Conservative Treatment for a Cervical Herniated Disc

The majority of the time, the arm pain from a cervical herniated disc can be controlled with medication, and non-surgical (also called conservative) treatments alone are enough to resolve the symptoms.

Once the arm pain starts to improve it is unlikely to return. If the arm pain gets better it is acceptable to continue with nonsurgical treatment, as there really is no literature that supports the theory that surgery for cervical disc herniation helps the nerve root heal quicker.

All treatments for a cervical herniated disc are essentially designed to help resolve the arm pain, and usually the weakness and numbness/tingling will resolve with time.


When the initial pain from a cervical herniated disc hits, anti-inflammatory medications (NSAIDs) such as ibuprofen (e.g., Advil, Nuprin, Motrin) or COX-2 inhibitors (e.g. Celebrex) can help reduce the pain.

The pain caused by a cervical herniated disc is caused by a combination of two processes:

  1. Pinching of the nerve root
  2. Inflammation associated with the disc material itself

Therefore, taking anti-inflammatory medications to remove some of the inflammation can reduce this component of the pain while the pressure component (pinching of the nerve root) resolves.

For patients with severe pain from a herniated disc, oral steroids (such as Prednisone or a Medrol Dose Pak) may give even better pain relief. However, these medications can only be used for a short period of time (one week).

Nonsurgical Treatments

In addition to anti-inflammatory medications mentioned above, there are a number of non-surgical treatment options that can help alleviate the pain from a cervical herniated disc, such as:

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  • Physical therapy and exercise. Just as in the lumbar spine, Mckenzie exercises can be used to help reduce the pain in the arm. In the initial period a physical therapist may also opt to use modalities, such as heat/ice or ultrasound, to help reduce muscle spasm.
  • Cervical traction. Traction on the head can help reduce pressure over the nerve root. It does not work for everyone but is easy to do, and if effective the patient can use a home traction device.
  • Chiropractic manipulation. Gentle manual manipulation can help reduce the joint dysfunction that may be an added component of the pain. This type of low-velocity manipulation is referred to as mobilization. Any high velocity manipulation, often referred to as an adjustment, should be avoided as they can make the pain worse, or worsen any neurological damage.

  • Osteopathic medicine. Gentle osteopathic manipulation manipulation and special techniques to restore normal joint motion can be helpful in reducing pain from a cervical herniated disc.
  • Activity modification. Some types of activities may tend to exacerbate the herniated disc pain and it is reasonable to avoid these activities to keep from irritating the nerve root. Such activities may include heavy lifting (e.g. over 50 pounds), activities that can cause increased vibration and compression to the cervical spine (boating, snowmobile riding, running, etc.), and overhead activities that require prolonged neck extension and/or rotation.
  • Bracing. In some instances a cervical collar or brace may be recommended to help provide some rest for the cervical spine.
  • Medications. In addition to the anti-inflammatory medications mentioned above, narcotic agents (painkillers, or opioids) might be used on a temporary basis to help reduce the pain and discomfort from a cervical herniated disc. Also, muscle relaxants or certain anti-depressants may help reduce the nerve-type pain (neuropathic pain) and help restore normal sleep patterns.

  • Injections. Cervical Epidural steroid injections or selective nerve root blocks can be helpful to reduce inflammation in cases of severe pain from a cervical herniated disc, and can be very effective if accompanied by a comprehensive rehabilitation program that may involve a number of the above treatments.

Physicians who provide the above treatments for a cervical herniated disc may include family practitioners, physiatrists (physical medicine and rehabilitation physicians), osteopathic physicians, neurologists, and orthopedic spine surgeons or neurosurgeons. Chiropractors and physical therapists may also provide some of the above treatments for a cervical herniated disc in their respective areas of specialization.