Herniated Cervical Discs
At Southwest Scoliosis Institute, our board-certified, fellowship-trained orthopedic doctors, Richard Hostin, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD have treated thousands of patients with complex spine conditions that included herniated cervical discs.
While a herniated cervical disc can occur from injury or trauma, the effects of aging cause many more cases. Because this ailment occurs over time, patients often don’t notice the symptoms until they become severe. Additionally, this ailment typically occurs between the ages of 30 and 50. Unfortunately, it tends to affect older adults because age causes tissue to be less effective. Therefore, the cervical discs crack and other injuries occur to increase the risk of herniation.
Symptoms of a Herniated Cervical Disc
To clarify, herniated disc symptoms can differ based on the location of the disc and the compression of any nerves. In this case, symptoms often include:
- Pain the neck that radiates down the arm towards the hands and fingers
- Numbness or tingling in the shoulders, arms, or hands
- Muscle weakness in hand and/or arms
In severe cases, a herniated disc may put pressure on the spinal cord. Actually, this is much more serious and can cause pain, tingling, numbness, or weakness to be felt in both arms and possibly even lower in the body.
Symptoms of spinal cord compression may also include:
- Difficulty walking straight or unsteady gait
- A reduction in fine motor skills in the hands and arms
- Painful tingling or feelings like electric shocks in the torso or even into the legs
Herniated Disc Diagnosis
Our doctor will review your medical history. Then he or she will perform a thorough physical exam, and look for any signs of limited mobility. After that, the doctor will ask about any pain, check balance, muscle reflexes, loss of sensation, or muscle weakness. If a herniated cervical disc is suspected, the doctor will use X-ray imaging, computed tomography (CT) scans, or magnetic resonance imaging (MRI) to confirm the diagnosis. Because X-rays can only show issues with the bones, a CT or MRI scan may also be needed.
For imaging, we use a state-of-the-art digital low-dose X-ray system. In less than a minute, this advanced unit takes high-quality patient images. Also, this system can take X-rays of patients in a standing or seated position. Moreover, it’s located inside our Dallas office and you and your doctor can review the X-rays ASAP.
Treatment for a Herniated Cervical Disc
As a result, treatment options range from physical therapy and medicines to surgery. At our offices, our doctors always start with a conservative approach to treatment before thinking about surgery. In addition, our Doctors always take the time to discuss all options with our patients. So we talk with the patient about our options and how treatment depends on age, health, and severity of the problem.
Most patients see rapid improvement with medicines that reduce pain, inflammation, and muscle stiffness that accompany a herniated disc. Medicines manage the pain while any numbness or tingling sensations tend to improve with time and rest.
Non-surgical treatments for a Cervical Disc Herniation include:
- Physical therapy and/or exercises to relieve the pressure on the nerves
- Medications to reduce swelling and pain, such as non-steroidal anti-inflammatory drugs (NSAIDs)
- Epidural steroid injections and nerve root injections to reduce swelling around the affected disc and nerves, as well as to relieve acute pain radiating to the hips or down the legs.
Cervical Disc Herniation Surgery
If the pain, numbness, and other symptoms persist for more than 6-12 weeks, or if there is evidence of severe spinal cord compression, your doctor may recommend surgery.
Surgical Treatment Includes:
Anterior Cervical Discectomy and Spinal Fusion involve removing the bad disc through the front of the neck. This will relieve the pressure on the nerves and/or spinal cord. Because most (if not all) of the disc is removed, a fusion procedure will then stabilize the spine. A fusion procedure involves a small bone graft, screws, and rods to ensure that the bones fuse properly.
Posterior Cervical Decompression (Microdiscectomy). In cases where the herniation of the disc is minor, your doctor may use a minimally invasive technique. The Doctor removes the portion of the disc pressing on the nerve and makes a small incision on the back of the neck. Because only the small herniated portion of the disc is removed, this surgery does not usually need to be combined with a spinal fusion procedure.
At Southwest Scoliosis Institute, we treat disc herniations based on symptoms. The initial treatments are physical therapy and medicine. The next set of treatments would be pain relief, and then some people will require surgery to relieve the damaged disc and stop the nerve pain.” Richard Hostin, MD