Cervical Disc Herniation: Symptoms, Treatment, Outlook

A herniated disc, also known as a slipped disk or ruptured disk, occurs when a tear in the tough outer covering of a spinal disc allows the spongy center to bulge out. A cervical disc herniation occurs in the part of the spine in the neck, or cervical region.

Spinal discs are found between most of the bones of the spine (vertebrae). They cushion the bones and allow the spinal joints to move smoothly.

When a disc herniates, it can press on the spinal cord or spinal nerves and cause pain, numbness, or other symptoms. Damage to the disc can also cause local inflammation and swelling that irritates a nerve.

Causes

Spinal discs have a soft center ( nucleus pulposus) and a tough outer covering ( annulus fibrosus). Disc herniation is when part or all of the center pushes out through a tear or weak area of the outer covering.

Most often a herniated disc develops gradually, or chronically. This is generally due to age-related changes that occur in the spinal disc, also known as disc degeneration. In this case, symptoms tend to develop more gradually and be less severe.

Disc herniation can also occur suddenly due to an injury or other trauma. This causes a tear in the outer covering of the disc, which allows the center to protrude. Symptoms of an acute disc herniation will usually begin suddenly and be more severe than with chronic disc herniation.

Symptoms

The type of symptoms that occur and their location depend on which nerve is compressed by the herniated cervical disc, but include:

• Muscle tenderness or spasms in the neck or shoulders
• Pain in the neck, shoulder, or shoulder blade.
• Numbness or weakness in the arm or hand.
• Eye or ear pain, or headache.

Certain symptoms may indicate another problem such as an inflammatory condition, tumor, or infection, such as:

• Fever or chills
• Night sweats
• Unexplained weight loss
• Pain that doesn’t go away
• Tenderness over a bone of the spine (vertebra)
• Swollen lymph nodes

Risk Factors

Certain factors increase the risk of having a herniated disc in the cervical spine, including:

• Age. The risk of cervical disc herniation increases with age due to the degeneration of the spinal disc.
• Female. Women in all age groups are more likely to have a herniated cervical disc.

Other factors may increase the chance of an acute disc herniation, such as certain occupations, sports, or other activities that carry a risk of neck injuries.

Diagnosis

The following may be used to diagnose a cervical disc herniation:

• Medical history, including symptoms and past neck injuries or surgeries.
• Physical examination to identify which nerve(s) might be compressed.
• Blood tests to look for inflammation, tumor, or other conditions that might be causing the symptoms.
• Imaging tests to look for a herniated disc or damage to the vertebrae or other tissues of the spine. This may include X-rays, CT scan, or an MRI.

Treatment

Cervical disc herniation is usually managed first with non-surgical, or conservative, treatments. This may include:

• Neck collar. A special collar worn around the neck can reduce movement of the spine. This is generally only used for a short time and in people with acute neck pain.
• Traction. Short periods (15 to 20 minutes) of traction can sometimes relieve compression of the spinal nerve.
• Medications. Non-steroidal anti-inflammatory drugs (NSAIDs) or oral steroids such as prednisone may be used to reduce inflammation. A muscle relaxant can relieve muscle spasms. Antidepressants and anticonvulsants may be used to reduce nerve-related symptoms.
• Physical therapy. Some people benefit from physical therapy after a short period of rest. This may include ice or heat therapy, strengthening exercises, or electrical stimulation therapy.
• Spinal steroid injections. Steroids injected into the spine can reduce inflammation and nerve-related symptoms.

If these conservative methods don’t help, or if symptoms are severe or worsening, surgery may be required, such as:

• Anterior cervical discectomy with fusion. In this procedure, the herniated disc is removed. The vertebrae on either side are then fused using bone or bone-like material and metal implants. This stabilizes the spine at that level.
• Total disc replacement. The herniated disc is removed and replaced with an artificial disc device that mimics the function of the spinal disc. This procedure stabilizes the spine and allows for more natural movements of the neck.

Prevention

It is not possible to completely prevent the age-related changes that occur to the spinal discs, but you can take several steps to keep your cervical spine and spinal discs healthy, including:

• Maintain good posture in the neck and upper back, especially while using a computer or handheld device.
• Exercise regularly with proper form.
• Eat healthy, well-balanced meals.
• Break up long periods of sitting or standing with movement or stretching
• Stop smoking.

Outlook

For most people with a cervical herniated disc, symptoms decrease on their own over six weeks as the body heals the herniated disc and the tissues that surround it. Non-surgical treatments can support this healing and reduce symptoms during that time.

However, around one-third of people who are treated non-surgically will have ongoing symptoms. If symptoms last for more than six weeks, they are less likely to go away without the need for surgery.

Conclusion

A cervical disc herniation is when a damaged spinal disc in the neck presses on the spinal cord or a spinal nerve. This can cause symptoms such as numbness, weakness, or pain in the neck, shoulders, or arms.

Most cases of cervical herniated discs are due to age-related changes that occur in the spinal discs. Non-surgical treatments are generally tried first. If those don’t help, or if the symptoms worsen, surgery may be needed.

Originally published at https://spinenation.com.