Cervical Disc Herniation

What is a cervical disc?

A cervical disc is a sac filled with a gel-like material found between your vertebrae. Your vertebrae are the bones in your back that are linked together to form your spine. Your spine surrounds your spinal cord that contains your nerves. Your cervical discs and vertebrae are found in your neck. Your cervical vertebrae and discs help your spine support your head. Your discs allow your neck to make certain movements such as bending and turning. Your discs also help protect your spine from being damaged by movement.

What is cervical disc herniation?

Cervical disc herniation occurs when the gel-like material bulges out from between your vertebrae. The bulging disc may press on your nerves or spinal cord. A bulging disc may be painful and decrease your neck movement. Having your cervical disc herniation treated may decrease your pain. Treatment may also prevent your nerves or spinal cord from being permanently damaged.

What causes cervical disc herniation?

• Cracked vertebrae: Cracks or changes in the shape of your vertebrae may increase your risk for a bulging disc. The gel-like material inside your disc may leak out of the cracks. The whole disc may also begin to bulge out of the cracks in your vertebrae.
  
  
• Disc weakening: Your discs become weak if the gel-like material inside decreases. The disc loses its cushion and may bulge out from between your vertebrae. Your discs often begin to weaken as you age.
  
  
• Injury: Your discs cushion the forces that occur when you fall, twist, or strain your neck. A disc may herniate if these forces are very strong, or if your discs are weakened.

What are the signs and symptoms of cervical disc herniation?

A mild cervical disc bulge may not cause any signs and symptoms. You may have signs and symptoms if your bulging disc presses against your nerves or spinal cord. You may have any of the following:

• Neck pain.
  
  
• Arm, shoulder, and upper back pain.
  
  
• Numbness (no feeling), tingling, or a burning feeling in your arms or hands.
  
  
• Headaches.
  
  
• Trouble moving your arms or using your hands.
  
  
• Leg weakness and trouble walking.
  
  
• Leaking urine or stool (bowel movements).

How is cervical disc herniation diagnosed?

Your caregiver will ask you about your symptoms and any health problems you may have. He will do a physical exam and check your movement and function. You may also need the following:

• Imaging tests: These tests may use a dye to help your caregiver see the pictures better. People who are allergic to iodine or shellfish (crab, lobster, or shrimp) may be allergic to some dyes. Tell your caregiver if you are allergic to shellfish or have other allergies.
  
  
  • Computed tomography scan: A computed tomography (CT) scan uses a special machine to take pictures of your neck.
    
    
  • Magnetic resonance imaging: During magnetic resonance imaging (MRI), pictures are taken of your neck. An MRI may show a bulging disc, and if it is pressing on your nerves and spinal cord. Never enter the MRI room with any metal objects. This can cause serious injury.
    
    
  • Myelography: A myelography is an x-ray picture of your spinal cord. Dye will be given as a shot into the area around your spinal cord before the pictures are taken.
    
    
  • X-ray: An x-ray picture may be taken to check for abnormal areas in your neck.
    
    
  • Discography: Discography is done to learn if your bulging disc is what is causing your pain. During this test, your caregiver injects dye into the disc he believes is herniated. When the injection is done, you may feel pain. After the injection, you may have a CT scan done to look at your disc. Ask your caregiver for more information about discography.
  
  

How is cervical disc herniation treated?

Your caregiver may have you rest your neck in bed for a few days. You may also have any of the following:

• Medicines:
  
  
  • Pain medicine: Pain medicine may help decrease, or take away your pain.
    
    
  • Nonsteroidal anti-inflammatory medicine: Nonsteroidal anti-inflammatory medicine (NSAIDs) may help decrease pain and inflammation (swelling). This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.
    
    
  • Muscle relaxers: This medicine helps relax your muscles. It is also given to decrease pain and muscle spasms.
    
    
  • Steroid medicine: Steroid medicines help to decrease inflammation.
  
  

• Injection therapy:
  
  
  • Chemonucleolysis: During chemonucleolysis, your caregiver will give you a shot of medicine into your bulging disc. The medicine used for this treatment works by shrinking your bulging disc.
    
    
  • Epidural injection: An epidural injection is medicine given as a shot into the area of your bulging disc. The injection may numb the area and decrease your pain.
    
    
  • Nerve block: A nerve block is a shot of medicine into a nerve near the area of your bulging disc. The injection may help to decrease pain and inflammation.
  
  

• Acupuncture: You caregiver may suggest you try acupuncture treatments. Acupuncture may help to decrease your neck pain. Ask your caregiver for more information about acupuncture.
  
  
• Physical therapy: A physical therapist works with you to make your neck muscles stronger and decrease your pain. A physical therapist may teach you exercises and stretches that help your neck and back. They may also use massage and other treatments to improve your functioning.
  
  
• Support devices: You may need to wear a neck brace, or use a special pillow to support your neck. Support devices help decrease your neck movement and prevent more damage. Ask your caregiver for more information about support devices.
  
  
• Electrothermal therapy: During electrothermal therapy, a heating coil is inserted in your neck and into your bulging disc. The heating coil will then seal any breaks in the disc wall that are causing it to bulge out.
  
  
• Spinal cord stimulation: Spinal cord stimulation uses an electric current to "awaken" your spinal cord and decrease your pain.
  
  
• Surgery: You may need surgery to fix your bulging disc if other treatments have failed. Surgery may also be done to decrease pressure on your nerves and spinal cord. Surgery may be done to remove your bulging disc and make your spine stronger. Your caregiver may use a bone graft (bone from another area of your body) to replace your disc. A man-made disc may also be used to replace your disc. Ask your caregiver for more information about the different surgeries for herniated discs.

Where can I get more information?

Contact the following:

• American Academy of Orthopaedic Surgeons
  6300 North River Road
  Rosemont , IL 60018-4262
  Phone: 1- 847 - 823-7186
  Web Address: http://www.aaos.org/
  

When should I call my caregiver?

Call your caregiver if:

• You begin leaking urine or stool, and it is not normal for you.
  
  
• Your pain worsens even after taking your medicines.
  
  
• Your voice becomes hoarse (rough).
  
  
• You have questions or concerns about your condition, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You cannot move your neck.
  
  
• You are unable to move one or both of your arms.
  
  
• Your legs become weak and you have trouble walking.
  
  
• You suddenly have trouble breathing.
  
  
• You suddenly have trouble swallowing.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Cervical Disc Herniation