Treating a Cervical Herniated Disc in Northern New Jersey
Cervical herniated discs are relatively common neck pain issues for adults as they enter their thirties and thereafter. In some cases, the pain can be severe, and it can involve weakness of an arm. When new pain develops in the neck or upper back, a patient may have a herniated disc in the neck.
At Centers for Neurosurgery, Spine & Orthopedics, we help patients throughout Northern New Jersey find relief from their herniated disc symptoms using personalized treatment plans, compassionate care, and a multi-specialty approach. At each of the CNSO locations, neurosurgeons, orthopedic spine surgeons, pain management doctors, physiatrists and physical therapists are available for interdisciplinary consultations.
CNSO combines access to the most advanced technology and high-quality care, which is why we are regarded as New Jersey’s top private comprehensive spine and brain care center. For a cervical herniated disc, there are a variety of cervical herniated disc treatments available; the key is determining the correct treatment for you.
What Are Herniated Discs in the Neck?
The spine has three major parts — cervical, thoracic, and lumbar. The cervical spine is at the top, the thoracic is in the middle, and the lumbar is at the bottom. Herniated discs may develop anywhere in the spine, including the neck. These cases in the neck are called cervical herniated discs.
Discs provide cushioning between the vertebrae, which are the spinal bones. The discs feature an outer layer called the annulus and an inner nucleus. The discs attach to the vertebrae which have adjacent endplates. Often referred to as a slipped disc or ruptured disc, herniated discs occur when the disc annulus tears and a portion of the nucleus extrudes out, placing pressure on the exiting nerve roots or spinal cord. This pressure on nerve tissue causes pain and loss of function of the extremity.
Symptoms of Cervical Herniated DiscThe cervical spine is comprised of seven vertebral bodies, named per level of the spine. Starting from the base of the skull, the first cervical vertebra is called C1. The last cervical vertebra is called C7, ending above the first of twelve thoracic vertebrae. A cervical herniated disc most frequently occurs between C5-C6 and C6-C7. At this level of the spine, symptoms are experienced in the arm or upper back. Symptoms of a cervical herniated disc causing pressure on a nerve root include neck pain, weakness, loss of function, and/or paresthesia, which is a tingling or numbness sensation. The discomfort in the neck, down an arm, or between shoulder blades t may worsen in certain positions or with some movements. When the herniated disc applies pressure on the spinal cord, patients may experience additional symptoms, such as:
- Loss of balance and coordination
- Difficulty walking
- Trouble with fine motor skills
- A shocking sensation emitting down the body and into the leg
Risk Factors for Cervical Herniated Disc
Pinpointing the exact cause of a cervical herniated disc can be challenging because the condition might have a sudden onset or develop slowly over time. Factors that increase the risk of herniating a disc include:
A motor vehicle accident, lifting a heavy object improperly, or twisting the neck too quickly, can cause a sudden strain on the structural integrity of the cervical spine. The physical forces can cause the discs to tear, herniate, or bulge out of their anatomical position.
Repetitive motions or improper posture of the neck can lead to a cervical herniated disc. Sitting posture, or the tasks people routinely complete, might continually strain the anatomy of the cervical spine.
With age, the wear and tear on the discs may make them more susceptible to herniation. Discs are more gelatinous in their consistency in the young, which allows the discs to be more flexible. As people age, the water content in the disc diminishes, and discs become more stiff and fragile. With limited flexibility in the discs, quick or repetitive strain increases the chances of a herniation or ruptured disc.
Diagnosing a Herniated Disc in the Neck
Whether a cervical herniated disc is acute or chronic, a spine expert may recommend only conservative treatment, which means non-surgical treatment. But this depends on the severity of the symptoms and the image results. However, if symptoms persist past four to six weeks, a spine expert such as a neurosurgeon, orthopedic spine surgeon, or pain management doctor, should be sought for further evaluation. Specialists utilize the following methods to diagnose neck pain including a cervical herniated disc(s):
MRI is the preferred imaging technique if a patient is believed to have a herniated disc. It offers greater accuracy of the soft-tissue structures including any pinched nerves or compressed spinal cord. It will also reveal which anatomical structure is compressing the neural tissue and if present, will allow for surgical planning.
X-rays are utilized to rule out bone diseases that may cause neck pain. These X-rays detect f degenerative spine disease or spondylosis, fractures, scoliosis, as well as spondylolisthesis. If necessary, a neurosurgeon also may recommend taking lateral flexion and extension views to establish if any instability of the spine is present.
For patients who cannot receive an MRI, a CT scan is an ideal alternative to viewing the anatomical structure of the spine and any herniated discs. CT scans also show other medical conditions that may be causing neck or back pain.
Electromyogram is an electrodiagnostic test in which small needles are inserted into different muscles to assess nerve function. It can help spine specialists uncover which nerves are most affected by a herniated disc. A related electrodiagnostic test is nerve conduction studies. This tool measures how quickly and effectively electrical signals of the nerves travel throughout the body. These studies help doctors determine where a nerve is compromised or whether a patient has a muscle disorder.
Treatment Options for Herniated Cervical Discs
Pain from a herniated disc can resolve with time, depending on the severity. Patients can decrease the associated inflammation and experience pain relief, by taking over-the-counter NSAIDs applying heat or ice to the neck, and resting for a few days. More advanced treatments are available for patients whose symptoms do not resolve on their own. Assuming there is no weakness or loss of function, the pain management, neurosurgeons, and orthopedic spine doctors at Centers for Neurosurgery, Spine & Orthopedics will first suggest the following treatments:
A core issue with herniated discs is muscle weakness and imbalance, leading to spine instability. Physical therapy can help address these muscle problems. Physical therapists provide various exercises to help patients stretch and strengthen muscles, as well as regain movement abilities. Some modalities the certified physical therapists and rehabilitation specialists at Centers for Neurosurgery, Spine & Orthopedics perform include:
- Physical exercise
- Manual therapy
- Heat and cold therapy
- Ultrasound therapy
- Electrical stimulation
Epidural steroid injections can help reduce inflammation of the nerve tissue to decrease pain caused by a herniated disc in the neck. For this technique, using image guidance, an interventional pain management physician administers an injection of local anesthetic and steroids near the affected nerve root. If the patient experiences 50% or more relief, then the procedure was a success. If the symptoms return, the patient can receive another epidural injection. No more than four epidural injections per year can be done. Patients seldom encounter complications from steroid injections, but if they do, it is short-lived and mild.
Nerve-related pain and muscle spasms frequently accompany a herniated disc. Besides NSAIDs, some other classes of medications can help patients manage the symptoms of a cervical herniated disc. For example, oral steroids can relieve pain from inflammation, and muscle relaxers can treat muscle spasms. If symptoms are severe, a physician may recommend opioids for short-term use. Opioids are usually suggested only if other medications have proven ineffective.
While the conservative treatments described above resolve most cervical herniated discs, surgery may be necessary if the care of physical therapy or injections do not relieve the symptoms. Surgery should only be recommended if the imaging reveals where a structural abnormality that would account for the patient’s symptoms. Surgery will be recommended sooner if the patient displays progressive weakness or loss of function. The board-certified neurosurgeons and orthopedic spine surgeons at Centers for Neurosurgery, Spine & Orthopedics perform every type of spine surgery. Several common surgical treatments are listed below:
DiscectomyA discectomy surgery involves removing a portion of or the entire herniated disc to decrease pressure and inflammation of the nerve root and/or spinal cord. There are two techniques a surgeon may use to perform the discectomy — minimally invasive or microdiscectomy.
Cervical Disc ReplacementIf the entire cervical disc needs to be removed, the doctor will replace the diseased disc with an artificial disc that allows for complete articulation of the neck. Patients have great and long-lasting success with the artificial disc. When patients arrive home from the surgery, they will need to rest for 24 hours. Most patients can walk on flat surfaces after this period of rest. Lifting, bending, and twisting are discouraged for at least two weeks after surgery. The surgeon will schedule a follow-up appointment with the patient at one week, three months, and again at six months assuming no further symptoms are experienced.
LaminectomyLaminae are the bony arches of the spine that create a roof over the posterior portion of the spinal canal. Cervical laminectomy is neck surgery that removes a small piece of the lamina to alleviate pressure on the spinal cord and nearby nerve roots. Laminectomy is also done to access portions of the spine to remove the problematic portion of a herniated disc. Patients typically can go home the same day as the surgery if performed at one level of the spine. Limiting activities is necessary following laminectomy — bending, twisting, and lifting heavy objects should be avoided for a short period. Patients can go back to work within a few days but may need to wait longer for more physically demanding jobs.
Fusion SurgeryFusion surgery is invasive but is essential in some cases. Diseased portions of the spine may be so extensive that neurosurgeons or orthopedic spine surgeons must remove significant portions of the spine. They will ensure a strong spinal construct for the patient to carry on their daily activities after the surgery. To ensure the spinal constructs integrity, height, and stability, the anatomy is rebuilt using bone grafts, and cages which are secured into place with titanium pedicle screws and if necessary plates or rods. Recovery from these procedures depends on the extent of the surgery and the patient’s preexisting health. A general guideline is to avoid bending, lifting, and twisting for two weeks. Some surgeons will recommend patients start physical therapy or other rehabilitation two to six weeks after surgery. Most patients can return to work within a week and non-strenuous activity in 12 weeks, but those whose jobs involve heavy lifting or bending may need to wait six months or more to return to work. Complications may occur following surgical treatments. Some side effects are:
- Esophageal injury
- Vertebral and carotid injuries
- Recurring laryngeal, superior laryngeal, and hypoglossal nerve injuries
- Degeneration of nearby areas of the spine
- Horner syndrome
- Dysphagia (difficulty swallowing)
Neck Surgery and Other Pain Management Solutions in Northern NJFor patients experiencing symptoms that are related to a cervical herniated disc, treatment is available at Centers for Neurosurgery, Spine & Orthopedics. The dedicated surgical and non-surgical team including pain management experts are committed to a cure at all stages of care from physical therapy to surgery. Choosing Centers for Neurosurgery, Spine & Orthopedics means working with a comprehensive team of board-certified neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists. Care is available at multiple office locations throughout northern New Jersey, including Bergen, Passaic, Essex, Morris, and Hudson counties. Patients can contact Centers for Neurosurgery, Spine & Orthopedics today to learn more about cervical herniated discs and potential treatment options.