Cervical Herniated Disc: Doctor Answers Patient Questions

Peter Ullrich, MD

The following explanations, insights and advice about cervical herniated discs - including diagnosing the source of the pain, non-surgical treatments and surgery - are provided by Peter F. Ullrich, Jr., MD, an orthopedic spine surgeon and Medical Director for Spine-health.com.

Patients frequently e-mail us questions about their cervical herniated disc problem, and while we don’t provide individual responses, periodically, Dr. Ullrich will take time to respond to the more frequently asked questions and we publish the responses in this section of the site.

Please understand that the following responses to cervical disc herniation questions represent the opinion of one physician, and are intended for informational purposes only and not as a substitute for professional medical help or advice.

Cervical herniated disc questions and physician responses

Question:

I have a cervical herniated disk at C5-C6. I was recently in a car accident and now the herniated disk is causing severe pain. When I had my second MRI, the doctor concluded that my disk was “hardening” and that there may not be “enough space” for the disk. What does it mean for a disk to harden and not have space? Could that be the cause of the severe neck pain? How do I avoid aggravating the symptoms caused by the cervical herniated disk?

Doctor’s response:

A cervical disc herniation may or may not be the cause of your pain, and an MRI scan often does not show what is causing the pain. An MRI scan is not a test for pain, but rather a test for anatomy (e.g. for a herniated disc). A disc bulge, herniated disc or similar pathology may be detected on an MRI scan, but it does not cause pain or any other symptoms in 30 to 50% of patients. After a car accident, it is more likely that your neck pain is caused by soft tissue damage to the muscles or ligaments in the neck, and this type of injury cannot be seen in an MRI scan.

Often the best way to treat auto-accident pain is to maintain the range of motion in the spine and to strengthen the back and neck muscles. In general, active rehabilitation programs with physical therapy, plus time (it can take up to two years to heal) are the best treatments. A rehabilitation doctor, such as a physiatrist who specializes in treating spine disorders, would be a good specialist to help you through the rehabilitation process. Surgery is rarely necessary for a disc problem (such as a cervical herniated disc) after an auto accident.

Lastly, I do not know what was meant by the disc “hardening”. You would have to ask the physician who told you this to clarify.

Question:

Is it possible for a C4-C5 cervical disc herniation to cause radicular pain and sciatica on one side of my body? My right side, from below my armpit to my toes, is completely numb with occasional tingling and burning sensations in the calf area. Everywhere I am reading and asking people, C4-C5 problems contribute to neck pain, shoulder pain and arm pain, which I don't have. But I do have a cervical herniated disc at C4-C5. I am confused as to what to do.

Doctor’s response:

You are right that the typical sort of symptoms one would experience from a cervical disc herniation would be upper arm pain and possibly shoulder weakness, and a C4-C5 herniated disc does not lead to sciatica or radiculopathy in the leg. You may find it helpful to see a neurologist to have a complete examination and to confirm the diagnosis for your particular symptoms, as they do not fit the pattern of a cervical herniated disc. A cervical disc would not be able to produce numbness on one side of the body. It could produce pain only in an arm and not in a leg. I would recommend seeing a neurologist for an accurate diagnosis of your current symptoms.

What next?

If you have questions about cervical disc herniation, please use this site to find peer-reviewed health information about spinal conditions, diagnosis and treatment options. The quickest way to locate information on the site is to use the “keyword search” box located in the upper left hand corner of each page. Also, if you want to talk online with others who may be in a similar situation or exchange information with other patients with a cervical herniated disc, please go to the Spine Forum Message Boards.

Additional disclaimer: Spine-health.com does not offer medical advice or treatment. This information does not replace the physician-patient relationship, and the information is not medical advice or treatment. It should only be considered as one physician's opinion based on an extremely limited amount of information. Patients should always seek the advice of a trained health professional for back pain or any health condition. Please note that the contents of this section have not been peer reviewed by Spine-health.com’s Medical Advisory Board.