Cervical disc herniation
A disc herniation can be called a few things including a disc protrusion, disc extrusion, disc prolapse, disc rupture, a slipped disc or a disc bulge. Technically all these things just fall under the umbrella of disc herniation (except the disc bulge – thats not a herniation). Put simply, a disc herniation occurs when the material from the centre of the disc (nucleus pulposus) escapes through tears in the outer part of the disc and then pokes out to some degree. Sometimes this is referred to as a contained or non-contained disc herniation. Imagine a jam donut, contained is when you push down on the donut and the jam doesn’t come out. Non-contained is when you push down on the donut and the jam does come out.
This next part is important. Disc herniations in themselves are not painful. That is, we can have asymptomatic disc herniations. However the little tears that allow for a disc herniation can be painful and these are called annular tears. The other thing that makes a disc herniation painful is when the inner substance (the jam) pokes out and protrudes into some nervous tissue such as the spine or the spinal nerve roots. This can give us back pain or pain all the way down to the hands or feet such as in the case of sciatica (radicular pain). The following is a summary of the types of disc herniations:
- Disc protrusion: A small herniation
- Disc extrusion: A large herniation
- Disc sequestration: A disc extrusion that breaks off and seeps into the spinal canal (epidural space)
The most common symptom of cervical disc herniation is typically neck pain. Tears in the disc can be painful and when the herniation is large enough to place physical compression onto nerves (root) causes or the spinal cord an inflammatory process (radiculitis/myelopathy) is activated that leads to further pain. Pain can be on one side or both sides of the neck with a cervical disc herniation. Pain may refer from the neck into the shoulder, between the shoulder blades and down the arm to the fingers. Numbness and tingling are common and muscle weakness may result as the condition progresses.
The chiropractic and physiotherapy treatments for cervical disc herniation causing neck pain will depend on the location, severity, and associated symptoms/impairments such as pain and muscle weakness. Treatments are centred around reducing pain and improving the function of the neck. Exercise therapy and rehabilitation exercises play a large role in this condition. Surgical opinions at times are needed depending on the progression of the injury.