Cervical Disc Herniation
What is Cervical Disc Herniation?
Herniated discs can occur in any part of the spine, but they are most common in the neck (cervical) and lower back (lumbar) spine.
The seven vertebrae between the head and the chest make up the cervical spine. The bones (vertebrae) that form the spine are cushioned by round, flat discs. When these discs are healthy, they act as shock absorbers for the spine and keep the spine flexible. If they become damaged, they may bulge abnormally or break open (rupture) in what is called a herniated or slipped disc.
What Causes Cervical Disc Herniation?
A herniated disc is usually caused by wear and tear of the disc (also called disc degeneration). As we age our discs lose some of the fluid that helps them stay flexible. A herniated disc also may result from injuries to the spine, which may cause tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material (nucleus) inside the disc may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture) or break into fragments.
Herniated discs are much more common in people who smoke.
Symptoms of Cervical Disc Herniation
Herniated discs in the neck (cervical spine) can cause pain, numbness, or weakness in the neck, shoulders, chest, arms, and hands. In some cases a very large herniated disc in the neck may cause weakness or unusual tingling affecting other parts of the body, including the legs.
Diagnosing Cervical Disc Herniation
We can usually diagnose a herniated disc from your history of symptoms and a physical exam. We will ask about pain and numbness that might be caused by irritation of one or more of the nerves in the cervical spine are often recommended before further testing is done. If other conditions are suspected, or if there is no improvement in symptoms after a period of rest and rehab, imaging tests such as X-ray, MRI, or CT scan may be done.
Treating Cervical Disc Herniation
In most cases, cervical herniated discs are first treated with nonsurgical treatment including rest or modified activities, medicines to relieve pain and inflammation, and exercises. We may recommend that you see a physical therapist to learn how to do exercises and protect your neck and, perhaps, for other treatment such as traction. Traction is gentle, steady pulling on the head to stretch the neck and allow the small joints between the neck bones to spread a little. If symptoms continue, you may require stronger medicine such as corticosteroids. Symptoms usually improve over time; however, if the herniated disc is squeezing your spinal cord or nerves and/or you are having weakness, constant pain, or decreased control of your bladder or bowels, surgery will be considered. In rare cases, an artificial disc may be used to replace the disc that is removed.