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Cervical Disc Herniation

Symptoms of a Herniated Cervical Disc

cervical disc herniationOne of the most common causes of neck pain, shoulder pain, and arm pain is a herniated or ruptured cervical disc. Symptoms of cervical disc herniation include:

  • Dull or sharp neck pain which is intensified by certain positions or movements
  • Pain between the shoulder blades
  • Pain that radiates down the arm to the hand or fingers
  • Arm numbness, tingling, or weakness

In more severe cases, a cervical herniated disk can cause spinal cord compression. Symptoms of this more serious condition include:

  • Problems with hand/arm fine motor skills
  • Difficulty walking, i.e. stumbling/awkward gait
  • Tingling or shock feeling down the torso/into the legs

Cervical Spine Anatomy

The cervical spine – your backbone – is made up of seven cervical vertebrae which are separated by discs that act as shock absorbers and which together with their adjoining facet joints allow you to bend and rotate your back and neck. Doctors commonly refer to these vertebrae as C1-C7, with C1 being closest to the skull and C7 near the chest/rib cage (thoracic) region of the spine.

Each disc features an outer band called the ‘annulus fibrosus,’ which encases a gel-like substance called the ‘nucleus pulposus.’ In addition, nerve roots are found in the passageways between the vertebrae in the spinal canal which relay sensory and motor information between the body and brain. When damage occurs to the intervertebral discs, the nucleous pulposus may protrude from the disk, causing compression of the surrounding spinal nerves manifesting in pain. In the case of a herniated or ruptured disc, the annulus fibrosus actually breaks open or cracks, allowing the nucleus pulposus to escape. This is also known as herniated nucleus pulposus (HNP). A ruptured or herniated disk may cause pain, weakness, tingling, or numbness in the arms, shoulders, and sometimes legs.

Stages of a Cervical Herniated Disc

There are four stages to a cervical herniated disc:

  1. Disc Degeneration: As part of the natural aging process, chemical changes occur which cause intervertebral discs to weaken, dry out, or become thinner.
  2. Prolapse: Commonly referred to as a protruding or bulging disc, the form of the disc changes, slightly impinging into the spinal canal or spinal nerves.
  3. Extrusion: The nucleus pulposus breaks through the annulus fibrosus but remains within the disc.
  4. Sequestration or Sequestered Disc: The nucleus pulposus breaks through and moves outside the disc into the spinal canal.

Spinal Disc Rupture: Risk Factors

The following factors increase the risk of spinal disc herniation, which may occur suddenly or develop gradually over many weeks.

  • Daily wear and tear
  • Natural process of aging wherein intervertebral discs dry out and become thinner, affecting disc strength and resiliency
  • Poor lifestyle choices, i.e. lack of regular exercise, smoking, inadequate nutrition
  • Incorrect lifting/twisting
  • Injury (i.e. whiplash accident)
  • Poor posture/biomechanics

Cervical Herniated Disc Treatment Options

The good news is that over 90% of people recover naturally from cervical disc herniation within six weeks and resume normal activities. Non-surgical treatment options for relieving symptoms include:

  • Painkillers/anti-inflammatory medications/muscle relaxants to reduce pain and swelling
  • Short period of rest followed by a resumption of normal activities as soon as possible to prevent stiffness
  • Physical therapy (cold/heat therapy, gentle massage, neck traction, stretching)
  • Chiropractic manipulation
  • Neck strengthening exercises
  • Epidural steroid injection therapy

Surgical Options to Treat Ruptured Disc

If spinal cord suppression is suspected or if non-surgical treatments do not relieve neck pain sypmtoms, spinal surgery may be in order. With the goal of removing the part of the disc compressing on the nerve, doctors perform a surgical procedure called a discectomy. Operating from either the front of the back of the neck to reach the spine (anterior or posterior discectomy), disc material is removed from the nerve. The procedure is minimally invasive and the prognosis very good. In fact, many patients go home within 24 hours after surgery. As part of their post-operative rehabilitation, patients often attend physical therapy and exercise programs.

How to Prevent Neck Pain and Cervical Disk Herniation

While the process of aging is unavoidable, certain lifestyle changes can go a long way in preventing a herniated cervical disc. Since risk factors for the condition include poor body mechanics, poor posture, smoking, obesity, and weak muscles, adopting healthier habits in each of these areas will help preserve your back and neck health long into the future.