Potential Causes of Post-Surgical Neck Pain

Assuming patients and healthcare providers follow clinical guidelines for managing neck
pain, most neck pain sufferers can experience resolution of their pain and disability with the aid
of a conservative, multimodal treatment approach, such as those provided by chiropractors.
However, for a variety of reasons, some patients may still undergo surgical intervention, and it is
estimated that up to 40% may continue to experience persistent or disabling neck pain. Why is
this the case, and is there anything chiropractic care can do to help these patients?
The first potential cause of persistent post-surgical neck pain is an incomplete or
incorrect diagnosis. This can occur when imaging reveals positive findings—such as a disk
herniation—that are attributed to the patient’s symptoms but may not, in fact, be the underlying
cause. In some cases, a disk herniation may play a role; however, other contributing factors that
are not visible on imaging or are missed during a physical examination may also be involved.
There are also cases in which the pain generator is correctly identified and treated, but
complications from surgery result in ongoing neck pain. For example, scar tissue formation
around nerves and soft tissues can tether nerves or create a chronic inflammatory environment
that triggers pain. In addition, a decompressed nerve may continue to experience impaired
function as though it were still compressed.
Finally, a new source of neck pain may develop following an otherwise successful
surgical procedure. This can occur when spinal alignment is restored but the joints and soft
tissues are not accustomed to supporting the altered loads and forces and subsequently become
injured. Additionally, in cases of surgical fusion that restrict movement at a cervical spinal level,
the vertebrae above and below the fusion may become hypermobile to compensate, pushing them
beyond their normal range of motion and increasing the risk of injury.
With all of this in mind, how can a doctor of chiropractic help manage post-surgical neck
pain? The first step is a thorough review of the patient’s history, which guides the physical
examination. The examination not only seeks to identify potential pain generators but also helps
detect red flags that contraindicate chiropractic treatment. In addition to traditional red flags
(such as fracture, infection, tumor, severe osteoporosis, and vascular abnormalities), the
chiropractor will also assess for signs of cervical instability or incomplete healing. To help
restore normal movement and function of the cervical spine, a doctor of chiropractic will often
employ a multimodal approach that combines low-force manual therapies, gentle traction,
therapeutic exercises, and physiotherapy modalities.
Brent Binder, D.C. 4909 Louise Dr. Suite 102 Mechanicsburg, PA 17055 (717) 697-1888

Tags: mechanicsburg pa chiropractor, neck pain