Cannot sleep/sit - Burning pain down neck and upper back (had surgery)
Hello spine warriors!
I want to preface this with that I am a 41M and had a two-level cervical disc replacement 9 weeks ago to address long term cervical herniations which I thought was causing my issues but now I'm desperately looking to see if I can get some relief and some kind quality of life back.
My quality of life is really diminished as I currently cannot really lean my head back without all sorts of very odd tingling sensations occurring around my face and neck after a short period of time when I sit and if I lay down, I eventually get burning pain all down my neck and upper back which constantly wakes me up all night.
Pain management hasn't been too helpful as meds aren't working for relief. I'm just looking for what could still possibly be driving this or what I can do to get some relief and sleep/work again.
Every day I wake up with the burning agony still and my mental health is declining.
I put together a timeline of my issue:
October 2024:
While working out in my home gym, I noticed that I was getting nerve irritation in my right shoulder/bicep/forearm. I figured it had something to do with my shoulder, so I took some time off from working out.
Late December 2024:
I started to experience radiating nerve pain laterally across my upper back into my shoulders. Was very difficult to deal with so I went to the local Ortho clinic and they x-rayed my right shoulder which came back negative. They sent me home with some medications and a script for PT.
January 2025:
I began going to PT, 3x a week. They had me doing the standard upper back/posture exercises like prone Ys, Is, some Lat pulldowns, and bunch of thoracic stretches. I was waking up at night constantly with neck pain, so I set out to buy a new mattress and pillow. Also, my upper back and traps were extremely tight during this time.
February 2025:
Finally bought a new medium firm mattress which is seemingly helping my back (lower back too) but now I have a new issue where my hands (pinky and hands finger) were falling asleep more times than not. I guess the soft mattress may have been hiding some of the issues and my body is adjusting to the firmer surface. I also began shopping around for a pillow (went through many pillows). Each pillow I tried I would also wake up with neck pain in the middle of the night until I finally found a cervical pillow (Groove pillow) that allowed me to sleep some through the night.
March 2025:
I didn't make much progress going to PT, so I decided to go book an appointment with an Ortho doctor who specializes in neck/back. They x-rayed my cervical spine which was negative and sent me home with more medications and a script for an MRI.
MRI results came back with the following findings:
C5-6: Broad-based left paracentral/foraminal disc herniation is noted with an annular fissure. This minimally indents the spinal cord. No spinal cord signal abnormality seen. There is mild left neural foraminal stenosis.
C6-7: Broad-based right paracentral/foraminal disc herniation is noted with an annular fissure. This very mildly indents the spinal cord. No spinal cord signal abnormality seen. There is very mild right neural foraminal stenosis.
April 2025:
After showing my PT my MRI results and being blown off, I switched PT providers to someone more experienced. I also noticed that my upper back pain and tightness was dissipating upon waking up but now I was getting a deep ache in the sides of my neck which would slowly sink down into my upper back after about 30 minutes. I could feel the nerves tingling in my traps as this occurs.
April 2025 to June 2025:
I continued going to PT who started me on cervical traction, some manual therapy (central PAs on my neck), massages, and TENS therapy. There was seemingly slight improvement over this time but was not anything significant. My head would continue to ache each morning I get up out of bed, but the upper back tightness was going away much quicker. I explained this to my PT, and they thought it was positive because my symptoms seemingly were centralizing.
July 2025:
I thought I was progressing in PT, so we added supine chin tucks and a new banded exercises to target my serratus muscle.
Unfortunately, all hell broke. After mowing the lawn and doing some of my PT exercises. I felt a spasm in my left shoulder blade area, and it tightened up, so I decided to just ice and heat for the day. I laid off the PT exercises for a few days and went back to my PT to explain what happened. They thought I overloaded my serratus muscle which was a sign of weakness and did some more manual therapy on me along with the standard heat and TENS.
However, a few nights later I woke up in the middle of the night with the most intense burning nerve pain in the back of neck. It radiates down to my upper back and a little into both shoulders. The pain does let up a little during the day (heat and ice constantly) but when I fall asleep on my back, the intense burning in my neck and other areas comes roaring back after a little while.
August 2025:
The pain wasn't going away so that's when I decided to go to a spine institute for more help. We tried a cervical ESI but that wasn't of any help and along with some opioid medications.
We did a repeat MRI showed that I still had the herniations at C5-C7, so I decided to surgery as I couldn't function anymore. I wasn't sleeping, working, or do much of anything. I opted for a disc replacement over fusion as my CT scan was pretty clean from my bone structure.
Thanks for taking the time to read and providing any input.
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@iamnp83
What does your surgeon say about your symptoms? Did you have your 2 weeks and 6 week post surgery follow up appointments? Did they go through the front of your neck? Did you just get disc replacement with no hardware/fusion? How did they free the nerve compression in the left and right foraminal space at c5-c6 and c6-c7?
Before having surgery, did you get an EMG/nerve conduction study of upper limbs?
It sounds like you need an updated cervical MRI to check nerves and spinal cord/soft tissues. If you are not fused and have no hardware, there could be movement of vertebrae/discs above/below levels worked on. Adjacent segment issues can happen.
Were you careful not to twist your head/neck and have you been wearing a collar/neck brace?
@iamnp83
Another thought in the new disc replacements could have changed the height space between vertebrae and irritating nerve roots differently than prior to surgery.
How did they secure the new discs inbetween your vertebrae to ensure they would not move/shift?
I have had ACDF surgery on c5-c6 and c6-c7 in 2022 and 2025 plus lumbar l3-l5 in 2024 so can empathize. I have some issues following my c6-c7 ACDF surgery that was done in June 2025 and will try PT but think there is an issue with the surgery/something shifted and new compression. I have hardware and fused. My spinal column is narrow congenitally so any compression is felt sooner than most would notice.
@dlydailyhope
My surgeon says the disc replacements are in perfect position and to work with pain management.
EMG prior to the surgery was good so there was no permanent nerve damage.
They did through go front of my neck and I have ADR without hardware as my bone structure was good on the preop CT scan. The surgeon notes said they did a foraminotomy to decompress the nerves and the discs are secured through spikes at the top of the discs (Prodisc Vivo). The disc height was restored in the process as well so it’s possible the nerve roots are being irritated at the level above.
With my ADR a collar was not required post surgery and we’ve taken multiple X-rays to confirm the implant has not shifted at all.
Not sure what can be done at this point to help get me some quality of life back, especially with sleeping or sitting.
I am actually planning on getting another MRI today and will let you know the results.
Thanks for your reply!
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Hope you can learn more following your MRI. I have a lumbar MRI later this month with and without contrast to check nerve health/inflammation and any new compression. My hope is to get an updated MRI of my cervical spine after I try PT for 4-8 weeks to see if it helps any with neck pain on the left.
One thing to keep in mind is that EMG/nerve conduction studies of limbs really only measure neuromuscular health of communications within the limb. They do not fully measure spinal cord/nerve root/spine signaling health. That is what I have been told by my orthopedic spine surgeon and one neuromuscular specialist. For example, I was told my lower limb EMG/nerve conduction studies showed “normal” results when I had severe spinal stenosis/degenerative disc disease and neurogenic claudication (low back/buttocks/hips/legs and down to feet pain/weakness/numbness). The one person said that they wouldn’t recommend lumbar surgery because it won’t do anything but in actuality, the surgery stopped some of the pain/numbness. I still have some residual pain/weakness due to long term compression and permanent injury to nerves due to delayed diagnosis/treatment.
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1 ReactionSo sorry this is happening to you at such a young age. I'm 62. I had surgery May 2025. Those nerves are still firing/healing but I feel that had I not had surgery I'd be worse at this point. The tingly fingers and forearm pain is much less frequent so I'm thinking time is all I need. My doctor was honest and said it can take up to 18 months to heal and even then it's a chance that this is as good as it gets. So at this point I have no regrets and await for the positive.
Here's my stuff. God bless!
Cervical myelopathy due to multilevel cord compression with normal sagittal alignment. I plan a cervical laminoplasty C4-C6 with plate screw reconstruction and laminectomy inferior portion of C2 all of C3 and dome of C7.
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1 ReactionGive your self grace and give your self time to heal. My first surgery was in 2013. My last was in 2022. I am fused from C/2-T-5 and T/9 -S/1. I will always be in pain. Managing pain is a full time job. Anxiety can make you symptoms worse. Try relaxation meditation.
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