When Neck Pain Requires Specialist Assessment and Surgery

Neck pain is a common experience, especially in Singapore’s fast-paced, desk-bound work culture. When discomfort starts after a long day at the computer or waking up stiff, it is easy to assume it is just posture, tiredness, or simply getting older. But when the ache becomes more persistent or begins to limit how freely you move, you might start asking yourself, “Is this still normal? Should I see a doctor? Who do I even see for this?”

As symptoms progress, it helps to understand what they might be signalling and when they deserve closer attention. Learning to spot important changes, knowing when to involve a head and neck surgeon, and becoming familiar with the treatment and surgical options that may be discussed can bring some clarity to an otherwise uncertain situation.

Signs Your Neck Pain Might Be More Serious

Not every episode of neck pain is serious, but certain symptoms suggest that something may be affecting the nerves or other important structures in the neck. Recognising these patterns can help you decide when it is time to seek a specialist opinion. A head and neck surgeon can assess your symptoms, arrange the appropriate imaging, and determine the most suitable next steps.

You should consult a specialist if you experience:

• Neck pain that lasts several weeks without improvement
• Pain that radiates to the shoulder, arm, or hand
• Numbness, tingling, or pins and needles in the arms or hands
• Weakness or reduced grip strength in the arms or hands
• Changes in balance, coordination, or walking
• Neck pain that disrupts sleep or daily activities

A specialist evaluation does not automatically mean surgery. In fact, many patients improve with non-surgical treatments. Seeing a specialist simply ensures that you are not overlooking a condition that could worsen over time if left unaddressed.

How Problems in the Cervical Spine Lead to Neck Pain

Many of the symptoms that signal more serious neck issues come from the structures within the cervical spine, which is the portion of the spine that sits in the neck. It contains the discs, joints, and nerves that support the head and allow the neck to move. When any of these structures become irritated, worn, or compressed, the pain can feel very different from a simple muscle strain.

The cervical (neck) conditions commonly responsible for these issues include:

• Cervical disc herniation: When a spinal disc in the neck bulges or ruptures, the displaced material can press on nearby nerves. This often creates sharp pain running down the arm, along with numbness or weakness.
• Cervical spondylosis: Neck structures can gradually wear down with age, especially the discs and joints. That degeneration may lead to stiffness, chronic pain, and nerve compression caused by developing bone spurs.
• Cervical radiculopathy: Nerve roots in the neck may become pinched or irritated for various reasons. The result is often shooting pain, tingling, or numbness that travels from the neck into the arm.
• Cervical spinal stenosis: A narrowing of the spinal canal can place pressure on the spinal cord. People may notice balance problems, clumsiness in the hands, or more widespread weakness and numbness.
• Degenerative disc disease: Over time the discs can lose moisture and height, which reduces their cushioning ability. This change can create instability, inflammation, and persistent neck discomfort.

To identify the exact cause of your symptoms, your specialist will begin by reviewing your medical history, including previous injuries, daily activities, and the nature of your pain. This is followed by a physical examination to assess your neck movement, alignment, muscle tenderness, and nerve function. Imaging is not always necessary, but X-rays, MRI, or CT scans may be recommended if there is concern about nerve compression, instability, or more serious structural problems. In selected cases, additional tests such as nerve studies or blood tests may be used to rule out less common causes. These findings help determine whether conservative treatment is appropriate or whether a surgical option may offer more reliable relief.

Types of Neck Surgery and When They Are Recommended

Different neck conditions call for different surgical approaches. Depending on whether the issue involves a damaged disc, nerve compression, spinal cord pressure, or instability in the cervical spine, your surgeon may recommend one of the following procedures.

Cervical (Neck) Discectomy With Fusion

A cervical discectomy with fusion involves removing a damaged or herniated disc and stabilising the spine by fusing the surrounding vertebrae. This is most commonly performed through the front of the neck in a procedure known as Anterior Cervical Discectomy and Fusion (ACDF). It is typically recommended when a herniated disc or bone spur compresses a nerve or the spinal cord, causing symptoms such as arm pain, numbness, weakness, or persistent neck discomfort that has not improved with conservative care.

Cervical (Neck) Artificial Disc Replacement

Neck disc replacement surgery involves removing a damaged disc and implanting an artificial disc that maintains normal motion between the vertebrae. This approach preserves mobility and reduces the risk of adjacent segment wear. It is generally suitable for patients with a single damaged disc who have nerve compression but want to maintain neck flexibility and avoid the stiffness associated with fusion surgery.

Laminectomy

A cervical laminectomy removes part of the lamina, the bony roof of the spinal canal, to create more space for the spinal cord and nerves. This relieves pressure caused by narrowing of the spinal canal.It is often recommended when spinal cord compression leads to symptoms such as stiffness, weakness, difficulty with balance, or trouble walking, particularly in cases of cervical spinal stenosis.

Laminoplasty

A laminoplasty reshapes and reopens the lamina instead of removing it entirely. The bone is gently hinged open and secured in a widened position to increase space around the spinal cord while preserving more of the spine’s natural structure. This technique is commonly used when decompression is needed over multiple levels of the cervical spine and when maintaining spinal stability is an important surgical goal.

Get Dedicated Care for Your Neck Pain with Dr Chua Soo Yong

Neck pain, especially when caused by nerve irritation or spinal cord pressure, deserves a thorough evaluation to understand what is happening beneath the surface. A head and neck specialist can assess your symptoms, review your scans when needed, and explain whether conservative care or surgical treatment is the most effective path forward. If your discomfort is affecting daily activities or mobility, seeking expert guidance can help you make confident, informed decisions about your next steps.

Atlas Orthopaedic Group offers comprehensive evaluation and a full range of neck treatment options, from non-surgical care to advanced surgical procedures. Led by Dr Chua Soo Yong, the team focuses on helping patients understand their diagnosis, review the treatment options that are appropriate for their condition, and make informed decisions about their care. Reach out for a consultation to explore the path forward that best supports your well-being.