Are you suffering from neck, shoulder or arm pain frequently? If yes, you should have an immediate check up with your doctor, because it may be related to your cervical (intervertebral disc) spine. Our cervical spine is made up of first 7 vertebrae present between the head and the chest. So, any herniation or rupture of the cervical disc triggers the pain in the neck, shoulder and the arm. The pain is dull to sharp in nature, particularly in between the shoulder blades and the neck, which radiates to arm, hand, and the fingers, causing numbness and tingling sometimes. The pain aggravates by bad postures and movement of the neck.
In extreme conditions, a herniated cervical disc leads to spinal cord compression by pushing the disc materials on the spinal cord, which causesthe symptoms like difficulty in motor skills of hands and arms, difficulty in walking, tingling sensation in the legs.
What is the normal anatomy of Cervical Invertebral Disc?
There is an intervertebral disc, a fibrous shock-absorbing pad, in between each of the spine bones (vertebrae). There are also endplates, which lines the ends of bones (vertebrae), and holds each disc in position. Each of the discs contains an outer band which is called as annulus fibrous. The annulus fibrous contains a jelly like substance, called nucleus pulpous. The nerves pass through the small passages between the vertebrae and the discs, and exit the spinal canal.
What are possible causes of a cervical herniated disc?
According to a study published in the European spine Journal, it is mentioned that the cervical disc herniation mostly occurs at the lower cervical level than the upper cervical level. The study also says that mechanical stress plays the major role in the development of the herniation.
Basically, the cervical herniated disc occurs due to the wear and tear of the disc. It is also termed as disc degeneration. With increased age, the disc bands breaks, or cracks, which in turn, causes the leakage of the disc material(nucleus pulpous), and leads to the bulging or rupture of the disc. The breakage may also happen due to the injury to the spine, which causes cracks in the outer capsule of the disc. Herniated disc mostly occurs in chronic smokers. It can occur suddenly, or sometimes it develops gradually in weeks or months.
What are the possible risk factors of a cervical herniated disc?
There are various factors which can trigger the cervical disc herniation. Some of them are mentioned below:
- Lifestyle: Poor lifestyles like lack of physical activities, use of tobacco, insufficient intake of nutrition, etc. can impact on the disc health.
- Age: As age advances, the intervertebral discs go through the natural biochemical changes like gradual dry out, which can weaken the strength and resiliency of the disc.
- Bad postures: Poor postures with incorrect body movement can cause additional stress on the cervical discs.
How is Cervical Herniated Disc Diagnosed?
Cervical herniated disc is sometimes asymptomatic, because it does not cause symptoms in all the patients. It is mostly discovered by an x-ray, which is taken for an unrelated problem.
In most of the cases, the patients visit a doctor, when the symptoms become prominent. The doctor will do the following things during the checkup:
- Physical examination
- Neurological examination
- Medical history
- Evaluation of the symptoms
- History of the treatment
- History of Medication
- X-ray: To evaluate the other factors of the back pain, like arthritis.
- CT scan/MRI: To check the location and extension of the damage disc.
What are the non-surgical treatments available for a Cervical Herniated Disc?
In most of the cases, the herniated cervical disc is treated with non-surgical treatments. The non-surgical treatments usually include rest, cold/heat therapy, medication, and physiotherapy. The majority of the patients gets relieved ofthe symptoms within 4-6 weeks after the non-surgical treatment. It is estimated that only 5% of the patients require surgical treatment. So, it is important to be optimistic in choosing the right treatment.
Your doctor will first recommend for cold/heat therapy. In the first 24-48 hours, the cold therapy will work to decrease the muscle spasm, swelling, and pain. After 48 hours, you can use heat therapy, which increases the flow of blood to relax the soft tissues. The improved blood circulation will help flush away the toxins out of the soft tissues. Always use the ice or heat therapy on a soft cloths putting it on your skin. Do not use therapy for more than 15-20 minutes. Repeat it for 3-4 times in a day.
Medications are prescribed to reduce the pain and inflammation. The medications used are:
- Anti-inflammatory medication.
- Muscle relaxant
- Analgesic or pain killers (narcotic)
- NSAID (non-steroidal anti-inflammatory): For mild to moderate pain.
- Corticosteroid: If the symptoms continue.
Your doctor will recommend for physiotherapy. Usually, the physiotherapist will provide you the therapy as per the doctor’s prescription, which is done in combination with the non-surgical treatments, to cure the pain and improve the flexibility. The physiotherapy includes cold and heat therapy, stretching, gentle massage, and neck traction.
What are the surgical treatments available?
Surgical treatment of cervical herniated disc is considered if the non-surgical treatment avenues do not work in relieving the symptoms. The surgery is also recommended if spinal cord decompression is found. If your doctor suggests a surgery, then ask about the reason of it, and also the pros and cons of the surgery. Do not hesitate to take a second opinion, before undergoing the procedure.
How is the surgery performed?
Usually, the surgery is performed from the front of the neck. The surgeon will make a small incision, and removed out the intervertebral disc and replaced it with small graft of bone. The graft will fuse with the vertebrae gradually. During the procedure, the surgeon may need to remove a portion of the bone that covers nerve, to have a better access of the problem disc. It is done from the back of the neck, and it is called Laminotomy. The procedure can be performed by minimally invasive technique, where the surgery needs only a few small incisions and instruments, like endoscope and microscope.
What are the preventions cervical herniated disc?
Though the risk of herniation increases with age, but one can prevent it by adopting the following lifestyle changes:
- Improve your postures.
- Correct the body movements.
- Quit smoking.
- Maintain the body weight.
- Adopt the habits that are good for your spine.
- Exercise regularly.
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