Dr. Mohajer on Neck Pain: “Surgery should be the last option”

By Last updated on April 5th, 2020 Last updated on April 5th, 2020 No Comments

Dr. Mohajer on Neck Pain: “Surgery should be the last option”

Neck pain is an increasingly common symptom among patients old and young, as up to 70% of all people experience neck pain at least once in their lifetimes. Surgical intervention, however, is rarely the answer. Dr. Mojaver explains why.

Neck pain, just like lower back pain, is a common problem for many people. In order to discuss neck pain, it is important to define neck as any area just below your head and above your shoulder blades.

Up to 70% of the population can have at least one instance of neck pain throughout their lives.

Neck pain is considered anywhere from the cervical vertebrae number-one (C1) to cervical vertebrae number-seven (C7). 8 nerves that line within your cervical spine, all subject to transmit sharp pain.

Now, continuing with the anatomy, there are several structures that can cause neck pain. This can include pain from anywhere in your skin, the soft tissue just underneath your skin, your muscles, your ligaments, the discs, your facet joints and any combination of those can cause pain.

“In order to find where the pain is coming from, we have to do several tests. These tests can include the physical examination—actually touching the patient to see where the pain is coming for and what maneuvers cause the soreness.” Dr. Mojaver explains.

“In addition to physical examination, diagnostic images such as MRI and CT (X-ray) scans are very important to pinpoint the painful area that wouldn’t be noticed by the physical examination” the physician adds.

Other diagnostic images, such as nerve conduction studies can also be helpful to pinpoint a specific nerve root that’s being affected.

Neck Pain Causes and Treatment

Even minor damage to any of the structures we’ve talked about can cause serious neck pain. This could be motor vehicle accident, degeneration of the discs due to aging or bulging discs that imitate a nerve that causes pain down either arm.

Naturally, the best course of action is to take precautions to prevent neck problems in the first place. Exercise, weight loss, and smoking cessation have been shown to be very helpful in this regard.

As far as treatment is concerned, several options are available, from simple to incredibly complex.

The simplest measures would be preventative: weight loss and exercise. Anything to strengthen the core muscles alleviates pressure off the discs.

Over the counter medications, prescribed medications, alternative therapies (acupuncture, massage therapy, cognitive behavior therapy, medical cannabis) are also options to consider.

Interventional procedures are very helpful in both diagnosing and treating specific problems in the neck, as well as regenerative medicine (stem cells and Platelet Rich Plasma). And, of course, surgery.

“As with any orthopaedic problem, surgery should be the last option. Most people try other modalities before moving on to surgical intervention, and I believe it’s a good route to consider. The reason for that is that surgery does not completely alleviate the pain. There are many structures that we discussed earlier that can cause neck pain and all of those cannot be fixed with surgical intervention.” Dr. Mojaver warns.

Why Is Regenerative Treatment So Effective?

The general reason why naturally regenerative orthobiologic treatments are so effective is because they allow your own stem cells to be injected into your facet joints, or to the damaged ligaments and muscles, to fix the problem and get rid of the pain.

Quite often people have multiple levels that are degenerative and facet joints that are arthritic. With surgical intervention, big operations are not always successful.

“With regenerative medicine, we are able to inject into multiple levels, into the facet joints, that provide significant pain relief. After injection of stem cells, results are not immediate—it takes some time for stem cells to start regenerating the broken tissue. This can range anywhere from several weeks to several months. By the 3-month mark, patients usually notice significant change in their pain level and an increase in their range of motion,” Dr. Mojaver explains.

“Stem cells that we use at CELLAXYS are typically derived from the patient’s own bone marrow aspirate, this procedure can be done under light sedation with minimum discomfort. The patient comes in and lies on their stomach, we prep their back area where the pelvic bone is and we anesthetize it with a local anesthetic and try to make sure the patient is comfortable,” Dr. Mojaver says in the interview.

At that point, a needle is put to the pelvic bone and some volume is removed. It is then taken and centrifuged down. “We also take some blood from the patient and spin it down—this would become the Platelet Rich Plasma (PRP), the combination of PRP and bone marrow aspirate is then injected into a specific problem area,” the physician adds.

Recovery Times and Initial Examination

As far as post-procedure pain, there is some discomfort from the bone marrow aspirate in the injection site that typically lasts from 1 to 2 days. The injections into facet joints are can be followed by a mild pain in the area for a few days before it subsides. The injections into the disc, however, can make you feel uncomfortable for about 3-4 days.

“Here at CELLAXYS we tailor the treatment to the patients. Once the patient comes in for an initial consultation, a physical examination is done and a thorough history is taken at that point we tailor the treatment plan to the patient’s needs. At that point, we offer an array of options where the patient can make a conscious decision about what they would like to do.” Dr. Mojaver concludes.

Dr. Pouya Mohajer

Dr. Pouya Mohajer

Director of Spine & Interventional Medicine
Board certification in Anesthesiology and Interventional Pain Medicine
Fellowship-trained from Harvard University
UCLA Alumni