The cervical disc is the cushioning material that lies in between each vertebral body, allowing for space and shock absorption. When the disc protrudes or bulges beyond its normal boundaries, it is called a herniated or prolapsed disc. When a cervical disc prolapse occurs, it will often irritate a cervical nerve, resulting in neck pain and radiating pain down the arm. Treatment choice is driven by the severity of symptoms.
Physical Therapy
In most cases, the first choice of treatment for a cervical disc prolapse will be a six-week course of physical therapy. The patient can expect to be treated with heat, massage, ultrasound and electric stimulation to the surrounding neck muscles, in an attempt to decrease muscle spasm and pain. The physical therapist will instruct the patient in exercises to increase muscle strength, improve posture and flexibility, which the patient which will perform at home several times per day. In cases where the cervical disc prolapse results in radiating arm pain, cervical traction may be implemented in an attempt to increase the disc space and relieve the pressure on the nerve.
Injections
If a course of physical therapy proves ineffective at reducing the symptoms from a cervical disc prolapse, the physician may recommend an epidural steroid injection. An epidural injection is performed by a neurologist, using an X-ray to guide the spinal needle to the exact area of trauma. A repeat injection is often recommended, one to three months later. According to the Chicago Institute of Neurosurgery and Neuroresearch, up to 95 percent of patients will get better without the need for surgery.
Surgery
When conservative approaches fail, or the disc prolapse is so severe that a conservative approach is not an option, surgery is a consideration. The most common surgery performed for a cervical disc prolapse is the anterior discectomy and fusion. This surgery is performed from the front of the neck. The offending disc is removed and replaced with a piece of bone, generally from the patient's own hip, or a metal plate. The patient will need to wear a cervical collar for several weeks and attend a course of physical therapy.
