Cervical Herniated Disc and Radiculopathy

Your cervical spine, located in your neck, is made up of seven small bones called vertebrae (labeled C1 through C7). These bones are separated by soft, cushion-like discs that help absorb shock and keep your neck flexible. Each disc has a jelly-like center (nucleus pulposus) surrounded by a tough, rubbery outer layer (annulus fibrosus).

A cervical herniated disc happens when the soft center of the disc pushes through a tear or weak spot in the outer layer. This can put pressure on nerve roots (the part of a nerve that branches out from the spinal cord) or the spinal cord, causing symptoms like pain, numbness, or weakness. The most common areas for herniated discs in the neck are between the C4 and C7 vertebrae.

The symptoms of a cervical herniated disc can vary widely depending on the location and severity of the herniation. Common symptoms include:

1. Neck Pain: Many patients experience sharp or dull pain localized in the neck. The pain may worsen with certain movements, such as turning the head or looking down.
2. Radiating Pain (Radiculopathy): Pain can radiate from the neck into the shoulders, arms, and even the hands. This pain often follows the path of the affected nerve and can feel sharp, burning, or electric-like.
3. Numbness or Tingling: A herniated disc in the neck can irritate nearby nerves, causing numbness or tingling in your arms, hands, or fingers. These sensations usually follow the path of the nerve affected by the disc and can feel like pins and needles or a “falling asleep” sensation.
4. Muscle Weakness: Compression of a nerve root may lead to muscle weakness in the shoulders, arms, or hands, making it difficult to grip objects or perform tasks requiring fine motor skills.
5. Loss of Reflexes: Some patients may experience diminished reflexes in the arms due to nerve compression.
6. Headaches: Cervical disc herniation can sometimes cause headaches, particularly at the base of the skull.
7. Spinal Cord Compression Symptoms: In severe cases, a herniated disc may compress the spinal cord, causing myelopathy. Symptoms of myelopathy include difficulty walking, loss of balance, and issues with bowel or bladder control.

Several factors can contribute to the development of a cervical herniated disc. Common causes include:

Degenerative Disc Disease

Over time, the discs in the spine naturally lose water content, becoming less flexible and more prone to tearing or herniation. This age-related degeneration is one of the most common causes of cervical herniated discs.

Trauma or Injury

Sudden trauma, such as whiplash from a car accident or a sports-related injury, can cause a disc to herniate. Repetitive strain on the neck can also contribute to the condition.

Poor Posture

Prolonged poor posture, such as slouching while using electronic devices or sitting at a desk, places extra stress on the cervical spine, increasing the risk of disc herniation.

Genetics

A family history of spinal conditions may predispose individuals to developing herniated discs.

Smoking

Smoking can accelerate disc degeneration by reducing blood flow and oxygen supply to the spinal tissues.

Heavy Lifting or Strain

Improper lifting techniques or repetitive strain from heavy lifting can put pressure on the cervical spine, increasing the likelihood of herniation.

Accurate diagnosis is crucial to developing an effective treatment plan for a cervical herniated disc. Dr. Lauren Boden uses a thorough evaluation process, which may include the following steps:

Medical History

The diagnostic process begins with a detailed discussion of the patient’s symptoms, medical history, and any recent injuries or activities that could have contributed to the condition.

Physical Examination

During a physical exam, Dr. Boden assesses the patient’s neck and upper body for signs of pain, muscle weakness, numbness, or changes in reflexes. She may ask patients to perform specific movements to pinpoint the source of discomfort.

Imaging Studies

• X-rays: While X-rays cannot reveal herniated discs directly, they can rule out other conditions such as fractures, infections, or tumors.
• Magnetic Resonance Imaging (MRI): MRI scans provide detailed images of the spinal discs, nerves, and surrounding tissues, making it the most effective tool for identifying herniated discs and nerve compression.
• Computed Tomography (CT) Scan: A CT scan can offer detailed images of the spine, particularly when combined with a myelogram to assess nerve involvement.
• Electromyography (EMG) and Nerve Conduction Studies: These tests evaluate nerve function and can help determine the extent of nerve damage caused by the herniation.

Provocative Testing

In some cases, diagnostic nerve blocks or injections may be used to confirm the specific nerve affected by the herniated disc.