Disc herniation (Cervical)
Introduction
Intervertebral discs are positioned in between each vertebral body (the bones of the spine). Each disc is composed of a tough outer ring (the annulus) and a soft gel-like inner core (the nucleus). Disc degeneration or acute injury can cause the nucleus to herniate into the spinal canal or the neural foramen. The herniated disc can directly compress a nerve root (radiculopathy) or disc material can irritate the nerve root (radiculitis), causing pain, numbness, and tingling radiating down the path of the nerve from the neck through the shoulder and into the arm and hand.
Symptoms
Sharp pain, burning, tingling, or numbness in the arm and hand
Muscle weakness in the shoulder, arm, or hand
Loss of reflexes in the arm
Weakness or numbness in the legs*
Loss of bowel or bladder control*
* These symptoms indicate a very serious condition, medical attention should be sought immediately
Treatments
Treatment for a cervical disc herniation will largely depend on the length of time the patient has had symptoms and the severity of the pain. For most patients, symptoms from a cervical disc herniation will go away over time. Patients usually start with 3 to 6 months of conservative (non-surgical) treatments. Surgery may be considered if a course of conservative treatment does not provide pain relief,if the pain is too severe, or the patient is having difficulty functioning due to weakness. Conservative treatments include:
Physical therapy, stretching programs
Ice or heat
Anti-inflammatory drugs (ibuprofen, naproxen, etc.)
Prescription pain medications
Cervical epidural steroid injection
TENS
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