A cervical herniated disc occurs when the soft core of a cervical disc leaks out of its harder outer shell. Although this condition can be asymptomatic, pain occurs when the herniated material compresses a nearby nerve root. Usually, this form of ruptured disc affects the 30-50 age group.
In addition to wear and tear, cervical disc herniations may stem from some kind of trauma or neck injury. When this occurs, the symptoms often blindside the patient.
When a cervical disc herniates, the material may press on nearby cervical nerves, leading to pain that radiates all the way down the arm. In addition, numbness and tingling may also present alongside the pain. Muscle weakness in the biceps, triceps, or hands may also arise in these types of cases.
Cervical discs are not very big. But, that doesn’t mean that there is a lot of space surrounding the nerves in that area. Even the smallest crack in a cervical disc may lead to nerve pressure and, as a result, horrible pain for the patient. Usually, the arm discomfort that patients experience is among the most intense of the symptoms.
Cervical Herniated Disc Causes
Usually, it isn’t easy to figure out the exact cause of a cervical herniated disc. More often than not, the onset is slow and without a clear cause. While this may be the case, sometimes the causes can be narrowed down into the following:
- Age: Discs that have undergone the natural wear-and-tear process of aging are much more likely to herniate. When a patient is young, their discs have quite a lot of water content. Over time, the amount of water available in the discs dwindles. This makes the affected discs much less flexible, meaning that the chance of sustaining an unintentional injury is much greater.
- Genetics: Back problems often run in families and cervical herniated discs are unfortunately no exception to the rule.
- Movement: In some cases, sudden or extreme movements can lead to a cervical herniated disc. If you lift a heavy object or twist at a speed faster than your spine can handle, then you may damage a disc.
- Traumatic Event: In rare instances, a traumatic injury resulting from events such as falling or car accidents may lead to disc herniation.
Cervical Herniated Disc Symptoms
A cervical herniated disc may cause a number of symptoms in different parts of the body. For example, you may feel pain in your neck, arms, hands, fingers, or parts of the shoulder. Symptoms such as these are primarily determined by the location of the cervical herniated disc.
Remember, the cervical spine is composed of 7 bones stacked one on top of each other. Doctors order these vertebrae from C1 to C7, starting at the base of the skull and extending downward. With cervical disc herniations, the nerve affected by the condition is the one that exits at that specific level of the spine. Therefore, if the C6-C7 level has a herniation, then it is the C7 nerve that will be affected.
Herniated Disc Symptoms by Nerve Level
Again, the specific symptoms of a cervical herniated disc will depend on the affected pinched nerves. This typically breaks down as such:
- C4-C5: Here, a herniated disc will press on the C5 nerve root. At this level, disc herniations cause shoulder pain and weakness in the top portion of the upper arm. However, usually, this does not lead to numbness or tingling.
- C5-C6: This disc herniation compresses the C6 nerve root. A disc herniation at this level will lead to weakness in the biceps and wrist. Additionally, numbness and tingling may radiate along with pain down the thumb side of the hand. This nerve site is one of the most common locations for a herniated disc to occur.
- C6-C7: Here, the disc herniation impinges upon the C7 nerve root. When a herniated disc occurs in this region, it leads to weakness in the triceps and fingers. Numbness and tingling will also be present with pain that travels down the triceps and into the middle finger. This is another very common level for cervical disc herniations to occur.
- C7-T1: This occurs when a slipped disc presses against the C8 nerve root. This site sits at the base of the neck, which is then immediately followed by the thoracic spine. If a disc herniation occurs at this level, then it may lead to weakness in handgrip strength, as well as numbness and tingling that runs along the little finger side of the hand.
Of course, these are not absolute laws. Symptoms may vary across individuals—even among the same spinal levels. Everyone’s body is different in their own unique way, and as a result, symptoms may vary across the board.
Conservative Treatment Options for Cervical Herniated Discs
Most of the time, conservative methods are all a patient will ever need when it comes to resolving a cervical herniated disc. Luckily, when the arm pain starts to improve, it usually does not return. If the pain gets better and more manageable with conservative methods, then there will likely be no need for the patient to have surgery.
The following methods are effective, nonsurgical methods for treating cervical herniated discs:
- Medications: NSAIDs and COX-2 inhibitors are known to help reduce the pain of cervical herniated discs. These medicines reduce inflammation in addition to providing pain relief. Your doctor may also prescribe steroids for even stronger pain relief.
- Physical therapy: Certain therapeutic exercises may provide relief to those who have arm pain related to a cervical herniated disc. You may also use heat/ice application in conjunction with this treatment to further symptom relief.
- Cervical Traction: Neck traction will help reduce pressure over the nerve root in some cases. This does not work for everyone, but it is worth trying since it is so easy to implement.
- Chiropractic Manipulation: A chiropractor may opt to use a low-velocity manipulation technique known as mobilization. This technique can reduce joint dysfunction from cervical herniated discs.
- Bracing: In many cases, your doctor may recommend that you use a cervical collar to provide support during your periods of rest.
- Activity Modification: Certain activities will make your herniated disc pain even worse. These activities include things such as heavy lifting, boating, running, etc. By simply avoiding these activities, your pain will be much more manageable.
Surgical Treatment for Cervical Herniated Discs
If your pain is extremely severe or lasts for a period of 6 to 12 weeks, then your doctor may recommend surgery. Luckily, 95% to 98% of these surgeries result in long-lasting pain relief.
Surgery for the condition may be performed in the following ways:
- Anterior Cervical Discectomy & Spine Fusion: The most common surgical method used to treat the condition. In this procedure, the affected disc is removed through a tiny one-inch incision at the neck via an anterior approach. After the disc is removed, the surgeon fuses the remaining space together. Your doctor may also use a plate for added stability.
- Posterior Cervical Discectomy: This approach is not used as often as anterior approaches as it is more difficult. However, this procedure may become necessary if the case requires more spinal cord manipulation. This procedure follows many of the same steps as the ACDF, but requires a posterior port of entry.
- Cervical Artificial Disc Replacement: Much like the first procedure in this list, this operation is performed using a small incision in the neck with an anterior approach. The difference here is that instead of fusing the remaining disc space, an artificial disc is placed at the affected site instead. The goal here is to imitate both the form and functionality of the original spine structures.
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