Workers’ Compensation Neck Injury Treatment in Massachusetts

Specialized Evaluation and Treatment of Work-Related Neck Injuries

A work-related neck injury can cause persistent neck pain, stiffness, radiating arm pain, numbness, and weakness. These injuries may occur following workplace accidents, heavy lifting, repetitive movements, or other occupational activities.

Pat Bovonratwet, MD, is an orthopaedic spine surgeon at Massachusetts General Hospital (Mass General) specializing in the evaluation and treatment of cervical spine conditions, including work-related neck injuries, cervical herniated discs, spinal stenosis, and nerve compression.

Dr. Bovonratwet provides specialized spine consultations and treatment recommendations for patients with workers’ compensation injuries. Treatment options may include nonsurgical management, minimally invasive spine surgery, and surgical treatment when appropriate.

Common Work-Related Neck Injuries

Work-related activities and workplace accidents can contribute to several conditions affecting the cervical spine. The appropriate treatment depends on the underlying condition, symptoms, physical examination, and imaging findings.

Cervical Herniated Disc

A cervical herniated disc occurs when the soft inner material of an intervertebral disc protrudes through its outer layer. This can irritate or compress nearby spinal nerves, causing neck pain, shoulder pain, and radiating symptoms into the arm or hand.

Symptoms may include:

• Neck pain and stiffness

• Pain radiating into the shoulder or arm

• Numbness or tingling in the fingers

• Arm or hand weakness

Cervical Radiculopathy

Cervical radiculopathy occurs when a nerve root in the neck becomes irritated or compressed. Patients commonly experience pain radiating from the neck into the shoulder, arm, or hand.

Symptoms can include burning pain, numbness, tingling, or weakness in the upper extremity. Cervical radiculopathy may result from a herniated disc, bone spurs, or narrowing of the openings through which spinal nerves exit.

Cervical Spinal Stenosis

Cervical spinal stenosis refers to narrowing of the spinal canal in the neck, which can place pressure on the spinal cord or nearby nerves.

In some patients, cervical spinal cord compression can cause cervical myelopathy. Symptoms may include difficulty with balance, changes in hand coordination, difficulty with fine motor activities, and weakness or numbness in the arms or legs.

New or progressive neurological symptoms warrant prompt medical evaluation.

Cervical Strain and Neck Pain

Cervical strain involves injury to the muscles and soft tissues supporting the neck. It may occur following repetitive movements, lifting, awkward positioning, or sudden workplace injuries.

Patients may experience localized neck pain, stiffness, muscle spasms, and difficulty with neck movement. Most cervical strains can initially be managed without surgery.

Evaluation of Workers’ Compensation Neck Injuries

An accurate diagnosis is an important first step in determining the appropriate treatment for a work-related neck injury.

During a spine consultation, Dr. Bovonratwet evaluates the patient's symptoms, medical history, physical examination, and relevant imaging studies.

The evaluation may include:

• Review of the workplace injury and mechanism of injury

• Assessment of neck pain and radiating arm symptoms

• Neurological examination, including strength, sensation, reflexes, and coordination

• Assessment for signs of cervical spinal cord compression

• Review of MRI, CT, and X-ray imaging when available

• Evaluation of previous treatments and response to care

• Discussion of treatment recommendations and potential next steps

The goal is to identify the underlying cervical spine condition and determine whether nonsurgical treatment, additional diagnostic evaluation, or surgical intervention may be appropriate.

Treatment Options for Work-Related Neck Pain

Treatment recommendations depend on the specific cervical spine condition, severity of symptoms, neurological findings, and response to previous treatment. Not every patient with a work-related neck injury requires surgery.

Nonsurgical Treatment

Many patients with work-related neck pain can initially be treated without surgery. Depending on the underlying condition, treatment may include:

• Physical therapy and guided rehabilitation

• Activity modification

• Anti-inflammatory medications or other appropriate medications

• Cervical epidural steroid injections

• Other targeted pain management procedures

When appropriate, nonsurgical treatment may help improve symptoms and restore function without an operation.

Minimally Invasive Cervical Spine Surgery

For patients with persistent symptoms caused by cervical nerve or spinal cord compression, surgery may be considered when appropriate nonsurgical treatment has not provided sufficient relief or when neurological findings warrant intervention.

Depending on the underlying condition, surgical procedures may include:

• Anterior cervical discectomy and fusion (ACDF)

• Cervical disc replacement in appropriately selected patients

• Posterior cervical decompression

• Cervical foraminotomy for selected cases of nerve compression

The appropriate surgical approach depends on the location of compression, number of affected spinal levels, spinal alignment, and overall patient health.

Dr. Bovonratwet evaluates patients for appropriate surgical treatment options and discusses the potential benefits and risks of each approach.

Workers’ Compensation Spine Consultations at Mass General

Dr. Bovonratwet evaluates patients with work-related cervical spine injuries at Massachusetts General Hospital.

Patients seeking a workers’ compensation neck consultation may include:

• Individuals with persistent neck pain following a workplace injury

• Patients experiencing radiating arm pain, numbness, or tingling

• Workers diagnosed with a cervical herniated disc

• Patients with cervical spinal stenosis or nerve compression

• Individuals who have not improved with physical therapy, medications, or injections

• Patients seeking a cervical spine surgery consultation or second opinion

The evaluation focuses on understanding the underlying cervical spine condition and providing an individualized treatment recommendation.

When additional orthopaedic evaluation is needed, patients may also have access to other orthopaedic specialties within the Mass General system.