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Shoulder and Neck Pain After ACDF Surgery

Shoulder and Neck Pain After ACDF Surgery

With age, the intervertebral discs and joints in the vertebral column start to wear and tear. Damage to these supporting structures of the spine can result in medical problems. For example, the cervical spine (neck region) pain might result from a damaged disc pressuring your spinal cord or nerve. Furthermore, due to this disc wear and tear, you may experience walking difficulties, numbness, and pain in your neck, shoulder blade, and arm.

When you visit a doctor to complain about pain or numbness in your neck, back, or arm, they may recommend several therapy options, including medication, lifestyle changes, and physical therapy. Sometimes, you may need surgery.

One surgery they may recommend is ACDF, however, some people still experience pain in the neck and shoulder after it.

This article discusses the procedure and if shoulder and neck pain is normal after an ACDF surgery. You’ll also learn tips to help hasten your recovery. Let’s get to it!

What Is ACDF Surgery?

ACDF stands for anterior cervical discectomy and fusion. This procedure is ideal for removing injured discs in the cervical spine and consequently alleviating pain. During the procedure, your surgeon will decompress the spinal cord and affected nerve roots by relieving the pressure from the damaged disc. ACDF treats spinal instability, cervical radiculopathy, fractures, and disc herniations.

The ACDF surgery requires the surgeon to make incisions in the anterior region (front of the neck) and perform a discectomy (spinal disc removal). Next, the surgeon holds the vertebrae above and below the removed disc with a bone graft. This fusion stabilizes the region in the absence of the disc.

Your doctor may get the graft from three sources. One of these sources is your bone, usually a piece of your pelvic bones. The other sources are from a donor or a substitute from a bioresorbable compound like ceramic.

Who Is A Candidate For ACDF Surgery?

Before your doctor recommends you for ACDF surgery, they must have tried other non-surgical remedies, all to no avail. If your neck pain persists or worsens after these remedies, you may be suitable for ACDF surgery. Your doctor will also check your spine for other spine issues. If you have other spine issues, your doctor may recommend correcting those issues before you undergo neck fusion surgery.

Lastly, your doctor will consider your general health. For example, suppose you have heart disease, severe obesity, or chronic high blood pressure. In that case, you may not qualify for ACDF surgery.

Who Needs ACDF Surgery?

After consulting with your doctor, you may qualify for an ACDF surgery if you have any of the following:

Herniated Disc

Due to aging and traumatic injuries, wear and tear is the primary cause of herniated discs. A herniated disc is a problem with one of the discs sitting between your vertebrae that make up your spine. They may slip off their original position, compressing surrounding structures. This condition can occur in any part of your spine, especially the lower back.

You may experience pain in several locations depending on the site and the extent of the damage. If you have a herniated disc, you may feel pain in your neck and shoulder and numbness in your shoulders and arms. Sometimes this numbness may radiate into your arms.

Degenerative Disc Disease

This condition also occurs due to age. Your spinal discs naturally absorb shock between your vertebrae, improving flexibility, and helping you bend and twist. When these natural actions cause pain, it often results from degenerative disc disease.

Furthermore, this disease causes stiffness, pain, and decreased flexibility. Some patients even develop bone spurs which cause nerve irritation. Symptoms of degenerative disc diseases include constant sharp pain in your neck or back.

Spinal Stenosis

This condition results from the narrowing of the spinal canal till it becomes too small. This small space then pressurizes the nerves and spinal cord, which pass through it, resulting in pain, muscle weakness, and numbness.

Degenerative disc disease, disc herniation, and scoliosis are some of the causes of stenosis. In addition, you may have stenosis if you experience symptoms, including balancing and walking difficulties, neck pain, and tingling.

When Should You See A Doctor?

You may feel neck pain as a result of muscle stiffness. Nevertheless, this pain should wear away over time. However, you must seek medical attention if your neck pain persists or if specific symptoms accompany the pain. Some accompanying symptoms include urinary or fecal incontinence, swollen neck glands, chest pain, and muscle stiffness. Furthermore, if you experience weakness, numbness, or tingling radiating into your extremities, visit your doctor as soon as possible.

Is ACDF Surgery Painful?

The ACDF procedure is minimally invasive. That is because your surgeon does not cut through a lot of soft tissue during the surgery. Furthermore, you should not feel pain because the procedure is performed under anesthesia.

However, you may experience voice hoarseness or sore throat after the procedure. You may also experience swallowing difficulties. Nevertheless, this discomfort should wear off with time.

Recovery After ACDF Surgery

Although ACDF surgery has a success rate, complications still occur like any other surgery. This complication often results from anesthesia. Some of the potential complications include excessive bleeding and infection of the vertebrae. You may also experience long-term pain at the bone graft location.

Following your doctor’s instructions, post-surgery can speed up your recovery and limit the risk of complications. Some after-care tips after your ACDF surgery include;

  • Wearing your neck brace as your doctor instructs. Ensure you don’t bend, tilt, or twist your neck
  • Managing your pain as your doctor instructs. Do not use NSAIDs like aspirin or ibuprofen to alleviate pain because they may hinder bone healing.
  • Getting enough sleep and rest. However, avoid staying sedentary for a long time. Nevertheless, avoid physically demanding activities if your doctor clears you to do so.
  • Maintaining a healthy diet and staying hydrated. In addition, avoid taking alcohol or tobacco products.
  • Contacting your doctor if you experience fevers, chills, severe neck pain, or swallowing or breathing difficulties

Should You Have Shoulder And Neck Pain After ACDF Surgery?

shoulder pain after cervical disc replacement

After ACDF surgery, it is normal to feel pain in your neck and between your shoulders for a few weeks post-surgery. This pain is normal and results from the incisions during the ACDF surgery. Furthermore, because your body is adjusting to the changes created by the fusion, you should feel some neck and shoulder discomfort. Fortunately, this pain subsides as your wounds and muscles heal over the next few weeks.

Do You Need Physical Therapy After ACDF Surgery?

Yes. Although your neck will be in a brace for at least four weeks after your surgery, it is still essential to undergo physical therapy post-surgery. Fortunately, your physical therapist in Merrick, NY, carries out physical therapy treatments in phases to speed up your recovery. Reasons why you need physical therapy after ACDF include;

Improved Range Of Motion

After your ACDF surgery, you will lose some range of motion in your neck. Consequently, the levels below and above the fusion may wear out due to the lack of movement post-surgery. Fortunately, your physical therapist can help you with low-intensive exercises that maintain movement in your neck vertebrae.

Postural Flexibility Strength

Your physical therapist will retrain your chest and neck muscles to maintain good posture, stabilize your head and maintain flexibility. In addition, you should undergo exercises that strengthen the muscles around your incision and the muscles surrounding your vertebrae.

Better Recovery

The purpose of an ACDF surgery is to remove herniated discs resulting from decreased flexibility in the neck. After your surgery, your physical therapist will educate you on maintaining proper posture to speed up your recovery. The physical therapist will instruct you on the best posture when sitting, sleeping, reading, or working at a computer.

What Are The Phases Of Physical Therapy After ACDF Surgery?

Usually, after the surgery, your doctor will recommend physical therapy in Merrick, NY. But because your neck is delicate and you are wearing a neck brace, your physical therapist will perform your treatment in phases to avoid straining the neck.

Protective Exercise Phase

This is the wound healing and protection phase, which usually occurs within the first four weeks post-surgery. And during this phase, your physical therapist focuses on educating you about the best posture to improve your range of motion. You will also undergo gentle extension, flexion, and retraction exercises. During this phase, avoid lifting, twisting, or bending.

Strengthening Exercise Phase

The strengthening exercise phase occurs between weeks 4 to 8 post-surgery. During this phase, your physical therapist initiates light strengthening exercises to stabilize your neck and upper extremities. Your physical therapist will also review your posture and increase your aerobic endurance exercises.

Sports Phase

You should be able to return to your normal activities after 12 weeks post-surgery. Your physical therapist in Merrick may also certify you are ready to carry out sports activities like running, yoga, swimming, and outdoor biking.


After an ACDF surgery, it is normal to feel neck and shoulder pain. In addition, recovery may take several months depending on factors including age and general health. However, physical therapy in Merrick, NY at Summit Physical Therapy, can help speed up your recovery and regain your range of motion.

Physical therapy in Merrick includes a series of exercises with increasing intensity as you heal. In addition, the physical therapists at Summit Physical Therapy will work with you after an ACDF surgery to develop a customized treatment plan and educate you on your posture to speed up recovery. Get in touch with us to learn more.

Summit Physical Therapy