The spine is cushioned by cartilage-filled discs that function as shock absorbers. Bulging discs, also known as herniated discs, can put pressure on the spinal cord and cause pain and nerve dysfunction. This condition, known as spinal stenosis, commonly occurs in the cervical vertebrae in the neck.
Causes
Sometimes an injury can lead to bulging of a cervical disc, such as trauma to the neck or improper lifting of objects, the Mayfield Clinic explains. Age is also a factor. As people age, the discs that cushion the spine lose fluid, which causes them to become dry and less pliable. This can lead to the outside of the disc, which is made of a tough fibrous material, to become weaker, which can cause the softer gel-like interior to penetrate through the outer layers, causing the disc to bulge or herniate. Smoking, genetics and certain activities can contribute to this process.
Symptoms
The symptoms of a bulging neck disc depend on which nerves are affected. Many patients will experience numbness or weakness of the hands, feet and limbs, the Mayo Clinic notes. This can cause patients to have problems with dropping objects or losing their balance. If nerves in the neck are compressed, neck or shoulder pain can result. Severe cases of herniated discs in the neck can affect the nerves that control the bladder and the bowels, which can cause fecal or urinary incontinence.
Complications
One of the most dangerous complications of cervical stenosis, the North American Spine Society notes, is called cervical myelopathy. This condition leads to loss of control of the upper and lower extremities because of prolonged damage to the nerves that control motor signals to these areas. Cervical myelopathy tends to progress gradually, so patients might feel that their hands are becoming clumsier. Patients might also have problems walking and might develop an unsteady gait.
Diagnosis
Diagnosis of a bulging neck disc begins with a physical exam and questions about the symptoms that the patient is experiencing. Imaging tests, including a CT scan and a MRI, can also help identify any damaged or herniated discs. Patients can also benefit from an X-ray, which will allow for the visualization of bones in the spine. In order to determine which nerves are affected, a myelogram, which involves the injection of a special dye into the spinal canal followed by an X-ray, can allow doctors to see which nerves are being compressed. Finally, electromyography and nerve conduction velocity testing can identify which nerves are affected by the bulging disc.
Treatment
Conservative treatment for a herniated disc involves the use of pain relievers and muscle relaxants to help reduce muscle spasms as a result of the herniation. Patients might also benefit from the use of corticosteroids, which reduce inflammation and can be taken orally or injected into the affected neck region. Physical therapy can be used to increase strength and stability in the neck. In some cases surgery may be needed. Several surgical procedures can be done that will either attempt to create more space for the spinal cord, remove the damaged disc or fuse vertebrae together.
