November 29, 2012
Herniated Cervical Disks
What is a herniated cervical disk? This is when the outside layer of the disks, or annulus fibrosis, begins to tear and the inside of the disk, or the nucleus pulposus, is displaced into the space occupied by the spinal nerves. When a disk is herniated, it can cause pain, numbness, tingling or weakness in the shoulders or arms, and can sometimes put pressure on the spinal cord, which can cause issues in the legs. X-ray imaging, computed tomography (CT) scans or magnetic resonance imaging (MRI), are all ways to determine whether someone has a herniated cervical disk. X-Rays can show if someone has bone spurs and/or narrowing of the disk space, but cannot show herniation of the disk, or nerves in the spine. To retrieve more detailed pictures of the spinal elements, a CT and/or MRI are the better choice. They will provide more information as to whether a person has a herniated disk or not. Although most patients with a herniated cervical disk will improve without treatment, some may not.
For the patients who do not get better over time, there are many options which they may choose to have done for the disk. Patients may go the nonsurgical route, which will hopefully reduce irritation of the verves, and relieve pain. The non-surgical route treatment includes, rest, a neck collar, anti-inflammatory drugs, analgesic drugs for pain, physical therapy, and exercise. Nonsteroidal anti-inflammatory medications (NSAIDs) are also another choice one can go with. These are drugs made to help reduce swelling and inflammation. These include aspirin, ibuprofen, naproxen and a variety of other prescription drugs. If a patient has very severe arm, and neck pain, corticosteroids medications may be used. These medications can be done either orally, or by injection. If the patient has severe arm pain, a doctor may recommend epidural injections or “blocks”. These injections are corticosteroids into the epidural space in the spinal area. Trigger point injections are very rarely used as well. These are injections put directly into painful soft tissue or muscles along the