Cervical disc herniation
When tissue has protruded from the center of the intervertebral disc, we call this a herniated disc. A herniated disc is a bulge of the intervertebral disc that can occur in any part of the spine. But here we will take a closer look at the cervical spine. If a herniated disc occurs in the cervical spine (i.e. the neck) it presses against a nerve and can cause pain in the neck that radiates to one arm. It can even extend into the hand, causing symptoms such as tingling, numbness or muscle weakness. In the neck, unlike in the lower back, not only the nerves run through the spinal canal, but also the spinal cord. The spinal cord requires more space than the nerves. A larger herniated disc in the cervical area can therefore also cause the spinal cord to become compressed. This is more dangerous than a pinched nerve.
A pinched nerve in the neck causes radiating pain along the path of that nerve. A herniated disc between the fifth and sixth cervical vertebrae is a common occurrence (i.e. a herniated disc in the neck on the level C5/C6of the spine). The affected C6 nerve, which is then under increased pressure, travels through the upper arm to the thumb and index finger. The skin in this area can become numb and the strength in the upper arm (biceps) can decrease, for example when trying to make a fist. These symptoms can sometimes be triggered by turning and nodding the head in a certain way.
When tissue has protruded from the center of the intervertebral disc, we call this a herniated disc. A herniated disc is a bulge of the intervertebral disc that can occur in any part of the spine. But here we will take a closer look at the cervical spine. If a herniated disc occurs in the cervical spine (i.e. the neck) it presses against a nerve and can cause pain in the neck that radiates to one arm. It can even extend into the hand, causing symptoms such as tingling, numbness or muscle weakness. In the neck, unlike in the lower back, not only the nerves run through the spinal canal, but also the spinal cord. The spinal cord requires more space than the nerves. A larger herniated disc in the cervical area can therefore also cause the spinal cord to become compressed. This is more dangerous than a pinched nerve.
A pinched nerve in the neck causes radiating pain along the path of that nerve. A herniated disc between the fifth and sixth cervical vertebrae is a common occurrence (i.e. a herniated disc in the neck on the level C5/C6of the spine). The affected C6 nerve, which is then under increased pressure, travels through the upper arm to the thumb and index finger. The skin in this area can become numb and the strength in the upper arm (biceps) can decrease, for example when trying to make a fist. These symptoms can sometimes be triggered by turning and nodding the head in a certain way.
If the herniated disc is located between the sixth and seventh vertebrae (herniated disc at the level C6/C7), the C7 nerve is affected. It runs from the shoulder blade over the back of the arm to the middle finger. If the entire spinal cord is pinched, movements of the neck can cause the sensation of electric shocks down the spine.
What symptoms are not indicative of a herniated disc?
Our head is a mobile body part that is attached to the upper end of a series of cervical vertebrae that form the upper part of the spinal column. We are constantly moving our heads. Without strong muscles, it would not be possible to keep our heads stable. These muscles are constantly under strain. The largest of these muscles is the trapezius muscle, also known as the monk's hood
muscle.
This muscle is attached to the back of the head, to the shoulders and then down the spine to halfway between the thoracic vertebrae. It is a very important muscle, essential for keeping the head upright. Like all other muscles, this one can also become overworked, especially if the head has to be held in one and the same position for a long time, for example in an office job where one has to work at the computer for long periods of time.
A muscle that has to exert itself beyond its capacity will go into spasm. You can imagine what happens when this large muscle goes into spasm. Typically, the pain does not go to the hand, but to the back of the head (sometimes even to the forehead), towards the shoulders and across the back. These symptoms occur precisely in the places where the monk's hood muscle is attached to the bones. The symptoms are therefore very different from those of a herniated disc. Relaxation, gentle movement or a massage are usually sufficient to relieve the pain. It is also important to regularly alternate the head's position.
Causes of cervical disc herniation
A cervical herniated disc, also known as cervical disc herniation, occurs when an intervertebral disc in the neck (cervical spine) bulges or ruptures and presses on the nerves or the spinal cord. There are several causes that can contribute to the development of a cervical herniated disc:
- Degenerative processes: As we age, the intervertebral discs can wear out and dry out, making them more vulnerable to tears and bulging.
- Trauma: An accident or injury, such as a car accident or a fall, can lead to a herniated disc in the cervical spine. However, this is quite rare.
- Repetitive strain: Overloading the neck through repetitive movements or strenuous physical activity can contribute to the development of a herniated disc.
- Poor posture: Sitting or standing with poor posture for long periods of time, especially when using mobile devices, computers and while driving, can put pressure on the cervical spine and contribute to disc problems.
It is important to note that not everyone with a herniated disc will experience symptoms. In some cases, a herniated disc is discovered by accident during examinations for other medical conditions. An MRI scan is necessary to recognize a herniated disc.
Examination and diagnosis
A pinched nerve in the neck causes radiating pain along the path of that nerve. A herniated disc between the fifth and sixth cervical vertebrae is a common occurrence (i.e. a herniated disc in the neck on the level C5/C6of the spine). The affected C6 nerve, which is then under increased pressure, travels through the upper arm to the thumb and index finger. The skin in this area can become numb and the strength in the upper arm (biceps) can decrease, for example when trying to make a fist. These symptoms can sometimes be triggered by turning and nodding the head in a certain way.
What symptoms are not indicative of a herniated disc?
Most herniated discs in the neck naturally resolve over time. This means that we have to assess whether medical intervention is necessary to treat the herniated disc. Sometimes the herniated disc can be so large that there is a risk of disability or in severe cases the patient has already become incapacitated. In some cases the pain is too severe for the patient to live with. In these cases we will decide together with the patient whether to proceed with a cervical disc herniation surgery.
If it is less urgent, then pain relief is the first step, followed by trying to avoid unfavorable positions of the neck so that the nerve does not swell even more. Physical therapy can provide support. A second step is treatment at a pain clinic. The pain clinic eliminates the nerve's pain receptors (rhizotomy). This is a temporary measure, as they do not want to permanently damage the nerves. When the pain is reduced, it is a little easier to wait until the body has dissolved the herniated tissue on its own.
If the cause is not a herniated disc but a muscle problem, then the best approach is to avoid unfavorable postures, take muscle relaxants (temporarily), or to get physical therapy to increase mobility and to get massages to relax the muscles.
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