The cervical spine consists of seven vertebrae, labeled C1-C7, which form the upper part of the spine in the neck. As people age, the discs between the vertebrae that cushion them and help them move more easily, degenerate. Herniated discs, also called protruded, slipped or ruptured discs, can crack, allowing the soft material inside to leak out, putting pressure on nerves, which causes pain and numbness in the neck, shoulders and upper extremities. Conservative treatment usually alleviates pain caused by protruded discs; surgery is rarely required.
Immobilization
Bed rest or reduced activity for several days to a few weeks helps relieve pain and reduce inflammation, the American Association of Neurological Surgeons advises on NeurosurgeryToday.org. A neck brace can also provide immobilization to allow healing. Using cervical traction to immobilize the cervical vertebrae, with the neck in a flexed forward position, reduces the pressure on the nerves.
Medications
Oral medications that reduce inflammation such as nonsteroidal anti-inflammatory drugs (NSAIDs) treat the pain and swelling from protruding discs. Muscle relaxants reduce muscle spasms around the damaged areas that increase pain. Injection of steroids, called an epidural steroid injection, reduces inflammation and decreases pain, the University of Florida Department of Neurosurgery states.
Physical Therapy
Physical therapy techniques that help decrease discomfort from protruding discs include massage therapy, ice and heat application, electrical stimulation and ultrasound therapy. Stretching exercises under the supervision of a physical therapist also help relieve pain.
Surgery
Over 95 percent of people with protruding cervical discs avoid having surgery, the Chicago Institute of Neurology and Neurosurgery reports. Surgery may help people who fail to improve after six to eight weeks of conservative treatment, those who are unwilling or unable to undergo conservative treatment, and those with severe symptoms requiring immediate relief to avoid permanent nerve damage.
Protruding discs can be repaired through an anterior or posterior incision, going through the front of the neck or the back, with the anterior providing more direct access, since the discs are in front of the spinal cord. Most cervical spine surgeries are done through the anterior, with the anterior discectomy and fusion technique being the most commonly performed surgery. The disc is removed and replaced with a piece of donor bone or bone from the patient's own hip. Artificial discs now available to replace the removed disc may help maintain normal mobility and prevent disc disease in other parts of the spine, according to the University of Florida. Wearing a cervical collar to immobilize the neck for 1 to 12 weeks after surgery protects the area while it heals.
References
- Chicago Institute of Neurosurgery and Neuroresearch: Cervical Disc Herniation Causes Symptoms, Diagnosis and Treatment
- NeurosurgeryToday.org: American Association of Neurological Surgeons: Herniated Disc
- University of Florida Department of Neurosurgery: Cervical Herniated Disc
- NYU Hospital for Joint Diseases: Cervical Herniated Disc
