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Neck Pain

Neck Doctor

Neck pain is estimated to be present in anywhere between 6-39% of adults at any one time and it is the 4th leading cause of disability. Neck pain duration can be classified as

Individuals with herniated discs with nerve pain have a good chance of experiencing disc resorption and recovery. Studies show that seeing a Physical Medicine and Rehabilitation specialist like Dr. Bainbridge or Dr. Trainor within 48 hours of an acute event or within 10 days of seeking care will reduce your risk of needing surgery and increase your satisfaction with care. In most cases, surgery is not required and you can get back to your normal lifestyle.

The Denver Spine and Pain Institute has the diagnostic, therapeutic, and prevention education tools to address your neck and arm pain. We can provide assistance in reducing your pain and helping you get back to the activities that you enjoy.

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What Are Some of the Causes of Neck Pain?

There are a variety of potential causes of neck pain:

  • Inadequate ergonomics at work
  • Sitting and maintaining awkward neck positions for long periods of time
  • Trauma to the neck, including falls or the sheer forces of motor vehicle collisions
  • Prolonged, forced position sitting, such as during car travel
  • The use of a new and different pillow can stress the discs and lead to painful internal disc tears or herniation

In addition, disc degeneration and herniation are heavily influenced by genetics, with disc and other conditions running in families.

Anatomy and Sources of Neck Pain

The spine contains the following components, each of which can be a source of pain.

Discs (Intervertebral Discs)

Discs are made up of the nucleus (the load-bearing cushion) and the annulus (a network of circularly arranged fibers that provide structural support). The nerve and blood supply of the discs comes from adjacent edges of vertebral bone (end-plates) and the outer layers of the annulus.


Disc pain can occur when small, inner tears of the annulus reach these nerve fibers, or with “microfractures” of the end-plates. These painful findings can occur with trauma and/or be associated with degenerative changes. However, it is important to know that visible imaging (MRI) findings are not always painful and that your pain can resolve through treatment.

Disc herniations associated with annular tears can cause both neck pain and the pain of pinched or inflamed nerves. Terms used to describe disc herniations include:

  • Protrusion
  • Extrusion
  • Sequestration (free disc fragment)

These disc protrusions cause nerve root pain through mechanical compression and/or inflammation associated with the disc material. Fortunately, disc protrusions resorb in many cases. Treatment can provide pain relief and the ability to function by reducing inflammation of the nerves as the problem resolves. When the pain of a pinched nerve remains severe, there is significant weakness, or the situation is growing worse, surgery may be indicated.

Facet Joints (Zygapophysial Joints)

There are two facet joints at each spinal level, forming a weight bearing “tripod” with the disc. The facet joints allow spinal motion and have cartilage and a covering (capsule). They can be injured while twisting or with trauma, or can become painful gradually. Normally, the disc bears most of our weight, but as the discs degenerate and become thin, more of the load is shifted to the facet joints.

Chronic posture and ergonomic problems can also stress the facet joints. This leads to joint degeneration which can sometimes be associated with pain and can even cause pain in joints that do not show any signs of degeneration.

Bones (Vertebrae)

The vertebrae can become fractured, house tumors, or degenerate and lead to bone spurs that can pinch nerves. Fractures can arise from trauma such as a fall, blow to the head, or whiplash.

Ligaments (Connectors)

Ligaments run along the edges of bones and discs of the spine to keep the spine stable, while also allowing normal motion. When the ligaments are torn by trauma or loosened through degeneration, a condition called spinal instability develops. This can be painful and cause “catching,” shifting and muscle spasms in the neck.

Muscles (Movers and Stabilizers)

Muscles can become torn, bruised or overstressed, all of which can be painful. More commonly, pain from other structures in the spine cause a reaction in the muscles such as tightness, pain in muscles “on-guard,” or a lack of supportive activity and protection from other muscles. You can then have both spastic muscles and inactive muscles at the same time, requiring physical therapy to retrain them.

This muscle dysfunction can happen even after a brief episode of neck pain and usually requires formal physical therapy, as they do not often return to becoming functional on their own. Correction of muscle length and activity helps protect you from future neck pain episodes and gets you get back to life.

Inflammatory Rheumatological Conditions

Rheumatoid arthritis is a set of conditions that can cause neck pain. The physicians and physician assistants at The Denver Spine and Pain Institute keep a look out for symptoms suggestive of these conditions. Our team can order labs and refer you to a rheumatologist when needed.


Infections of the spine are rare but can occur, especially when someone is immunocompromised for any reason (disease, chemotherapy). Infection can also spread from other areas of the body. Severe, focused, spine pain while being sick or feverish would possibly indicate an infection, which would need immediate attention.

Neoplasm (Benign Tumors, Cancer)

Tumors of the spine are found in less than 1/1000 spine images. They are more commonly from metastatic disease, with breast, lung, prostate, kidney, gastrointestinal, and thyroid being the most common of those. Lymphoma and myeloma can be found, and primary tumors arising from the structures of the spine are least likely.

Non-Spine (Referred Pain) Causes of Neck Pain

Medical problems in the front of the neck, chest or head can refer pain to the spine. Please let your doctor know about any symptoms that you are experiencing so that they can determine if there is any link to the neck pain that you are experiencing.

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Diagnosis of the Cause of Your Neck Pain

The Denver Spine and Pain Institute care providers will listen carefully to your history and perform a detailed, hands-on physical exam to begin the diagnostic process. Diagnostic tools that we use include:

Treatment of Spine Pain

The “backbone” treatment of neck pain is directed towards:

Details of specific treatments can be found on our Pain Management page.


Conservative Treatment of Neck Pain (Pain Management)

We will design a treatment plan that takes your individual needs and preferences into consideration. This plan will often contain multiple approaches (our Connected Care Approach™) to provide pain relief and improve your quality of life.

Potential treatments may include:

Interventional Treatment of Neck Pain (Pain Management)

The physicians/providers at The Denver Spine and Pain Institute can be trusted to help you make good decisions about the use of injections, highly specialized procedures, or surgery to treat your spine pain. We have expertise in a wide range of procedures which use fluoroscopic (x-ray) or ultrasound guidance, including:

Our team has close working relationships with the area’s top spine, neuro and orthopedic surgeons and radiologists. The Denver Spine and Pain Institute can counsel you regarding indications for surgery to make your decision an informed one. We can also provide you with post-operative care and rehabilitation.

Research Trials at The Denver Spine & Pain Institute

We have been carrying out pain research since our founding in 2012 and are happy to be able to offer pain patients the option of participating in state-of-the-art research treatments through our many clinical trials. Ask your care provider if one of our trials might be right for you, or call our knowledgeable research administrator, Sara Light, at 303-327-5511, extension 319.

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Exceptional Pain Management Treatment

At the Denver Spine and Pain Institute, we’ve witnessed firsthand how debilitating pain can derail your quality of life. Our team is committed to providing you with the relief necessary to enjoy your favorite activities and perform routine daily activities with greater ease. Our goal is to help you live life to the fullest once again.

Our exclusive Connected Care Approach™ has been designed with your needs in mind, and it will get you back to enjoying life without the frustration and challenges that often come along with chronic pain. As part of this approach, you’ll receive:

We’ll work closely with you to identify and deliver the treatments necessary to achieve the pain relief you’re seeking.

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Schedule an Appointment

Please contact us today to schedule an appointment. The Denver Spine and Pain Institute serves patients in Denver and the surrounding areas of Colorado.

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