A cervical herniated disc is a condition where the soft inner core of a spinal disc pushes through a tear or weak point in the tough outer layer. A herniation causes pain when inflammatory proteins leak out of the disc and inflame a nearby nerve root. Or if the herniation mechanically compresses a nerve root.
Most cases of cervical herniated discs can be managed with non-surgical treatments. Applying an ice or cold pack to the neck reduces swelling around the inflamed nerves and numbs the nerves, providing immediate pain relief. Heat therapy applied to the neck and shoulder can relieve muscle tension and spasms, improve blood flow to the area, and foster a healing environment.
Pain relieving medication such as acetaminophen, anti-inflammatory drugs, muscle relaxants, and medicated ointments help relieve painful flare ups of herniated disc, pain. Guided physical therapy and exercise programs that include stretching, strengthening, and aerobic conditioning rehabilitate the muscles and spinal structures in the neck, shoulder and upper back, which in turn improves posture and relieves pressure on the disc and surrounding nerves. For some people, injection treatments may be recommended to manage herniated disc pain.
An epidural steroid injection consists of a steroid administered directly to the spine to reduce nerve inflammation and pain. A selective nerve root block consists of a steroid and anesthetic injected near the spinal nerve as it exits the spinal canal. Other non-surgical treatments for cervical herniated discs include rest, TENS therapy, massage therapy, manual manipulation, yoga, water therapy, ergonomic changes, and lifestyle changes. Surgery may be an option for severe herniated disc symptoms that have not been relieved through non-surgical treatments.
There are three main types of surgeries for a cervical herniated disc. A posterior cervical decompression is a procedure where the herniated portion of the cervical disc is cut and removed from the back of the neck, while the rest of the disc remains intact. An anterior cervical discectomy and fusion, or ACDF surgery, is designed to relieve nerve root compression in the neck by removing all or part of the herniated disc.
An ACDF surgery involves placing some type of bone graft in the spinal segment to foster bone growth between the two vertebrae and form one long, stable bone. A cervical artificial disc replacement surgery is also done from the front of the neck, and involves removing the entire damaged disc and replacing it with an artificial disc implant, which acts like a natural disc. Unlike a spinal fusion surgery, this procedure maintains movement in the spine, similar to natural spinal movements. For chronic pain from cervical herniated discs that has not been relieved by non-surgical or surgical treatments, spinal cord stimulation may be an option.
A spinal cord stimulator is a small implanted device that delivers mild electric pulses to the nerves surrounding the spinal cord to interrupt pain signals from the spinal cord to the brain. Before implantation, a trial procedure is done to determine if nerve stimulation effectively reduces pain. If the trial is successful, surgical implantation may be considered.
Finding the right treatment for cervical herniated discs is determined by a combination of factors, such as your specific symptoms, overall health, and personal preferences, and it may require trial and error to find what works best for you.
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