Often the arthritic changes in the neck can cause pressure on the nerves of the spine. This can cause pain which spreads down the arm and may be associated with numbness or weakness in the arm. This pain may also be felt between the shoulder blades. If the arm pain is severe or not settling by itself, then surgery may be performed to free up the compressed nerve. This surgery may be performed from the front of the neck (anterior cervical discectomy) or through the muscles at the back of the neck (posterior keyhole foraminotomy).