Cervical degenerative disc disease occurs when the fibrous outer layer of the intervertebral disc begins to decay. This leads to the formation of microscopic tears and defects in the outer layer. As the vertebrae press on the disc, the more gelatinous inner material can extrude through the defect and form a bulge. The symptoms of cervical degenerative disc disease occur when the bulge pushes on the adjacent spinal nerves or the spinal cord. Pathology in these neural tissues produces different symptoms and affects different body regions, depending on which cervical level is involved.
Lack of Symptoms
People with degenerative disc disease may be asymptomatic, which means they may not experience symptoms at all during the course of the disease, according to the Mayfield Clinic. The condition usually begins in the person's 20s and 30s, with the first symptom being pain. People over 60 usually do not have degenerative disc disease.
How Symptoms Begin
Pain and other symptoms of degenerative disc disease are usually triggered by a traumatic physical event, like a head or neck injury. The resultant pain may appear unexpected, and even an insignificant injury may suddenly result in neck and back pain. Sometimes, no trigger at all is required and the pain seems to simply appear and gradually worsen.
Radiculopathy and Myelopathy
As the bulging disc pushes onto the spinal nerves, it produces symptoms characteristic of problems in the spinal nerve roots, called radiculopathy. The primary symptom is called radicular pain. In contrast, when the bulge pushes on the spinal cord, it produces symptoms of pathology in the spinal cord, or myelopathy.
Parasthesia and Pain
A February 2001 article in the "British Medical Journal," states that a common symptom of cervical degenerative disc disease is arm and neck pain. Sometimes, pain and numbness can even be felt on the soles of the feet. With progressive disc disease, bulging sensory dysfunctions escalate causing pain in the neck, back of the head and in the shoulder blades, as well as behind the eyes and the ears. Bending the head can cause dizziness. Continued bulging can result in shoulder, arm and hand pain, and the fingers can start to feel numb. According to the "British Medical Journal" article, other symptoms can include partial diaphragm paralysis, weakness, and Horner's syndrome.
Motor Symptoms
The February 2001 article in the "British Medical Journal," also states that motor disturbances with cervical degenerative disc disease are generally felt as clumsiness of the hand instead of weakness. Simple tasks may be difficult to perform. Moving the neck may be difficult and walking may also be affected. Walking may become broad-based, unsteady and stiff-legged. Also, walking may seem like shuffling, with jerky or hesitant movements. Continued disc degeneration may press onto the central interior portion of the spinal cord. This produces more complex motor dysfunctions which create more involved problems with walking.
Associated Symptoms
Sometimes, the central mass of the disc can herniate after trauma and produce other sensory symptoms. These include loss of feeling around the mouth, and widespread shoulder and neck pain. This might also be accompanied by sluggish reflexes and disturbances in upper limb sensations, as opposed to lower limb disturbances.
References
- Mayfield Clinic: Degenerative disc disease
- Centra Care Health Library
- "British Medical Journal"; Degenerative cervical disc disease causing cord compression; P. Bently, et. al.; February, 2001
- "Spine"; The Clinical Presentation of Uppermost Cervical Disc Protrusion; T. Chen; February, 2000
- "Journal of Neurology, Neurosurgery and Psychiatry"; Midcervical central cord syndrome: numb and clumsy hands; M. Nakajima and K. Hirayama; June, 1995
