What neck pain usually means
Neck pain rarely stays in the neck. Where it travels tells our doctors where to look, because a tight muscle, a worn joint and a pinched nerve are treated differently.
- Muscle strain and spasm. Long hours at a desk, a bad night's sleep or a sudden turn of the head can leave the muscles along the neck and upper shoulders tight and tender. This is the most common cause and usually the quickest to settle.
- A pinched nerve (cervical radiculopathy). When a disc or arthritic bone in the neck presses on a nerve root, pain follows that nerve into the shoulder blade, down the arm and sometimes into the fingers, often with tingling, numbness or a weak grip. Looking up or turning toward the painful side tends to make it worse.
- Arthritis and disc wear. Cervical spondylosis (arthritis of the neck) and worn discs cause a deep ache that builds through the day and with prolonged sitting.
- Headaches that start in the neck. Pain at the base of the skull that spreads over the back or side of the head often comes from the upper neck joints or the occipital nerves. When the occipital nerve itself is irritated, the result is occipital neuralgia: sharp, shooting, electric pain that is frequently mistaken for migraine.
Whiplash, years of looking down at a phone, and old neck injuries all raise the odds, and often more than one of these is going on at once.
How our pain physicians treat it
Your first appointment at Davie or Boynton Beach is a full consultation. The doctor takes a detailed history, examines the neck, shoulders and the nerves in your arms, checks strength and reflexes, and reviews any MRI or X-ray you already have. If imaging is needed, it is ordered then. You leave with a written plan and goals that mean something to you: turning your head to reverse the car, sleeping through the night.
Depending on what we find, the plan may include:
- Trigger point injections into the tight bands of muscle in the neck and upper trapezius, usually a short series of two to four sessions.
- Medication management, starting with anti-inflammatories, muscle relaxants and nerve pain medication at the lowest effective dose, reviewed at every visit.
- Nerve blocks for pain that follows a specific nerve, including an occipital nerve block for headaches at the back of the head and cervical medial branch blocks for arthritic neck joints. The relief you get is documented so we know whether to repeat or move on.
- Referral for a cervical epidural steroid injection when a pinched nerve is confirmed on imaging and conservative care has not been enough. We coordinate the referral and keep managing your care.
Headaches that do not start in the neck, such as migraine or tension-type headache, are treated by our neurologists. See our headache treatment page.
Does insurance cover it? Consultations, follow-up visits, trigger point injections and nerve blocks, including occipital nerve blocks, are covered by Medicare, Aetna, Blue Cross Blue Shield and Cigna when medically necessary. Some Medicare Advantage and commercial plans require prior authorization for injections, and our front desk handles that for you. Workers' compensation and auto injury claims are accepted. Read more about insurance and self-pay.
What to expect at your first visit
- Before you come in, we verify your insurance and ask you to bring photo ID, your medication list and any imaging reports or prior records.
- At the consultation, the doctor examines you, reviews your imaging and explains in plain language whether the pain is coming from muscle, joint or nerve.
- You leave with a plan. Some patients have their first trigger point injection at that visit. Others start with medication or imaging and return once the results are in.
- Follow-up is scheduled based on the plan, usually every four to twelve weeks, so we can measure what is working and adjust.
When neck pain needs urgent attention
Most neck pain, even with arm symptoms, improves over several weeks with the right plan. Call the clinic promptly, or go to the emergency room, if you have worsening weakness in an arm or hand, trouble with balance or walking, numbness in both arms or legs, or neck pain with fever, a sudden severe headache, or after a significant fall or crash.
Is a pinched nerve in the neck serious?
Usually not. Most cases of cervical radiculopathy improve over six to twelve weeks with medication, activity guidance and injections. It becomes serious when weakness is progressing or the spinal cord itself is being compressed, which is why the doctor tests strength and reflexes at every visit.
Can neck pain really cause headaches?
Yes. The joints and nerves of the upper neck share pathways with the nerves that supply the back of the head. Pain at the base of the skull that spreads upward, especially when it is worse with neck movement, often responds well to an occipital nerve block or to treating the neck itself.
How do I get an appointment for neck pain?
Book online through Zocdoc or phone either clinic. The front desk confirms your coverage, then offers you a suitable appointment at Davie or Boynton Beach and tells you what to bring.
Will I need surgery?
Most patients do not. Surgery is considered only for significant nerve compression with weakness that is not improving, or when months of conservative care have failed. If so, we refer you to a spine surgeon and keep managing your pain.
Which clinic treats neck pain?
Both. Davie serves Broward County and Boynton Beach serves Palm Beach County. Consultations, trigger point injections, medication management and nerve blocks are available at both clinics.