A 36-year-old professional had been suffering from neck pain for a while, thinking it was related to sitting long hours at the desk. His pain would travel down one arm and pass. But then he got worried when the pain got intense, his hand felt weak and numb and he experienced tingling. We found a bulging disc in his cervical spine, commonly known as the neck region, was pressing on a nerve. This occurs when the soft, jelly-like center of a disc in the neck pushes out of its outer ring, pressing on nearby nerves. This can lead to neck pain, along with radiating pain, numbness, or tingling in the arms, shoulders or hands. Most of us do not make much of a neck pain, which is often attributed to muscle strain, poor posture or minor injury. However, in some instances, it may reflect a deeper neurological or systemic issue. Here are situations when you need to consult a neurologist: Neck Pain with Fever, Headache, and Stiffness This may be indicative of bacterial meningitis, an infection involving the meninges — the protective covering of the brain and spinal cord. The inflammation leads to neck rigidity, severe headache, fever and may progress rapidly. This condition demands immediate hospitalization and intravenous antibiotics. Pain Radiating Down the Arm with Weakness or Numbness This is the one that my patient came in with as mentioned above. Depending on which nerve is compressed, patients may experience tingling, weakness, or loss of sensation in specific parts of the arm or hand. Treatment ranges from physical therapy and medication to spinal injections or surgery in severe cases. Pain with Loss of Bowel or Bladder Control Though rare, this can signal pressure on the spinal cord, requiring immediate attention, especially if accompanied by weakness or imbalance while walking. Unusual Neck Movement After Trauma Following trauma, if the neck becomes excessively flexible or unstable, it may suggest ligament injury or vertebral fracture. This can pose a direct threat to the spinal cord. While the person may not always feel severe pain, the internal damage could be significant. Cervical spine imaging (X-ray, CT, or MRI) is essential to decide on treatment. Swollen Lymph Nodes and Persistent Neck Pain If neck pain is accompanied by persistently enlarged lymph nodes, especially if firm or growing, it may point to an underlying infection, lymphoma (a kind of blood cancer) or a cancer which has spread. In such cases, neurological symptoms may emerge if surrounding nerves or structures are affected. A clinical evaluation, blood tests, and imaging are crucial for early diagnosis. Neck Pain with Chest Discomfort Sometimes neck pain can radiate from the heart during a heart attack. In these situations, neck pain may accompany chest pressure, shortness of breath, or dizziness. These symptoms should always be evaluated in an emergency setting. While neck pain is usually benign, it can sometimes be the first sign of a serious neurological issue. Recognizing the warning signs and seeking timely care can make a critical difference. (Dr Renjen is neurologist, Indraprastha Apollo Hospitals, Mumbai)
