Orthopedic doctors are primary specialists for treating neck pain, particularly when the discomfort arises from structural issues within the cervical spine. An orthopedic doctor is a medical physician focused on the musculoskeletal system, which includes the bones, joints, ligaments, tendons, and nerves throughout the body. Their specialized training enables them to diagnose and manage a wide range of conditions affecting the neck, from acute injuries to long-term degenerative processes.
The Orthopedic Scope for Neck Pain
Orthopedic care is centered on mechanical and physical problems of the neck, or cervical spine. Specialists frequently manage degenerative conditions that occur over time, such as cervical spondylosis (age-related arthritis affecting the neck joints and discs). They treat intervertebral disc issues, including herniated discs where material irritates nearby nerves, and spinal stenosis, which is the narrowing of the spinal canal that can compress the spinal cord or nerve roots. Traumatic injuries like whiplash or cervical fractures also fall under an orthopedist’s care, as do conditions like degenerative disc disease. The orthopedist uses imaging, such as X-rays and MRI scans, to pinpoint the structural source of the patient’s pain and plan a targeted course of action.
Initial Non-Surgical Treatment Approaches
Most people experiencing neck pain begin with non-operative treatments directed by their orthopedic doctor. A common strategy is a referral for physical therapy (PT), which aims to strengthen cervical muscles, improve posture, and restore the neck’s range of motion. Physical therapists often employ specific exercises, like chin tucks and cervical retraction, to improve alignment and reduce muscle strain. Medication management involves using non-steroidal anti-inflammatory drugs (NSAIDs) to decrease inflammation or muscle relaxers to alleviate spasms.
If oral medications and physical therapy fail to control symptoms, the orthopedist may recommend targeted injections. Cervical epidural steroid injections deliver corticosteroids directly near the spinal nerves to reduce inflammation and pain. Facet joint injections may also be used to treat pain originating from the small joints between the vertebrae. These minimally invasive procedures are performed under imaging guidance to ensure precise placement, providing temporary relief that allows the patient to engage more fully in physical therapy. Short-term use of soft cervical collars or bracing may also be recommended to temporarily immobilize the neck and promote initial healing.
Surgical Interventions for the Cervical Spine
Surgery is typically reserved as a last resort, considered only after conservative treatments have failed, or if there is evidence of severe or worsening nerve compression (radiculopathy) or spinal cord compression (myelopathy). The primary goal of cervical spine surgery is to relieve pressure on neural structures and stabilize the spine. One frequently performed procedure is an Anterior Cervical Discectomy and Fusion (ACDF), where the surgeon removes a damaged disc and fuses the adjacent vertebrae using a bone graft or plate.
Another modern surgical option is cervical disc replacement, or arthroplasty, which involves removing the problematic disc and inserting an artificial implant. Unlike fusion, disc replacement is designed to maintain motion at the treated spinal segment, potentially preserving the function of adjacent segments. Other decompression procedures, such as laminectomy or laminoplasty, may be performed to create more space for the spinal cord and nerve roots when stenosis is the underlying issue.
When to See Other Specialists
While the orthopedist manages structural neck pain, other specialists often collaborate in patient care or take the lead for non-structural issues. A neurologist is the appropriate specialist if the pain is primarily related to brain or nervous system function, such as non-structural nerve disorders or certain headaches and migraines that originate in the neck. They focus on nerve conduction and neurological symptoms.
A physiatrist, or a physical medicine and rehabilitation (PMR) physician, specializes in non-surgical, interventional pain management and functional restoration. They are experts in therapeutic injections and prescribing comprehensive rehabilitation plans, often working alongside the orthopedist to guide recovery. A rheumatologist should be consulted if the neck pain is suspected to be caused by a systemic inflammatory condition, such as rheumatoid arthritis, which affects the entire body’s joints and requires specialized medical management.