Cervical Disc Pain

Your spine consists of 24 individual vertebrae stacked on top of each other with flexible cushions called “discs” between each set of vertebrae.  A disc is made up of two basic components.  The inner disc, called the nucleus, is like a ball of jelly about the size of a marble.  This jelly is held in place by the outer more fibrous part of the disc called the annulus, which is wrapped around the inner nucleus much like a ribbon wrapping around your finger.  The term “cervical disc lesion” means that your disc has been damaged.  This damage can range from annular fraying or tearing, to disc bulging, disc herniation or disc extrusion.

Disc lesions begin with the outer annular fibers becoming strained or frayed.  This can create a weakness and when the disc is compressed, the outer fibers may “bulge” or “protrude” like a weak spot on an inner tube. The irritation of the outer annular fibers can also be very inflammatory and painful. This inflammation itself can often irritate the nerves.  If more fibers are damaged, the nucleus of the disc may “herniate” outward.  Since the spinal cord and nerve roots live directly behind the disc, bulges that are accompanied by inflammation will likely create neck pain that radiates into your shoulder or arm. If the disc bulge is significant enough to cause compression of your nerve, you may also experience loss of your reflexes and weakness. Be sure to let a healthcare professional know if you notice progressive weakness or numbness, hand clumsiness, any symptoms in your legs, any loss of bowel or bladder control, or fever.

Surprisingly, cervical disc bulges are present without any symptoms in over half of the adult population. The condition is slightly more common in men.  Ninety percent of cervical disc problems occur at one of the two lower discs- C5/6 or C6/7. Certain occupations or activities may place you at a greater risk, especially if you spend extended periods of time sitting, driving or looking down.  Improper sleep positions, frequent heavy lifting, and cigarette smoking may also increase your risk. The condition is most common between the ages of 40 and 50, and is less common in children and seniors.

Disc lesions are rarely the result of a single traumatic event, but rather, the undesirable mid-point on a continuum of problems, beginning with repetitive disc sprain, leading to herniation, ending in degeneration.  Rushing to invasive treatment is not advised in the absence of a progressive neurological deficit. Figuring out the overloading mechanism, be it scapular stability, cervical stability, thoracic mobility.  Your non-surgical treatment options should include anti-inflammatory medication, functional examination guided rehabilitation, cervical/thoracic mobilization/manipulation, soft tissue therapies, dry needling/acupuncture, neuro-mobilization, and activity modification. Surgical alternatives, including discectomy, or discectomy with fusion, should be considered only after a failed trial of conservative therapy, or in the presence of progressive neurologic deficit.

You should avoid “loading” your neck with activities like carrying objects on your head or diving into water. Researches have shown that disc bulges may be successfully managed with conservative care like the type we provide.  You can see a few of the treatment options we may explore on our youtube site or here:

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