamsi, MD
Dr. Babak Khamsi is a native of California and finished his undergraduate studies in Electrical Engineering at UCLA graduating Cum Laude and inducted into the prestigious honor societies Tau Beta Pi and Eta Kappa Nu. He pursued his medical training at Upstate Medical University in Syracuse, NY. His Orthopaedic Residency was at Rutgers-New Jersey Medical School (formerly UMDNJ) where he served as administrative chief his last year and was recognized with “resident teaching award” by his peers. He completed his fellowship in Spine Surgery under world renowned spine surgeons at UCLA. Dr. Khamsi is board eligible and is a member of American Academy of Orthopaedic Surgeons (AAOS) and North American Spine Society (NASS). He has had several publications in books and peer reviewed journals and stays active in research.Learn more about Babak Khamsi, MD
Transcription:
What You Can Do to Help Your Neck Pain
Melanie Cole (Host): Many people have occasional neck pain or stiffness. In many cases, it may be due to poor posture, normal wear and tear or overuse. If you do suffer from neck pain, you know how difficult everyday movements and activities can be. My guest today is Dr. Babak Khamsi. He is an orthopedic surgeon and a member of the medical staff at Corona Regional Medical Center. Welcome to the show, Dr. Khamsi. What are some of the most common causes of neck pain that you see?
Dr. Babak Khamsi (Guest): Thank you very much. Thanks for having me. Neck pain can be caused by many, many different problems or as we call, different pathologies. As you know, in the neck you have the bones, you have the discs, you have ligaments and you have muscle, and any one of those can be causing the pain. So, as a doctor, as a surgeon, it's my job to figure out what's exactly causing the neck pain and based on that, there are different treatment options that we can try.
Melanie: People sometimes just have a stiff neck or even stress can affect neck and shoulder pain. What is a red flag, Dr. Khamsi, that would someone to see a doctor in a first place?
Dr. Khamsi: Well, I would say if your pain is persistent for more than a few days and if you have tried some of the over-the-counter medications such as ibuprofen or Tylenol and you don’t get any type of relief, that’s when you probably want to get it checked out. Now, I am not saying that you needed to jump to see a spine surgeon such as myself. You can always see your primary care physician, possibly get some x-rays and be examined by them and, if needed, they can refer to us. The other thing that's important to pay attention to, is if the pain shoots down the arms. If you have neck pain that is associated with tingling or numbness of the fingers or the pain that is going down to your shoulders or all the way to your hands, at that point, that can be some concern and you need to be evaluated by a specialist.
Melanie: Are there certain risk factors for neck pain?
Dr. Khamsi: The neck pain is really multi-factorial. We don’t really know what's causing it, but we know that there is a genetic factor to it. And, also it depends on the people who are working with heavy instruments or are construction workers, mechanics with a lot of physical activities that usually tend to have a higher rate of neck pain.
Melanie: Are you seeing more neck pain, Dr. Khamsi, from kyphotic positions--people looking down at their phones, working at their computers? Is that causing an increase in neck problems?
Dr. Khamsi: Absolutely. People who have their necks hanging, which you see in dentists a lot because their neck is always bent down looking in somebody's mouth; somebody who does a lot of reading, you see in students a lot, they do a lot of reading. They can have neck pain. Usually this type of neck pain is related to the muscle of the neck and treatment options for this type of neck pain are usually a lot of physical therapy, working on strengthening the muscles, especially the muscles in the back that hold the head up. And, the majority of those patients can have very good relief with physical therapy and strengthening of the muscles.
Melanie: Someone does suffer from neck pain. Do you like ice or heat to relieve some of those symptoms?
Dr. Khamsi: That's a great question. I get that question a lot. There is really no good scientific evidence on whether ice is better or heat is better. I always tell a patient, try both, whatever works for you. Some people like ice better, some will like heat better and neither one matters. As long as you get good relief with either one, you can try it.
Melanie: What kind of surgical interventions are available for people who suffer from chronic, very painful neck pain?
Dr. Khamsi: I would say, in general, the main treatment just for neck pain is conservative management, including physical therapy, strengthening and stretching, if it’s just neck pain. Now, if the pain starts radiating down the arms and/or the patient does not really respond to conservative management, then there are different surgical interventions that can be tried. It really depends on the pathology, but I would say most the common procedure that we do on a neck is a fusion surgery. It's called “ACDF,” which is anterior cervical discectomy and fusion. That's ACDF and, basically, what that consists of is the surgeon will go from the front of the neck and will remove the disc that we think is causing the problem and we put a spacer where the disc belongs to, that way we can restore the normal anatomy of the cervical spine. Then we put a small plate with some screws on the front of the spine just to keep everything together. That's probably the most common surgery that we do for neck problems. Of course, there are other procedures that can be done depending on different pathology, but that’s the most common one.
Melanie: What is it like after the anterior cervical discectomy for patients? Is, then, their neck pain gone? Do they feel a little more stiffness? What goes on?
Dr. Khamsi: Again, great question. I would say in general, ACDF or anterior fusion of the spine, is good successful surgery. A lot of you ask about stiffness. They think because we have fused one or two levels of their neck, they can be more stiff. Actually, there have been some studies done looking at that and, surprisingly, we see a better range of motion after fusion of the neck and the reason for that is that when you fuse the bad levels, the patient actually has less pain in their neck so they are actually able achieve more range of motion without pain. So, the stiffness is usually not a problem after this surgery. The majority of people do very well after this surgery. Some of the more common side effects that we see are that a lot of you have some problems swallowing after such procedure, but that's usually transient and it goes away after about a week or so. But, I would say that's the biggest complication of this surgery--difficulty of swallowing--but the results are phenomenal.
Melanie: What about neck braces?
Dr. Khamsi: I recommend neck braces sometimes on, what we call “PRN basis” or “as needed” basis. I see some patients who wear the neck brace as soon as they wake up and wear it throughout the day. That is not a good idea. As I said, a lot of times, the reason you would have neck pain is because the muscles are weak and that’s causing the pain. When you wear a neck brace at all times, what happens is, your muscles become lazy and they depend on that brace. So, this actually has the exact opposite effect of doing physical therapy. So, even though you may feel good while wearing the brace, it actually has a bad effect on the muscles. It makes the muscles weaker, which is exactly what we don’t want. So, I don’t recommend wearing a brace at all times, but if someone wants to wear it, if they are doing something hard, strenuous and they feel like they need that extra support for a few hours or if they are going for a long drive and they want to wear that because they feel more secure--that I don’t have a problem with. Wearing it on a persistent basis, it’s not a good idea.
Melanie: Are there some lifestyle modifications, Dr. Khamsi, that you can recommend? People don’t know if they can exercise their neck or what they should be doing to make their neck stronger.
Dr. Khamsi: Well, I would say if you do have neck problems, I really encourage you to be trained by a physical therapist. There are different exercises that can be done, but you should really be evaluated and be trained by a professional, by someone who is trained to do this, whether it’s a physical therapist or sometimes a chiropractor. What they do, they usually come up with a whole exercise program where they train you on what to do and in a safe manner where you can see the best benefit from it.
Melanie: In just the last few minutes, Dr. Khamsi, what should people with chronic neck pain think about when seeking care?
Dr. Khamsi: Well, the way I always tell my patients is that you should see…Pain is very subjective and different people have different demands in life. Before you see a surgeon, you should really think about it hard. As I always say, surgery is injury. So, surgery should be saved for those people who have tried everything else and they just come to this conclusion by themselves that, “I just cannot live like this anymore.” We take every surgery very seriously, even though the risk of complication from surgery is very, very low, usually less than 1%, we still take it very seriously and I don’t like jumping into surgery. But if someone with chronic neck problems who has tried everything else is thinking about surgery, the question they should ask themselves is “Can I or can’t I live like this for the next 10, 15, 20 years.” And if the answer is “No. You know what? This is making me miserable. It's affecting my activities of daily living. I cannot enjoy doing what I enjoy on a regular basis because of my neck problems, then those should really consider surgery and see a specialist.”
Melanie: And, why should they come to Corona Regional Medical Center for their care?
Dr. Khamsi: Well, here at Corona Regional Medical Center, we are very well trained. My partner, Dr. Cramer and I, we do only spine. I am an orthopedic surgeon, he is a neurosurgeon but we are both fellowship trained in spine and we can really tackle any type of problem that a patient can have. As I said before, we are very conservative. We try to reserve surgery as the very last solution, but if it comes down to surgery, we do any type of spine surgery all the time and we have very good results.
Melanie: Thank you so much for being with us today, Dr. Khamsi. It's such great information. You are listening to Corona Regional Radio with Corona Regional Medical Center. For more information, you can go to coronaregional.com. That's coronaregional.com. Physicians are independent practitioners who are not employees or agents of Corona Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.
What You Can Do to Help Your Neck Pain
Melanie Cole (Host): Many people have occasional neck pain or stiffness. In many cases, it may be due to poor posture, normal wear and tear or overuse. If you do suffer from neck pain, you know how difficult everyday movements and activities can be. My guest today is Dr. Babak Khamsi. He is an orthopedic surgeon and a member of the medical staff at Corona Regional Medical Center. Welcome to the show, Dr. Khamsi. What are some of the most common causes of neck pain that you see?
Dr. Babak Khamsi (Guest): Thank you very much. Thanks for having me. Neck pain can be caused by many, many different problems or as we call, different pathologies. As you know, in the neck you have the bones, you have the discs, you have ligaments and you have muscle, and any one of those can be causing the pain. So, as a doctor, as a surgeon, it's my job to figure out what's exactly causing the neck pain and based on that, there are different treatment options that we can try.
Melanie: People sometimes just have a stiff neck or even stress can affect neck and shoulder pain. What is a red flag, Dr. Khamsi, that would someone to see a doctor in a first place?
Dr. Khamsi: Well, I would say if your pain is persistent for more than a few days and if you have tried some of the over-the-counter medications such as ibuprofen or Tylenol and you don’t get any type of relief, that’s when you probably want to get it checked out. Now, I am not saying that you needed to jump to see a spine surgeon such as myself. You can always see your primary care physician, possibly get some x-rays and be examined by them and, if needed, they can refer to us. The other thing that's important to pay attention to, is if the pain shoots down the arms. If you have neck pain that is associated with tingling or numbness of the fingers or the pain that is going down to your shoulders or all the way to your hands, at that point, that can be some concern and you need to be evaluated by a specialist.
Melanie: Are there certain risk factors for neck pain?
Dr. Khamsi: The neck pain is really multi-factorial. We don’t really know what's causing it, but we know that there is a genetic factor to it. And, also it depends on the people who are working with heavy instruments or are construction workers, mechanics with a lot of physical activities that usually tend to have a higher rate of neck pain.
Melanie: Are you seeing more neck pain, Dr. Khamsi, from kyphotic positions--people looking down at their phones, working at their computers? Is that causing an increase in neck problems?
Dr. Khamsi: Absolutely. People who have their necks hanging, which you see in dentists a lot because their neck is always bent down looking in somebody's mouth; somebody who does a lot of reading, you see in students a lot, they do a lot of reading. They can have neck pain. Usually this type of neck pain is related to the muscle of the neck and treatment options for this type of neck pain are usually a lot of physical therapy, working on strengthening the muscles, especially the muscles in the back that hold the head up. And, the majority of those patients can have very good relief with physical therapy and strengthening of the muscles.
Melanie: Someone does suffer from neck pain. Do you like ice or heat to relieve some of those symptoms?
Dr. Khamsi: That's a great question. I get that question a lot. There is really no good scientific evidence on whether ice is better or heat is better. I always tell a patient, try both, whatever works for you. Some people like ice better, some will like heat better and neither one matters. As long as you get good relief with either one, you can try it.
Melanie: What kind of surgical interventions are available for people who suffer from chronic, very painful neck pain?
Dr. Khamsi: I would say, in general, the main treatment just for neck pain is conservative management, including physical therapy, strengthening and stretching, if it’s just neck pain. Now, if the pain starts radiating down the arms and/or the patient does not really respond to conservative management, then there are different surgical interventions that can be tried. It really depends on the pathology, but I would say most the common procedure that we do on a neck is a fusion surgery. It's called “ACDF,” which is anterior cervical discectomy and fusion. That's ACDF and, basically, what that consists of is the surgeon will go from the front of the neck and will remove the disc that we think is causing the problem and we put a spacer where the disc belongs to, that way we can restore the normal anatomy of the cervical spine. Then we put a small plate with some screws on the front of the spine just to keep everything together. That's probably the most common surgery that we do for neck problems. Of course, there are other procedures that can be done depending on different pathology, but that’s the most common one.
Melanie: What is it like after the anterior cervical discectomy for patients? Is, then, their neck pain gone? Do they feel a little more stiffness? What goes on?
Dr. Khamsi: Again, great question. I would say in general, ACDF or anterior fusion of the spine, is good successful surgery. A lot of you ask about stiffness. They think because we have fused one or two levels of their neck, they can be more stiff. Actually, there have been some studies done looking at that and, surprisingly, we see a better range of motion after fusion of the neck and the reason for that is that when you fuse the bad levels, the patient actually has less pain in their neck so they are actually able achieve more range of motion without pain. So, the stiffness is usually not a problem after this surgery. The majority of people do very well after this surgery. Some of the more common side effects that we see are that a lot of you have some problems swallowing after such procedure, but that's usually transient and it goes away after about a week or so. But, I would say that's the biggest complication of this surgery--difficulty of swallowing--but the results are phenomenal.
Melanie: What about neck braces?
Dr. Khamsi: I recommend neck braces sometimes on, what we call “PRN basis” or “as needed” basis. I see some patients who wear the neck brace as soon as they wake up and wear it throughout the day. That is not a good idea. As I said, a lot of times, the reason you would have neck pain is because the muscles are weak and that’s causing the pain. When you wear a neck brace at all times, what happens is, your muscles become lazy and they depend on that brace. So, this actually has the exact opposite effect of doing physical therapy. So, even though you may feel good while wearing the brace, it actually has a bad effect on the muscles. It makes the muscles weaker, which is exactly what we don’t want. So, I don’t recommend wearing a brace at all times, but if someone wants to wear it, if they are doing something hard, strenuous and they feel like they need that extra support for a few hours or if they are going for a long drive and they want to wear that because they feel more secure--that I don’t have a problem with. Wearing it on a persistent basis, it’s not a good idea.
Melanie: Are there some lifestyle modifications, Dr. Khamsi, that you can recommend? People don’t know if they can exercise their neck or what they should be doing to make their neck stronger.
Dr. Khamsi: Well, I would say if you do have neck problems, I really encourage you to be trained by a physical therapist. There are different exercises that can be done, but you should really be evaluated and be trained by a professional, by someone who is trained to do this, whether it’s a physical therapist or sometimes a chiropractor. What they do, they usually come up with a whole exercise program where they train you on what to do and in a safe manner where you can see the best benefit from it.
Melanie: In just the last few minutes, Dr. Khamsi, what should people with chronic neck pain think about when seeking care?
Dr. Khamsi: Well, the way I always tell my patients is that you should see…Pain is very subjective and different people have different demands in life. Before you see a surgeon, you should really think about it hard. As I always say, surgery is injury. So, surgery should be saved for those people who have tried everything else and they just come to this conclusion by themselves that, “I just cannot live like this anymore.” We take every surgery very seriously, even though the risk of complication from surgery is very, very low, usually less than 1%, we still take it very seriously and I don’t like jumping into surgery. But if someone with chronic neck problems who has tried everything else is thinking about surgery, the question they should ask themselves is “Can I or can’t I live like this for the next 10, 15, 20 years.” And if the answer is “No. You know what? This is making me miserable. It's affecting my activities of daily living. I cannot enjoy doing what I enjoy on a regular basis because of my neck problems, then those should really consider surgery and see a specialist.”
Melanie: And, why should they come to Corona Regional Medical Center for their care?
Dr. Khamsi: Well, here at Corona Regional Medical Center, we are very well trained. My partner, Dr. Cramer and I, we do only spine. I am an orthopedic surgeon, he is a neurosurgeon but we are both fellowship trained in spine and we can really tackle any type of problem that a patient can have. As I said before, we are very conservative. We try to reserve surgery as the very last solution, but if it comes down to surgery, we do any type of spine surgery all the time and we have very good results.
Melanie: Thank you so much for being with us today, Dr. Khamsi. It's such great information. You are listening to Corona Regional Radio with Corona Regional Medical Center. For more information, you can go to coronaregional.com. That's coronaregional.com. Physicians are independent practitioners who are not employees or agents of Corona Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.