Treating cervical herniated disc depends on whether or not that disc is symptomatic or not. So, not all herniated discs in the cervical spine and other parts of the spine necessarily are causing any symptoms - often they're not. Certainly cervical herniated discs - like other discs - can cause symptoms. When they do, the treatment is focused around reducing the inflammation and the swelling from around the disc and the nerve root that they're often irritating and then making sure that we adjust the biomechanics to help take the pressure off of the disc and the nerve so that the same stresses aren't going through them so that symptoms don't recur.

Often this begins with physical therapy, with exercise, especially with the neck with posture - with getting the head back over the neck to help take the pressure off of the neck, off of the spine so that takes pressure off the discs and the nerves.

Alongside physical therapy we'll sometimes give oral medications, depending on the severity of the symptoms, in order to reduce the symptoms, to an extent to alleviate the inflammation in order to help someone participate with physical therapy and just control the symptoms while they're getting better.

Within physical therapy, there are multiple passive modalities in addition to the exercises, such as manual traction, TENS units, electrical stimulation, ultrasound - different passive modalities that are both designed to relieve the symptoms and also to help take away the inflammation.

When the symptoms are persistent despite physical therapy exercises - despite some time - or if the symptoms are interfering with a person's ability to participate with physical therapy, then sometimes an epidural steroid injection can be very helpful to take away the inflammation and the swelling from around the disc and the nerve root, which doesn't fix a disc herniation, by the way. It doesn't make a herniation go away nor does it mask anything. What it does is it takes away the inflammation and that opens up a window of opportunity during which a person can stretch and strengthen and address the posture and the biomechanics in order to tweak the biomechanics so the same stresses aren't still going through the disc and the nerve so that the symptoms don't recur.

If the symptoms are persistent and interfering with quality of life, in those rare instances when physical therapy, time, injections aren't taking away the symptoms, it's certainly appropriate to have a conversation with a spinal surgeon about the different surgical alternatives. Often discectomy is a relatively small surgery - it is still a surgery - in order to take away some of the disc and decompress the nerve root.

Dr. Grant Cooper is a physiatrist with several years of clinical experience, specializing in the non-surgical treatment of spine, joint, and muscle pain. He is the Co-Founder and Co-Director of Princeton Spine and Joint Center and the Co-Director of the Interventional Spine Program.