Cervical disc protrusion
Disc protrusions can occur anywhere in the spine and are common in the neck (cervical spine). They are also very common in the low back (lumbar spine). Many people will have disc protrusions in their neck and never know it. This is because some disc protrusions are symptomatic and others are not. When a disc protrusion in the neck (or anywhere in the spine) is symptomatic this will usually cause pain, numbness, pins and needles (paraesthesia) or weakness in the arms (or legs for low back disc protrusions).
Now before we go on there are several terms that are used interchangeably and may lead to confusion unless addressed. A disc bulge simply means the disc is intact but the outer layers of the disc are bulging or have been pushed out a bit. In themselves a disc bulge isn’t usually symptomatic and doesn’t need a specific acute treatment however it would be a good idea to speak to a chiropractor or physiotherapist to get some helpful self management strategies to ensure your neck health is promoted. A disc protrusion is where a piece of the inner disc or disc material, which is softer than the outer layers of a disc, has pushed through the discs outer wall. A disc protrusion is likely to cause symptoms simply due to the fact it’s likely to crash into a nerve. If its significant we call this a disc extrusion and if its is now completely separated from the disc this is called a sequestration.
Symptoms of a cervical disc protrusion
When an intervertebral disc protrusion occurs in the neck, the disc can push directly back in the centre of the disc and we call this a central disc protrusion (in the middle). Central disc protrusions can crash into the spinal cord and cause serious issues. This would be a neurological emergency, and may or may not cause neck pain. In the neck we call this compression of a disc on the spinal cord compressive myelopathy. Compressive myelopathy in the neck can cause neurological symptoms and damage to the spinal cord. This can also occur in the low back, called cauda equina syndrome. Cauda equina is also a medical emergency and can cause weakness to the legs, bowel and bladder and this is also a surgical emergency.
A cervical (neck) disc protrusion is most commonly posterolateral and this means the intervertebral disc has ruptured straight back and to the side. This tends to pinch a spinal nerve rather than the spinal cord. When this occurs we call it radiculopathy and the most common symptoms of cervical radiculopathy is neck stiffness, neck pain, and numbness and weakness into the shoulders, arms and fingers.
Treatment of a cervical disc protrusion
Most people with a neck disc protrusion will be successfully treated with chiropractic and physiotherapy. The outcomes of chiropractic and physiotherapy for the treatment of a disc protrusion in the neck are typically excellent. At Sydney Spine & Sports Centre (S3C) in Balmain and Dee Why we use the latest evidence based treatments to ensure we fix you quickly. Our chiropractors and physiotherapists will test for any neurological symptoms and may need to send you for a surgical opinion if any neurological compromise is suspected. This is typically with a neurosurgeon. You may have heard of neck injections for pinched nerves and disc protrusions causing radiculopathy (arm pain). This is something that our chiropractors and physiotherapists will certainly consider if more conservative treatments don’t seem to be improving the condition. Most patients will respond to standard chiropractic and physiotherapy treatments.