Cervical Disc Herniation

Posted On: February 15, 2020

Imagine waking up with terrible neck pain which radiates down to the arm. The hand may tingle and you notice your arm isn’t as strong doing every day tasks like pushing open a door. These are typical symptoms of a cervical disc herniation.

Cervical disc herniations are not as common as lumbar disc herniations. Twenty five years ago the standard of care was to do some form of advanced imaging (CT or MRI), medication, epidurals and surgery. Fortunately a lot of physicians have recognized the utility of physical therapy in these cases.

In my experience most of these resolve with thoughtful physical therapy. There are exercises that move the pain out of the arm and centralize the pain to the neck. Teaching the patient about proper posture is useful. Manual traction in my practice has always helped. Mobilization or adjusting the upper thoracic spine has some evidence as to its effectiveness. As the pain abates at North Shore Spinal and Sports Rehabilitation we move the patient into spinal stabilization exercises.

This multimodal approach usually works, though occasionally an epidural injection may be required. Rarely does any patient ending up requiring surgery.

This is the opposite of what used to be done but I would submit that it is a far better option, given the risks and costs involved with surgery. Many of the patients we have rehabilitated have been able to resume high levels of exercise without ill effect.

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