Question
I have a history of neck pain and have previously had a C5-C6 fusion.  Over the last ten months I have hand increasing pain on the left side of my neck going across my shoulders.  I have a lot of cracking, popping, and grinding sounds shen I move my neck.  The pain is almost intolerable.  I have been referred to a neurosurgeon but have to wait about six week for the appointment.  Could you tell me if the CT shows the possibiliy of anything serious or anything treatable.  Impression: Anterior and interbody fusion is seen at C5-C6 with multilievel mild marginal spurring of the cervical vertebrae without large disc herniation; however, evaluation is limited without intratecal contrast.
Facet arthropathy is seen with interval increase in facet arthropathy on the left side at the C2-C3 level. Minimal neural foraminal narrowing on the left side at C2-C3 from facet arthrpathy is seen.   And also this is on the report...Findings:  There is anterior and interbody fusion at the C5-C6 level.  There is minimal marginal spurring of C3-C4 vertebrae and moderate spurring along the anteroinferior endplate of C6.  There are no subluxations.  There are degenerative changes at the C1-C2 articulation.  At C2-C3, there is moderate facet hypertrophic osteoarthritic change on the left side.  At C3-C4 and C4-C5, there is mild bilateral facet mypertrophic osteoarthritic change.  There is no sizable disc herniation, central canal.  Exam is limited without intrathecal contrast.  For evaluation of Disc herniation or neural foraminal stenosis.  The facet arthropathy at C2-C3 on the left side has prgressed in the interval.  
Can you help me understand what this all means?  Thank you so much.

Answer
Tamlin,

You have an arthritic neck.   The joints are degenerated, with bone spurs and cartilage degradation.   For some people, wearing a cervical neck collar takes the pain away.  Others need manual therapy including mobilization, manipulation (by a chiropractor), heat therapies such as therapeutic ultrasound, soft tissue mobilization (e.g. GrastonTechnique.com), manual traction (e.g. chiro or PT) and home neck traction, and exercise therapy or training.   Some folks need all of these all at once.    If you don't have any arm/hand/finger weakness or loss of reflexes, then likely the neurosurgeon is not the person to see.   You only have pain that refers across the shoulders.  This often comes from irritated joints in the neck.   Only when there is irritation of the nerves that exit the spinal canals will there be symptoms into the arms/hands, and only when these nerve roots are compressed (e.g. being pressed upon, displaced, or squooshed) by a herniated disc or protruding bone spur will there be arm/hand pain and weakness and loss of your reflexes.   When people just have irritated joints, e.g. arthritic joints or joints strained from an injury like a whiplash, they often get a referred pain pattern across the neck and shoulders in what's called a "coat hanger distribution," since the pattern people describe is in that shape.   You really ought to consider seeing an MD Pain Management Specialist, often MD Physiatrists or Anesthesiologists, and they can do procedures to alleviate the pain.  This might include "facet joint blocks" or epidural steroid injection procedures.    They also could help direct you to a chiropractor, PT, or, if need be, a neurusurgeon.   

'Hope this was helpful.

Dr. G'