Neck Pain and Hand Numbness... Similar Symptoms but Completely Different Diseases: How to Distinguish Them [Health Planning for the 100-Year Life]

[Financial News] Office worker Mr. Park (49 years old, male) who had been experiencing neck pain and hand numbness recently found it difficult to perform delicate finger tasks due to worsening hand numbness. Similarly, Mr. Lee (45 years old, male), also visited the hospital with neck pain and hand numbness. Although they visited the hospital with similar symptoms, Mr. Park was diagnosed with "ossification of the posterior longitudinal ligament" while Mr. Lee was diagnosed with a "cervical disc," resulting in different diagnoses for the two individuals.
Is there a way to directly distinguish between these two diseases with similar symptoms?
Ossification of the posterior longitudinal ligament is a condition where the ligament (posterior longitudinal ligament) supporting the back of the cervical spine hardens like bone. Although the exact cause is not clearly identified, the incidence rate is high among Asians, including Koreans and Japanese. It is presumed that genetic and racial factors play a significant role due to the high familial incidence rate. The progression is usually slow, and initially, it may be asymptomatic or similar to disc symptoms, but as the ossified (hardened) area enlarges and compresses the spinal nerves, it can cause tremors in the hands and feet or gait disturbances. In severe cases, it can lead to paralysis of the limbs, so caution is necessary.
A cervical disc is a herniated condition where the nucleus pulposus of the cervical spine protrudes and compresses the nerves due to reduced elasticity and cracks in the annulus fibrosus as one ages. In the case of a cervical disc, pain in the back of the neck and the upper shoulder is most common, along with numbness in the arms and shoulders, and in severe cases, it can damage the spinal cord, causing weakness or paralysis in the legs.
It is difficult to clearly identify the two diseases based on symptoms alone. Therefore, it is not easy for patients to distinguish the diseases themselves. Misdiagnosis or misunderstanding as another disease due to similar symptoms can lead to different treatment directions or prognoses, so it is advisable to seek a spinal specialist for an accurate diagnosis.
Depending on the case, both cervical disc and ossification of the posterior longitudinal ligament may progress simultaneously, so examinations such as X-ray, spinal CT, and MRI are conducted according to the patient's situation. MRI examinations can determine the degree of disc protrusion and nerve compression. Ossification of the posterior longitudinal ligament can accurately identify the shape and size of ossification, as well as the degree of spinal canal stenosis and compression. Both conditions can be treated with non-surgical methods such as exercise restriction, medication, and physical therapy in the early stages. However, if symptoms are severe and accompanied by limb paralysis, surgical treatment is necessary, so it is recommended to visit the hospital without delay if symptoms occur.
To prevent neck diseases, it is effective to maintain a correct posture and strengthen the back muscles regularly. The cervical spine is less resistant to external shocks or unstable postures compared to the thoracic or lumbar spine, so maintaining a correct posture is very important. If you need to maintain a certain posture for a long time due to PC or smartphone use, it is helpful to frequently stretch to relieve neck stiffness and reduce muscle tension.
 
Min Seonghun Director (Bareun Sesang Hospital Spine Center / Neurosurgery Specialist)



kim091@fnnews.com Kim Youngkwon Reporter