Neck pain affects almost every adult at some point. One of the more common causes of neck pain is cervical disc herniation.
Cervical disc herniation is a condition in which part of the intervertebral disc has moved outside of its normal place within the cervical spinal column.
The cervical spine is made up of seven vertebral bones, spanning from the base of the skull to the top of the shoulders. They make up the bones of the neck and must support the weight of the head while also allowing the neck to bend, flex, pivot, and move side to side. In order to accomplish this impressive feat, each vertebra has its own cushion called an intervertebral disc. Each disc acts as shock absorber, stabilizer, spacer, and protector. An intervertebral disc has a tough, outer ring structure and a soft, jellylike core.
Whether through aging, repeated stresses, or neck trauma, the outer ring may become torn allowing the soft core to expand beyond its borders. Mild cervical disc herniation may cause few or no symptoms at all. Most people with cervical disc herniation, however, will experience neck pain especially with certain kinds of movements. In severe cases, the disc may press upon other structures in the spine causing pain, numbness, or tingling in the arms.
How is cervical disc herniation diagnosed?
A skilled orthopedic surgeon can diagnose most cases of cervical disc herniation simply by taking a careful clinical history and performing a thorough examination. In certain cases, imaging tests may be ordered such as x-ray, CT scan, or MRI of the head and neck. Imaging is certainly ordered prior to any surgical treatment. If the condition causes moderate to severe neurological damage, such as abnormal sensations in the hands or muscle atrophy, the physician may order electromyography including nerve conduction studies to assess the extent of nerve damage.
How is cervical disc herniation treated?
The treatment for cervical disc herniation is tailored to the severity of the condition and patient preferences. It is almost always appropriate to start with conservative measures, since most people will get better with time and supportive care. Conservative treatments for cervical disc herniation include over-the-counter pain medications, prescription muscle relaxants, physical therapy, back/neck education classes, ice/heat, and selective rest.
Do I need surgery for cervical disc herniation?
Some people do need surgery for cervical disc herniation. Surgery is considered in cases where medical therapy has failed to provide adequate relief. Cervical disc herniation surgery may also be required for particularly severe symptoms, such as muscle atrophy, nerve damage, and unrelenting pain. There are risks and benefits to cervical disc herniation surgery that you should discuss with your surgeon. While surgery can sometimes offer a cure for cervical disc herniation, it may be reserved until medical therapies have proven unsuccessful. On the other hand, surgical outcomes are usually excellent for patients who have neurological symptoms from their herniation, instability of the spinal column, worsening nerve damage, or arm weakness.