Cervical Disc Herniation

Topic Overview

What is cervical disc herniation?

The bones (vertebrae) that form the spine in your back are cushioned by round, flat discs. When these discs are healthy, they act as shock absorbers for the spine and keep the spine flexible. If they become damaged, they may bulge abnormally or break open (rupture), in what is called a herniated or slipped disc. Herniated discs can occur in any part of the spine, but are most common in the neck (cervical) and lower back (lumbar) spine. The seven vertebrae between the head and the chest make up the cervical spine. See an illustration of the spine .

What causes cervical disc herniation?

A herniated disc usually is caused by wear and tear of the disc (also called disc degeneration). As we age, our discs lose some of the fluid that helps them maintain flexibility. A herniated disc also may result from injuries to the spine, which may cause tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material (nucleus) inside the disc may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments.

Herniated discs are much more common in people who smoke. See an illustration of a herniated disc .

What are the symptoms?

Herniated discs in the neck (cervical spine) can cause pain, numbness, or weakness in the neck, shoulders, chest, arms, and hands. In some cases a very large herniated disc in the neck may cause weakness or unusual tingling affecting other parts of the body, including the legs.

How is cervical disc herniation diagnosed?

A health professional usually can diagnose a herniated disc from your history of symptoms and a physical examination. Your health professional will ask about pain and numbness that might be caused by irritation of one or more of the nerves in the cervical spine. If your symptoms suggest a cervical herniated disc, rest and rehabilitation often are recommended before further testing is done. If other conditions are suspected, or if there is no improvement in symptoms after a period of rest and rehabilitation, imaging tests such as X-ray, magnetic resonance imaging (MRI), or computerized tomography (CT scan) may be done.

How is it treated?

In most cases, cervical herniated discs are first treated with nonsurgical treatment, including rest or modified activities, medicines to relieve pain and inflammation, and exercises, as recommended by your health professional. Symptoms usually improve over time. However, if the herniated disc is squeezing your spinal cord or nerves and/or you are experiencing weakness and constant pain, surgery (discectomy) will be considered first.

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Author:	Shannon Erstad, MBA/MPH	Last Updated July 28, 2006
Medical Review:	William M. Green, MD - Emergency Medicine Robert B. Keller, MD - Orthopedics
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