Cervical Herniated Disc Treatment

A cervical herniated disc is a dangerous disease that affects the intervertebral disc due to an injury in the neck resulting from an accident or sports activities.  As a result of the development of a hernia, blood circulation and the work of some organs are disrupted, and the lack of treatment leads to the risk of developing serious complications.

The disease is most often diagnosed in patients aged 30 to 50 years; men suffer from it prevailing. In terms of incidence, the cervical herniated disc is in second place after a hernia of the lumbar spine, but it is a more dangerous pathology due to the more fragile structure of the spine in the neck and the immediate proximity of the brain.

There are several ways to treat the disease:

• Conservative (non-surgical) treatment. Drug therapy includes anti-inflammatory drugs to reduce inflammation and swelling, muscle relaxants to reduce muscle spasms, and strong analgesics to reduce intense pain. Mild to moderate pain is treated with non-steroidal anti-inflammatory drugs; they eliminate inflammation and pain. Physical therapy may be prescribed, which includes a combination of non-surgical therapies to relieve pain and increase range of motion (cold and heat therapy, gentle massage, neck traction, etc.).

• Surgical cervical herniated disc treatment. The operation can be performed when conservative treatment does not reduce the severity of symptoms and when spinal cord contraction is expected. Disc removal may be performed to relieve nerve compression and neck pain.

• Prevention of cervical herniated disc. Age-related degenerative changes are inevitable, but lifestyle changes can help prevent or delay the onset of cervical disc disease. 

Spinal Hernias and Their Types

To explain the concept of the cervical herniated disc, let’s see the anatomy. Intervertebral discs are between the vertebrae. They make the spine flexible and stable. Each disc consists of a nucleus pulposus (liquid filling) and an annulus fibrosus (hard membrane). In some cases, one careless movement can provoke a rupture of the annulus fibrosus. From the resulting crack, the liquid begins to flow from the nucleus pulposus, after which the nerve endings of the spinal cord are pinched. All this leads to the disk, like a compressed balloon, protruding to the side; this is how a hernia of the spine occurs.

There are three types of hernia:

• Thoracic hernia is extremely rare and occurs in about 1% of cases.
• Hernia of the cervical spine occurs in 19% of cases.
• Lumbosacral hernia is quite common and occurs in 80% of cases.
• The most dangerous are dorsal herniated discs, in which the disc is displaced in the direction of the dural canal, nerve roots.

What Provokes Hernia?

The causes of this disease can be very different. A hernia is often a complication of scoliosis, osteochondrosis, or lordosis. It can also develop after a spinal injury from a fall on the back of a strong blow.

In many patients, it occurs as a result of disc nutrition. With a low load of the deep muscles of the back, the nutrition of the discs deteriorates, and one sharp movement is enough to rupture the annulus fibrosus.

The main risk factors for a spinal hernia are:

• inactive lifestyle
• hypothermia
• sharp movements: turn, fall, hit
• excess weight
• great physical activity
• improper posture.

Herniated discs will require timely treatment since the disease causes gastritis, heart disorders and stroke, cerebral blood flow impairment, and pancreatitis. At the last stage of the disease, a hernia compresses the spinal cord and disrupts the pelvic organs’ function, and can also cause paralysis of the legs or arms.

Stages of Cervical Herniated Disc Formation

• Disk degeneration. Age-related changes, numerous injuries, a sedentary lifestyle, and other factors lead to decreased muscle tone and weakening, drying out, and destroying intervertebral discs, leading to damage to adjacent vertebrae and their deformation.

• Disc protrusion. A phenomenon where part of the fibrous membrane is destroyed, resulting from which the nucleus goes beyond the allotted limits. At the same time, the outer part of the shell is preserved; therefore, the spread is limited and does not reach the spinal cord canal.

• Disc extrusion. A situation where a complete rupture of the annulus fibrosus occurs, as a result of which some of the nucleus pulposus enters the spinal canal, which can lead to damage to the spinal cord or nerves extending from it.

• Sequestered hernia. A case when the nucleus pulposus flows out of the discs. As a result, unbearable pain occurs, numbness of the arms or legs, muscle atrophy, the intoxication of the body. Without timely treatment, the disease can provoke paralysis of one or two hands.

Treatment of Cervical Herniated Disc

Hernia treatment is a long, multi-stage process. It can include:

• intensive therapy is used to relieve inflammation and pain;
• drug therapy –  pain relievers are often prescribed, muscle relaxants to relieve muscle spasms, chondroprotectors to restore cartilage tissue;
• manual therapy involves the impact of hands-on the spine and intervertebral discs (performed by highly-skilled neurologists);
• therapeutic massage, the specialist works on soft tissues to improve blood circulation and relieve muscle spasms;
• physiotherapy exercises can be prescribed, a set of exercises to improve motor functions, increase blood circulation and nutrition of soft tissues surrounding the intervertebral discs;
• surgical intervention is performed for large hernias when other methods are ineffective (in 15-20% of cases).

In most cases, conservative methods of drug and manual therapy, massage, and exercise therapy are used for the treatment of intervertebral hernias. This treatment can take several months. If it is ineffective or the hernia is large, the patient may need surgery.

FAQs

• What is the best treatment for herniated discs in the neck?

It is best to see your doctor if you have any symptoms or pain and prescribe the right solution. Usually, you will be prescribed conservative treatment or physical therapy, and only in some cases, doctors resort to surgical treatment.

• How do they fix a herniated disc in the neck?

Among surgeons, the ACDF method is used. The doctor makes a small incision and removes the disc in the front of the neck.

• How should I sleep with a herniated disc in my neck?

To sleep comfortably with the cervical herniated disc, you need to lie down to straighten your spine. Plus, lying on your side will help relieve pain.

• What size of hernia is dangerous?

On average, for hernias of the cervical spine, the critical size is 5 mm, and for protrusion of the lumbosacral disc – 9 mm. But if the hernia is foraminal, surgery may be performed much earlier, and sometimes even with a hernia size of 3-4 mm.