Neck Pain: Causes, Treatment & When to See a Spine Surgeon

Most neck pain is short-lived and improves with conservative care — activity changes, physical therapy, and time. It's worth seeing a spine specialist if your neck pain is severe, lingers beyond about six weeks, or comes with pain, numbness, or weakness that travels into your shoulder, arm, or hand — or with new clumsiness, balance changes, or trouble with fine tasks. Dr. Joseph Chavarria is a board-certified, dual-fellowship-trained orthopedic spine surgeon serving Reno, Sparks, Carson City, and Northern Nevada — and he is conservative-first, so an evaluation does not mean you are committing to surgery.

When to see a spine specialist

  • Neck pain that lasts longer than about six weeks despite conservative treatment
  • Pain, numbness, or tingling that radiates into the shoulder, arm, or hand
  • Weakness or loss of coordination in a hand or arm
  • New clumsiness with fine tasks (buttons, handwriting), balance problems, or a change in your walking
  • Neck pain after a fall, accident, or whiplash injury

Seek emergency care right away for severe symptoms such as sudden weakness in the arms or legs, loss of bladder or bowel control, or a serious neck injury after trauma.

What's causing it?

Neck pain has many possible sources — and the right treatment depends on the cause. These are among the most common conditions Dr. Chavarria evaluates and treats:

Cervical Radiculopathy

Cervical radiculopathy occurs when a nerve root in the neck is compressed or irritated — typically by a herniated disc or bone spur — causing pain, numbness, or weakness that radiates from the neck into the shoulder, arm, or hand. It is one of the most common reasons patients seek spine care, and it responds well to both conservative treatment and surgery when needed.

Cervical Myelopathy

Cervical myelopathy is compression of the spinal cord in the neck — the most common cause of spinal cord dysfunction in adults over 55. Unlike radiculopathy (nerve root compression), myelopathy affects the cord itself, causing progressive difficulty with balance, hand coordination, and bladder function. It is a surgical condition — decompression is required to halt neurological deterioration and allow partial recovery.

Cervical Stenosis

Cervical stenosis is a narrowing of the spinal canal in the neck that can compress the spinal cord and nerve roots. It develops gradually with age and may cause neck pain, arm symptoms, and — when the spinal cord is involved — problems with balance and hand coordination. Treatment ranges from conservative care to decompression surgery depending on severity.

Herniated Disc

A herniated disc occurs when the soft inner material of a spinal disc pushes through its outer fibrous ring and irritates or compresses a nearby nerve. It is one of the most common causes of neck and back pain, arm pain, leg pain, and sciatica — and responds well to both conservative and surgical treatment in the right patients.

Degenerative Disc Disease

Degenerative disc disease describes the gradual breakdown of the spinal discs that cushion the vertebrae. As discs lose height, flexibility, and water content with age, they can cause chronic neck or back pain, stiffness, and — when they compress adjacent nerves — radiating arm or leg symptoms. Though common, it is manageable with the right treatment approach.

I had an MRI — what do the findings mean?

A neck MRI often shows changes like disc bulges, degeneration, or narrowing that are common with age and may not be the actual source of your pain. What's on the report doesn't always match your symptoms.

That's why Dr. Chavarria reviews the actual images alongside your history and exam, rather than treating the report alone. If you have an MRI, CT, or X-ray, bring the images themselves (on a disc or in digital format) so he can walk through them with you.

Most neck pain never needs surgery

The large majority of neck pain is treated successfully without an operation. Dr. Chavarria starts with conservative care — physical therapy, activity modification, medication, and, when helpful, injections — and recommends surgery only when it is clearly the best option. One exception worth knowing: when neck problems compress the spinal cord itself (cervical myelopathy), earlier evaluation is often important, which is why new balance or hand-coordination changes are worth getting checked.

Learn about Dr. Chavarria's conservative-first approach →

Frequently Asked Questions

When should I see a doctor for neck pain?
Most neck pain improves within a few weeks. Consider seeing a spine specialist if your pain is severe, lasts longer than about six weeks despite conservative care, or is accompanied by arm pain, numbness, weakness, or new problems with coordination or balance.
Does neck pain mean I'll need surgery?
No. The large majority of neck pain is treated without surgery. Dr. Chavarria's approach is conservative-first, with surgery considered only when it is clearly the best option for your situation.
I have neck pain with numbness or tingling going into my arm — what does that mean?
Pain, numbness, or tingling that travels into the shoulder, arm, or hand often points to a pinched nerve in the neck (cervical radiculopathy), commonly from a herniated disc or stenosis. Most cases improve with conservative care, but it's worth an evaluation to confirm the cause.
What is cervical myelopathy and why does it matter?
Cervical myelopathy is compression of the spinal cord in the neck. Symptoms can include clumsiness in the hands, difficulty walking, or balance problems. Because it can progress over time, it often warrants surgical evaluation sooner than a pinched nerve alone — so new coordination or balance changes are worth getting checked.
Who treats neck pain — an orthopedic surgeon or a neurosurgeon?
Both orthopedic spine surgeons and neurosurgeons treat neck conditions. Dr. Chavarria is a fellowship-trained orthopedic spine surgeon who manages the full range of neck problems with non-surgical care and, when needed, minimally invasive or complex surgery.

Get an honest evaluation

Dr. Chavarria will review your history and imaging and explain your options — surgical and non-surgical — with no pressure. Serving Reno, Sparks, Carson City, and Northern Nevada.

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