I'm weighing the pros and cons of having surgery for a neck problem. I have cervical radiculopathy. What are the long-term benefits and effects of this operation?

Neck and arm pain from cervical radiculopathy are fairly common problems in adults over the age of 50. Arthritic changes in the spine can result in pressure on the spinal nerves. Besides pain, patients report numbness, weakness, and loss of function.

When the problem doesn't go away on its own, medical treatment may be needed. Anti-inflammatory drugs may help reduce swelling. This can help take pressure off the nerve.

Improving posture and positioning during daily activities, computer work, and while sleeping in bed are key features of a conservative approach to this problem. Modifying the way activities are done may be important.

Physical therapy intervention is another conservative way to approach this problem. The therapist uses a wide range of modalities for cervical radiculopathy. This may include manual therapy such as joint and soft tissue mobilization and joint manipulation. Cervical traction, strengthening exercises, and restoring nerve mobility may also be included.

When none of these efforts prove helpful in reducing painful symptoms, then surgery may be the next step. But studies show that more than 25 per cent of the patients who have surgery for this problem still have severe and debilitating pain 12-months later.

When looking at the long-term results, other studies support the use of conservative care over surgery. At least six months of conservative care are advised before considering surgery.

Sometimes it takes a combined effort of many treatments to get the desired results. Give yourself plenty of time to mix and match various approaches before moving on to a more invasive approach.