Left Neck Pain: Causes, Diagnosis, and Treatment Options

Left neck pain?

Four years ago, I experienced numbness in my left fingers and pain in my arm.
After an MRI examination, it was found that there was a herniated disc at the levels of C3-C4, C4-C5, C5-C6, and C6-C7, with the C5-C6 level being more severe.
I did not undergo surgery and after six months of rehabilitation, the numbness and pain resolved, and I only occasionally returned for rehabilitation until this year.
However, about three weeks ago, I woke up with pain in the left side of my neck, especially when turning to the left or looking down to the left.
I have been consistently undergoing rehabilitation for about two weeks and have noticed that the symptoms fluctuate; sometimes they improve, but often I feel particularly uncomfortable in the mornings after sleeping, especially when sleeping on my left side, which causes more pain.
During the day, I feel relatively fine unless I turn to the left or look down to the left, which causes pain in my left neck and shoulder.
Additionally, I have pain on the outer side of my left upper arm, and moving my arm can also trigger pain.
Sometimes, if I accidentally bump my shoulder or experience head vibrations, I feel some pain.
I do not have any particular sensations when looking up or down.
Two days ago, I visited an orthopedic doctor who took X-rays.
The doctor indicated that the imaging showed the cervical disc protrusion is similar to what it was four years ago, with not much change.
I would like to ask if I need to have another MRI? Is there a possibility of a cervical spine tumor? Can X-rays detect that?

Cheng Cheng, 30~39 year old female. Ask Date: 2019/07/04

Dr. Zhang Junwei reply Neurosurgery

X-rays cannot visualize intervertebral discs, let alone nerves.
If there is a suspicion of worsening disc herniation with nerve compression, it is best to perform an MRI again.

Reply Date: 2019/07/04

More Info

Understanding left neck pain can be complex, especially given your history of cervical disc herniation and the symptoms you are currently experiencing. Based on the information provided, it seems that your left neck pain is likely related to your previous cervical spine issues, particularly the herniated discs at the C5-C6 levels.

Causes of Left Neck Pain
1. Cervical Disc Herniation: As you mentioned, you previously had a herniated disc that was compressing the nerves. This can lead to pain that radiates down the arm, numbness, or tingling in the fingers. Even if the herniation has not changed significantly, the surrounding muscles and nerves can still be affected, leading to pain and discomfort.

2. Muscle Strain: Sleeping in an awkward position, especially on your left side, can strain the muscles in your neck. This is particularly true if you have a history of neck issues, as the muscles may be more susceptible to strain.

3. Cervical Spondylosis: Age-related wear and tear on the cervical spine can lead to degenerative changes, which may cause pain and stiffness. This condition can coexist with disc herniation and exacerbate symptoms.

4. Nerve Compression: If the herniated disc is still pressing on a nerve root, it can lead to pain that radiates into the shoulder and arm. This could explain the pain you feel in your left shoulder and upper arm.

5. Temporomandibular Joint (TMJ) Dysfunction: If you are experiencing pain in the jaw or ear area, it could be related to TMJ issues, which can also cause referred pain to the neck.

Diagnosis
Given your symptoms and history, it is essential to have a thorough evaluation. While X-rays can show structural changes in the cervical spine, they are limited in their ability to visualize soft tissue structures like discs and nerves. An MRI is more effective for assessing disc herniation and nerve compression.

When to Consider an MRI
- Persistent Symptoms: If your symptoms are not improving with conservative treatment (like physical therapy) and are affecting your quality of life, an MRI may be warranted to reassess the condition of your cervical spine.

- New Symptoms: If you experience new symptoms such as significant weakness in your arm, loss of coordination, or changes in bowel or bladder function, these could indicate a more serious condition that requires immediate attention.

Treatment Options
1. Physical Therapy: Continuing with physical therapy can help strengthen the muscles around your neck and improve flexibility, which may alleviate some of your pain.

2. Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and pain. If these are ineffective, your doctor may consider other pain management options.

3. Cervical Collar: A soft cervical collar can provide support and limit movement, which may help reduce pain during acute episodes.

4. Injections: In some cases, corticosteroid injections can be used to reduce inflammation around the affected nerve roots.

5. Surgery: If conservative treatments fail and there is significant nerve compression leading to weakness or other neurological symptoms, surgical options may be considered.

Conclusion
In summary, your left neck pain is likely related to your previous cervical spine issues, compounded by muscle strain from sleeping positions. While X-rays provide some information, an MRI may be beneficial for a comprehensive assessment of your current condition. It is crucial to maintain open communication with your healthcare provider about your symptoms and treatment options. Regular follow-ups will help ensure that any changes in your condition are promptly addressed.

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