Medically Reviewed by W.S. (Bill) Edwards, Jr., MD
Repetitive twisting or turning of your neck or a sudden jerk can trigger pain caused by a herniated disc in the upper part of the spine. McLeod Spine Surgeon W.S. (Bill) Edwards explains how to spot the symptoms and the range of treatments available for a herniated disc in the cervical spine.
Here’s a summary of Dr. Edwards’ comments:
In the cervical spine, disc herniations sometimes occur after a twisting/turning of the head or neck or repetitive activities by people working in plants and factories. Sometimes disc herniations in the neck occur after a motor vehicle accident, causing a whiplash injury. Yet, a lot of times there is no inciting event or injury. Patients just wake up with a crick in their neck and later start having pain radiating into the shoulder and arm. At least half of the time, when patients visit me, they have not sustained any type of an injury.
The conservative treatment options for disc herniations in the neck typically include physical therapy.
Medications to decrease the inflammation are very commonly used, such as Motrin-type medications and muscle relaxers. We feel conservative efforts are important, including a therapeutic epidural steroid injection in that area. We put some steroid medicine in that area around where the disc is herniated in an effort to decrease some of the inflammation. And, if that inflammation can be decreased, the disc will shrink on its own and the patient won’t not need more aggressive treatment.
Patients ask when surgery is needed for disc herniations in the cervical spine at the neck. Many times, it’s about pain. In other words, the conservative efforts we’ve tried just have been unsuccessful- the physical therapy, steroid injections, medication. Then we get to the point where surgery is the only thing left to do. Surgery should always be the last option rather than the first thing you do.
Once in a while, disc herniations are so big in the cervical spine that they produce a neurological danger. They put so much pressure that the nerves are in jeopardy. The result could be paralysis or permanent nerve damage. In those cases, we undertake surgery much earlier.
In neck disc herniation surgery, we always do a fusion. When the disc herniates from the neck it’s not functional as a good cushion or shock absorber anymore. A fusion involves removing the entire disc (not just the herniated portion), replacing it with a bone graft and placing a titanium plate on the front of the spine. Or, we will replace it with an artificial disc.
All of our neck surgery is performed from the front, if possible. Patients recover much quicker than surgery performed the traditional way from behind. Frequently, we’re able to do this as an outpatient procedure and the patient doesn’t have to stay overnight.