Neck Pain

At Nucellin Orthopedic Clinic in Seoul, Dr. Heejun Kim personally assesses neck pain through your symptoms, physical and neurologic examination, daily loading pattern and imaging when necessary.

A scan shows structure. It does not always explain pain.

The goal is to identify the source of symptoms and choose the least invasive treatment that can reasonably restore function.

Common Neck Problems

Neck pain may come from:

• Muscle or soft-tissue overload
• Cervical disc irritation or herniation
• Facet-joint pain
• Cervical nerve-root irritation
• Age-related disc and joint degeneration
• Shoulder-girdle dysfunction
• Whiplash or other traumatic injury
• Previous cervical injury or surgery

Symptoms such as pain extending into the shoulder or arm, tingling, numbness, weakness, hand clumsiness or balance difficulty can provide important clues.

Not all arm pain is caused by a cervical nerve. Symptoms may also arise from the shoulder, surrounding muscles or peripheral nerves.

Two people with similar MRI or X-ray findings may have very different symptoms. Imaging should therefore be interpreted together with the examination.

Diagnosis

Diagnosis begins with your history and a hands-on examination.

Dr. Kim may assess:

• Location and pattern of pain
• Cervical range of motion
• Muscle strength
• Sensation and reflexes
• Nerve-root and nerve-tension signs
• Shoulder and shoulder-blade function
• Hand coordination and grip
• Walking and balance
• Activities or positions that reproduce symptoms

The purpose is not simply to identify an abnormality, but to determine whether it actually explains the patient’s symptoms.

Imaging

X-rays may be used to assess alignment, instability, advanced degeneration, fracture or previous surgery.

Musculoskeletal ultrasound may evaluate selected muscles, tendons, joints, peripheral nerves and soft tissues around the neck and shoulder girdle. It can also guide targeted procedures when appropriate.

MRI is not required for every episode of neck pain. It may be recommended when there is persistent arm pain, significant numbness or weakness, abnormal reflexes, hand clumsiness, balance difficulty or concern about spinal-cord compression.

If MRI is required, imaging can be arranged at a nearby radiology centre and reviewed by Dr. Kim.

Treatment

Treatment depends on the diagnosis, neurologic findings and your functional goals.

Options may include:

• Load modification and rehabilitation
• Regenerative Physical Therapy
• Shockwave Therapy for selected soft-tissue pain
• Medication when appropriate
• Ultrasound- or fluoroscopy-guided injections
• PDRN-based regenerative injections
• Medial branch block or epidural treatment when indicated
• Activated PRF Therapy
• Selected cell-based regenerative treatments
• Surgical referral when necessary

Treatment is introduced step by step. A procedure should not be selected simply because an X-ray or MRI shows degeneration.

Forceful manipulation may not be appropriate when there is a cervical disc problem, progressive arm symptoms, weakness, spinal-cord signs or recent significant trauma.

The goal is not only to reduce pain, but to improve movement and restore the capacity of the neck and shoulder girdle to tolerate daily load.

Learn more about Regenerative Physical Therapy →

Learn more about Shockwave Therapy →

Activated PRF

For selected patients with chronic facet-related pain, ligament or soft-tissue pain, or other appropriate cervical and surrounding tissue conditions, Dr. Kim may recommend Activated PRF Therapy.

Activated PRF is prepared from the patient’s own blood using Nucellin’s mechanically activated platelet- and fibrin-based protocol.

The treatment is intended to support the biologic environment around the affected tissue. It is not a routine cure for cervical disc degeneration, cervical radiculopathy or spinal-cord compression, and results vary according to the diagnosis and severity of the condition.

Learn more about Activated PRF Therapy →

Cell-Based Treatment

Selected patients with chronic degenerative cervical or surrounding musculoskeletal pain may be considered for autologous blood-, bone marrow- or adipose-derived cell-based treatment.

These treatments are not appropriate for every patient with neck pain. They are not routine first-line treatments for non-specific neck pain, cervical disc degeneration, significant nerve compression or spinal-cord compression.

Suitability depends on the suspected pain source, neurologic findings, imaging, stage of degeneration, previous treatment and the patient’s goals. Current evidence for cell-based treatment in cervical spinal conditions remains limited.

Learn more about Cell-Based Therapy →

When Surgery May Be Appropriate

Non-surgical treatment is not always the right answer.

A surgical opinion may be appropriate when there is:

• Progressive arm or hand weakness
• Significant or worsening neurologic loss
• Hand clumsiness, gait disturbance or balance impairment
• Cervical spinal-cord compression
• Severe nerve-root compression with persistent disabling symptoms
• Major cervical instability
• Fracture, infection or tumour
• Persistent pain and loss of function despite appropriate non-surgical treatment

The goal is not to avoid surgery at all costs, but to determine when non-surgical treatment is reasonable and when surgery may provide a better result.

When to Seek Medical Attention

Arrange an assessment if your neck pain:

• Persists or repeatedly returns
• Extends into the shoulder, arm or hand
• Causes persistent tingling, numbness or weakness
• Limits work, sleep, driving or exercise
• Began after a significant accident or fall
• Is progressively worsening
• Has not improved despite previous treatment

Seek urgent medical care for progressive arm or hand weakness, repeated dropping of objects, new hand clumsiness, walking difficulty, poor balance, bladder or bowel dysfunction, severe pain after major trauma, or a sudden unusual headache with weakness, facial asymmetry, speech disturbance or visual change.

International Patients

International patients can consult directly with Dr. Kim in English.

You may send or bring previous X-rays, MRI images and medical reports. Same-day consultation, X-ray or ultrasound assessment and selected treatments may be possible when medically appropriate.

If MRI is required, we can arrange imaging at a nearby radiology centre.

Bone marrow- and adipose-derived procedures require separate planning.

Arm symptoms do not always begin in the neck. The correct target matters.

Contact Nucellin Orthopedic Clinic →