Neck Pain · Finding the Real Cause · Glastonbury, CT
Neck pain can come from a joint, a disc, a ligament, a nerve or a muscle, and each needs a different plan. Dr. Tortland's approach is built around finding the actual source of your pain and, when the history calls for it, testing for ligament looseness that a still picture cannot show.
Quick answer
Neck pain can come from the joints, discs, ligaments, nerves or muscles, and a bulging disc on an MRI does not always mean the disc is the cause. Dr. Tortland examines you, uses ultrasound, and orders digital motion X-ray (DMX, a video X-ray of the neck moving) when your history calls for it. Arm weakness, trouble walking, or loss of bladder or bowel control needs urgent care.
Most common conditions
Facet joint pain, whiplash, cervical radiculopathy, cervical instability
Diagnosis method
Live ultrasound, exam, and DMX when indicated
Non-surgical options
Ultrasound-guided PRP, prolotherapy, nerve hydrodissection
Return to activity
Usually within days; depends on treatment
First results
Weeks 4 to 16, depending on treatment
Who treats you
Dr. Tortland personally, every visit
When surgery is right
Spinal cord compression, progressive weakness, or radiculopathy needing decompression
Insurance
Not covered; but HSA / FSA applicable
Definition
Neck pain gets treated as a muscle or disc problem far too often. It often isn't.
Pain felt in the neck, shoulder, arm, or head can come from several different structures: the small facet joints, the ligaments that hold the vertebrae in alignment, the discs, the nerve roots, and the muscles at the base of the skull. An MRI report that says "bulging disc" is often handed to patients as if it explains the pain, but disc bulging is very common in people with no neck pain at all, so the finding alone doesn't prove the disc is the source. Dr. Tortland's evaluation examines the joints, ligaments, nerves, and surrounding soft tissue, using live ultrasound, before assuming the disc is guilty.
When neck pain continues after an injury and the MRI or CT looks normal, something may still be wrong. These scans show the neck at rest, and loose ligaments may only show up when the neck moves. Digital motion X-ray (DMX) records the neck on video as you bend forward, backward and sideways, and can show movement that a still picture misses.
Indications
Choose a focused guide to explore the symptoms, evaluation, and treatment considerations for a specific neck condition or injury.
Treatment options
Neck pain treatment depends on whether symptoms come from a joint, disc, ligament, muscle or irritated nerve. Dr. Tortland begins with diagnosis and discusses options based on the suspected pain source, examination and appropriate imaging.
For suitable diagnoses, options may include ultrasound-guided PRP or prolotherapy for selected ligament or joint-related problems, and nerve hydrodissection when a specific peripheral nerve entrapment is identified. Other image-guided procedures may be discussed when clinically indicated. These treatments are not appropriate for every neck condition.
Physical therapy, posture and movement changes, graded strengthening, activity modification and a home exercise program may help. Depending on the cause, medication, conventional interventions or referral to another specialist may be appropriate. Surgery is considered when the condition warrants it, especially with serious or progressive neurologic findings.
The best plan depends on the diagnosis, symptom severity and goals. A careful evaluation helps distinguish neck pain that may respond to conservative care from problems needing different or more urgent treatment.
Step by step
01
Dr. Tortland starts with your story and a hands-on exam, with ultrasound used in the visit, to work out whether the pain is coming from a facet joint, muscle, ligament, nerve root, or disc. A disc finding on an MRI doesn't always explain neck pain.
02
Any MRI, CT, or X-ray you have is reviewed alongside the exam. If neck pain lingers and standard imaging looks normal, digital motion X-ray (DMX) may be considered to look for loose ligaments (instability) that still pictures can miss.
03
Treatment is matched to the likely source of pain, such as a facet joint, a loose ligament, an irritated nerve, or a muscle, instead of one generic neck pain plan.
04
When PRP is the right next step, it's prepared in the office during the same visit and matched to the patient's age, condition, and platelet count, not a one-size-fits-all kit.
05
The injection is guided by live ultrasound, so Dr. Tortland can see the target and nearby structures while placing the needle.
06
You leave with written instructions on activity and medications. Some soreness for a few days after an injection is common.
07
Follow-up is typically about six weeks to three months later, to compare your symptoms with where you started and decide on next steps.
Candidacy
Looking for low back or mid-back pain instead?
Back Pain: Finding the Real Cause →Comparison
Frequently asked
Sources
01
Mulvaney SW, Tortland PD, Shiple B, Curtis K. Regenerative medicine options for chronic musculoskeletal conditions: a review of the literature. Endurance and Sports Medicine. 2018.
02
Nakashima H, Yukawa Y, Suda K, Yamagata M, Ueta T, Kato F. Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects. Spine (Phila Pa 1976). 2015;40(6):392-398. doi:10.1097/BRS.0000000000000775
03
Vernon LF, Benn A. Documenting Cervical Spine Injuries Following Negative MRI Findings: Clinical and Medico-Legal Overview of Dynamic Imaging. Cureus. 2025;17(7):e88121.
Candidacy is determined on exam and imaging, not over the phone. Bring your MRI and get an honest answer in one visit.