Cervical Disc Herniation

A herniated cervical disc is one of the most common causes of neck pain. If the disc is pressing on a nerve root, other symptoms can include:

• Numbness or tingling in the shoulder or arm that may travel down to your fingers
• Weakness in a hand or arm

If it presses on your spinal cord, you can experience severe symptoms, including:

• Stumbling or awkward walking
• Tingling or a shock-like feeling running down your body to your legs
• Problems using your hands and arms for fine motor skills
• Loss of balance and coordination

If you have neck pain with one or more of the above symptoms, combined with any weakness, you should see Dr Shiva.

It can be hard to figure out exactly what causes a herniated cervical disc. It often comes on slowly with no apparent cause. Causes can include:

• A disc can be more prone to herniating because of wear and tear with age
• Herniated discs can run in families
• Sudden, jarring movements
• Lifting heavy objects or turning or twisting your upper body too quickly.

Dr Shiva will perform a physical exam to find the source of your pain. He may also check the following:

• Your reflexes at the knee and ankle
• Your leg strength
• How you walk on your heels and toes
• Whether you can feel light touches or vibrations

If Dr Shiva suspects another condition or needs to see which nerves are affected, he may order one or more of the following tests.

• A standard X-ray cannot show if you have a herniated disc. It can show Dr Shiva the outline of your spine and rule out whether your pain is caused by something else, such as a fracture or tumour.
• A CT scan takes several X-rays from different angles. It combines them to create images of your spinal cord and the structures surrounding it.
• MRI images can locate the position of the herniated disc and determine which nerves are affected.

Nonsurgical treatment for a herniated cervical disc includes rest and medication to relieve pain and reduce swelling. Physical therapy can help improve the symptoms.

Most people with a herniated disc will not need surgery. Analgesia, physiotherapy and hydrotherapy should improve symptoms within 4 to 6 weeks. But if your pain does not improve, surgery might be an option.

You may require surgery if:

• You are not getting relief from pain relievers, injections, and physical therapy
• Your symptoms keep getting worse
• You have trouble standing or walking
• You cannot control your bowels or bladder

Postoperative care

• No lifting more than 5kg, no bending or twisting for six weeks
• No driving for two weeks
• Keep the wound dry for five days. You can get wet in the shower, but pat the area dry rather than rub.
• GP review postoperatively for wound review on day seven
• Monitor for any wound redness, discharge or fevers
• Monitor for new symptoms, including worsening back or neck pain, arm or leg pain, pins and needles or numbness
• Six-week review with Dr Shiva