The cervical disc provides cushioning between the vertebral bodies. When the disc which abnormally protrudes past its margins this is called a herniation. If there is a tear in the outer annulus of the disc, the inner nucleus can herniate from the middle of the disc. This can occur with a specific event or more commonly occur with progressive degenerative aging changes.
SYMPTOMS
An individual commonly experiences severe neck pain and possibly referred pain to the shoulder, elbow, or hand. Numbness or tingling may be present in the arm or hand and less commonly weakness can be present in the arm.
DIAGNOSTIC TESTING
As there are rare instances of a spinal cord injury from a cervical disc herniation, it is important to be evaluated by a physician. A full history and neurological exam including changes in walking patterns, weakness in the legs, and inability to urinate must be checked. Initial testing includes cervical spine X-rays to look for trauma, disc spacing, arthritis, tumor, infection, birth defects, and the overall structure. If there are any significant changes or symptoms are concerning the best test is an MRI of the cervical spine.
TREATMENTS
If there are no neurological deficits, then treatments include activity modification, anti-inflammatories, physical therapy and traction. An epidural steroid injection may be helpful for radicular pain or referred pain into the arm. If neurological deficits are worsening, then it may be time to see a spine surgeon.
