Herniated Cervical Disc
A quick explanation
A Herniated cervical disc is very common and often extremely painful - if you have been diagnosed with one, you will know how painful it can be. It is something that I have to treat on a daily basis my physiotherapy practice. But before we look at the causes, symptoms and treatments of this painful condition, let’s do a quick recall of what a ‘herniated cervical disc’ is?
The cervical region of your spine runs from the stem of your brain down your neck. This region as 7 vertebrae known as C1-C7. Each vertebra has nerves coming from its right and left sides. Between each vertebrae lies a disc, which allows the vertebra to move as well as cushion and protect the vertebra from shock and impact. I often describe a disc as being like a Jam Donut! It has a firm outer shell and a soft pulpy centre. I have another article that explains what a herniated disc is in a bit more detail.
A herniated disc is where the soft centre has oozed away from its central position and/or where the shell has been damaged and cracked. When the disc moves out of position it is known as a herniated cervical disc. Due to the close position of the discs to nerves, disc movement often results in a nerve becoming compressed by the disc, resulting in further pain and disability.
Common Cause of a Disc Herniation in the Cervical Spine
A disc herniation can generally occur anywhere along the cervical spine, but they commonly occur in the lower region of the Cervical Spine. I find that the cervical disc most prone to herniation is at the level of C5/C6. This is a disc at the base of your neck, close to where your upper back (Thoracic Spine) meets your neck. It is also worth noting that cervical disc herniations most commonly occur patients below the age of 55.
I generally find that there are two common causes of disc herniation:
- Disc injury from a trauma, such as a sports injury or car accident. but in my experience, the most common cause by far is:
- Poor Posture!
Why so? Well it commonly affects people who sit for long periods of time - usually office workers or long distance drivers. The posture that places excess pressure on your lower neck is a chin poke posture. This is where your chin is poked forwards causing a build up in pressure in your lower neck. Eventually over time breakdown in your neck, upper back or shoulders will result.
If you are suffering with posture-related neck pain after sitting seek physiotherapy advice before it becomes more serious. As you can see, correcting a poor posture, will help prevent such occurrences from happening in the future!
Symptoms of Herniated Cervical Disc
Although disc pain varies a lot it is usually very severe at the outset. Inflammation is often associated with a herniated disc and the pain you experience is simply the result of that inflammation. If the disc is pressing on a nerve you may also have what we call a referral pain - where you experience arm pain, weakness, pins and needles and numbness. The symptoms of this type of pain will be influenced by what disc is herniated and give a clue as to what disc is herniated. For example:
- if the disc at C5/6 - that is the disc between the 5th and 6th vertebrae, you may experience pain and weakness in the biceps, and pins and needles or numbness in on the upper side of your arm down to the thumbs;
- If the C6/7 disc is herniated, then the triceps and even middle finger could be affected; or
- If the C7/T1 disc is herniated, then you might also experience weakness in your hand grip, and/or pins and needles in your ring finger or little finger.
So, how do you treat a herniated cervical disc?
How you treat a herniated cervical disc will depend on the severity of the herniation as well as the degree of pain and symptoms that you are experiencing. This is best diagnosed and assessed by your doctor and/or physiotherapist, with the aid of an MRI scan if required.
When treating a herniated disc, we focus on reducing the inflammation around the disc as well as reducing the pressure on any nerve that might be impinged, causing those arm symptoms we were talking about earlier.
Most cervical disc herniations can be treated effectively with manual therapy to get help get the disc back into is correct position, followed with exercises. Another effective manual treatment technique for cervical discs is manual traction. This is where your neck is gently stretched longitudinally to allow the disc material to centralise again.
Once the disc is correctly aligned, the deep muscles of your neck will require strengthening exercises to reduce the risk of your disc herniating again. Strength work is very important in the long term management of cervical disc herniations.
If your herniated disc is severe or persistent, then medication, steroid and anti-inflammatory may also be prescribed by your doctor to help alleviate symptoms and reduce inflammation. However, while this may alleviate the symptoms, be aware that they will not address the cause of your herniated disc, so you should continue with your physical therapy where you can.
Occasionally, symptoms may still persist after both manual therapy and medical intervention, or the there may be associated neurological signs and symptoms. In these cases, surgery may be considered and you might be referred to a specialist surgeon to discuss possibilities, including removing some of the disc to ease pressure on the nerve (known as a discectomy). But please remember, surgery is quite a severe procedure, and should only be considered after trying all other forms of treatment. Read more about recovering from herniated disc surgery here.
Treating the cause of a herniated disc.
Once you have worked to treat the symptoms of a cervical herniated disc, it is important that you also address the reason why the disc herniated in the first place. Otherwise, there is a strong chance that it will happen again.
If the cause a traumatic injury, then the treatment will be dependent on the type of injury. However if the underlying cause is due to your posture, then you will need to work on improving your posture. Pilates is my exercise programme of choice in the latter stages of a treating herniated cervical disc, as there are exercises that help improve posture as well as help strengthen and condition the muscles.
Postural correction is a very important aspect of both the prevention and treatment of a herniated cervical disc. If you have a desk job, or drive for long periods, seek ergonomic advice with your work station layout to help reduce the risk of neck and back pain associated with poor sitting posture.
For example, my favourite piece of postural advice for your neck is this! Sit tall and imagine a helium balloon coming out from the top of your head lengthening you. Feel your neck extend and your lower back straighten. Hold this position! This will take the weight of your head off your neck and shoulders and reduce the pressure on your cervical discs.
While the content and materials contained in the articles on this website have been written & researched by Sally Ann Quirke, a professional, practising & fully qualified Chartered Physiotherapist (Physical Therapist) based in Ireland, they are provided for general information and educational purposes only. They do not constitute medical advice on any particular individual situation. Please see your Chartered Physiotherapist or other medical practitioner for full and individual consultation.
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