Cervical disc herniations can range from mild to severe. Mild cases may not produce any symptoms, whereas others can produce mild neck and upper back pain. As the cervical disc continues to bulge or herniate it may compress the cervical nerves which could produce radiating neck, arm, and hand pain. Severe cases can produce loss of strength, coordination, fine motor skills, and sensation in the arm and hand. Sometimes disc herniations produce tension headaches or migraine headaches.
Imagine your cervical disc as a jelly donut. It has a thick and tough outer covering with a fluid substance on the inside. With trauma and damage the thick covering begins to crack and tear. The fluid begins to move towards the back of the disc. If enough fluid gets near the edge the disc bulges or changes shape. If it gets worse the fluid can get pushed outside the disc, or herniate.
The body mounts an inflammatory reaction against the jelly substance. The fluid and inflammation increase around the jelly and end up compressing the cervical nerves. Since nerves are the softest material they are the first to compress.
Any time a nerve is compressed it can produce pain, numbness, tingling, weakness, loss of strength, or loss of reflexes. The nerves in the neck travel down to the arm and hand. Depending which nerve level gets damaged you may have weakness in the thumb or little finger. Likewise you might lose the strength to raise your arm or shoulder.
Some people experience extreme pain while others have very little pain. Some people might have all their strength and reflexes but loose sensation or feeling on the outside of their hand. Others experience muscle wasting with the compressing nerve.
Orthopedic testing can often show the level of the cervical disc. An MRI will show the severity and possible multiple levels of involvement. Extreme cases may require surgical intervention, but most cases of cervical disc herniations can be resolved with conservative treatment.
Therapy involves decreasing muscle spasms and pain in the neck. When neck muscle spasm they end up producing more compression force on the disc, which pushes the jelly material backwards. There are several treatments to decreasing muscle spasms including electric, heat, ice stretching, and massage therapy.
Cervical traction or decompression therapy can be utilized to enhance flexibility of the cervical spine. In addition decompression helps bring more blood flow to the discs to enhance healing. It can also help the jelly like substance migrate back towards the middle of the disc. Some people feel a significant relief during decompression treatments. They describe their pain as decreasing “every time their neck is stretched.”
Treatment time and frequency varies with the level of injury. Mild cases can improve in a matter of weeks. Moderate and severe cases will require more treatment.
Cervical disc bulges and herniations are injuries that we treat in the office frequently. Most people will find relief within the first week and consistently improvement throughout therapy. It is a condition that will experience several exacerbations as you try and return to normal activity too soon. When treated properly there is little risk of future injury.
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