Disc herniation or commonly referred to as a ‘slipped’ disc occurs when the discs between the joints crack and leak out the gel material. This disc material could encroach onto the nerve roots in the spine and eventually compress it, causing pain and neural symptoms. The disc could also dehydrate and shrink, narrowing the joint space. This can then cause bone spurs to develop on the vetebra which could be painful (also called stenosis). These changes contribute to the narrowing of the spinal canal/foramen which could lead to increased pressure on the nerve.
Some of the symptoms include but not limited to are:
- Neck pain that radiates to the arm
- Shoulder pain
- Numbness or tingling down to arm and fingersWeakness in the arm
- Sharp or burning type pain
- Cervical herniation develops from wear and tear of the disc. In time, the disc loses its elasticity and could crack and cause the gel material to leak out
- This can then put pressure onto the spinal nerves also known as radioculopathy, causing neural symptoms or pain.
- Joint space narrowing can increase friction and stress between joints leading to formation of osteophytes (bone spurs).
Studies support conservative intervention such as cervicothoracic stabilisation program, McKenzie’s approach, and manual therapy. Some of the physiotherapy treatments used are:
- Joint mobilisations to improve stiffness. Improving flexibility can prevent further repetitive microtrauma from poor movement patterns.
- Soft tissue release for stiff muscles around the neck. Shoulder muscles often stiffen up with this condition
- Exercise program to strengthen the muscles and improve flexibility. Strengthening the muscles of the neck could help relieve symptoms in the long term as the muscles would help support the neck, reducing the pressure onto the disc/joint.
- Postural correction
- Activity modification. Heavy lifting and certain sports could add stress on the joint and exacerbate the condition
- Cervical traction to gap the joint
There are surgical interventions used to treat disc degeneration problems such as artificial disc replacement, spinal fusion and discectomy. However, there are many possible risks and complications associated with surgical interventions. Therefore a conservative approach is recommended in the initial phase and surgical interventions should be considered only if there are no improvements.