Cervical Herniated Disc

Symptoms of a Herniated Disc

When a disc is herniated the symptoms will depend on the location of the herniation and what structures it effects. Cervical or neck disc injuries can effect the back of the head, neck, arm, shoulder blade, to the hand. Symptoms can vary from mild or none at all if the disc is the only structure involved or:

• Pain in the neck or radicular to the arm and down to the hand if the disc presses on the nerve root
• Sensory Changes such as numbness or tingling if the nerve is compromised.
• Weakness, muscle atrophy or wasting in the arm or hand may occur if the motor portion of the nerve is effected by the disc. In severe cases paralysis may occur.
• Diminished reflexes in the upper extremity
• Muscle spasm and changes in posture in response to the injury.
• Loss of motion inability to move head and neck
• Sitting for extended periods of time may produce neck and arm pain
• A patient with a herniation may be symptom free if the disc does not press on a sensitive soft tissue structure.

Treating a Disc Herniation

Treatment of a disc herniation or injury will depend on the severity of the condition. When treating acute disc or back problems

• Rest. Avoid the activities that produce the pain (jumping, running, stairs, kneeling, squatting, etc).
• Anti-inflammatory drugs and pain medications.
• Apply ice to the neck and cervical spine to help reduce pain and associated muscle spasm. Apply it right away and then at intervals for about 20 minutes at a time. Do not apply directly to the skin.
• Instruction in correction and maintenance of good posture.
• The use of a brace or other support may be necessary to reduce stress on the disc, muscles and cervical spine.
• Physical therapy for back and disc problems must remain conservative at the beginning to avoid aggravating the condition. Your therapist should emphasize rest, reducing the inflammation and increasing the blood circulation for healing. Once the initial inflammation has been reduced, a program of stretching and strengthening will be started to restore flexibility to the joints and muscles involved, while improving strength and stability of the spine. Each program will be based on the structure causing the problem and symptoms. A program not tailored to the specific problem may aggravate symptoms

Severe or Non responsive Disc Conditions

In the case of conditions that do not respond to conservative care after 8-12 weeks surgery may be indicated. If you continue to experience some of the following symptoms

• Increase in radiating or radicular pain from the neck to the arm
• Pain or nerve damage that is getting worse
• The development or increased weakness in the upper extremity and or hand
• Increase in numbness or parasthesia in the arm
• Loss of bowel and bladder control

Medical Procedures

Injections like facet injections, nerve blocks or an epidural. These may involve the injection of corticosteroids to a specific structure to reduce local inflammation.

• Caudal Epidural Injections
• Interlaminar Caudal Epidural Steroid Injections
• Transforaminal Epidural Injections
• Selective Nerve Root Blocks

Surgical Procedures

• Endoscopic Decompression
• Endoscopic Foraminotomy
• Percutaneous Decompression
• IDET Intradiscal Eletrothermal Therapy
• Selective Endoscopic Discectomy
• Spinal Cord Stimulator
• Epidural Lysis of Adhesions