What is cervical disc herniation?
Disc herniation or disc displacement is the compression of the spinal cord or a nerve root that occurs when a portion of an intervertebral disc is displaced. Generally, cervical disc herniations affect the discs located in the neck (cervical spine).
In the latter case we speak of cervical disc herniation or cervical herniations. The pain caused by a hernia can spread from the back to the leg, giving rise to leg pain, or to the arm. Most of the time, disc rupture occurs as a result of aging and/or natural deterioration, although it can also occur in young people due to various causes. The trigger for a healthy disc to herniate can be a traumatism, a violent blow or a wrongly performed effort. Cervical surgery may be necessary to reduce pressure on the spinal cord or nerve roots when pain is caused by a herniated disc or a bony narrowing of the spinal canal.
Prognosis of cervical disc herniation
In most cases, the patient’s health improves with treatment, although it may take more than a year before the patient is able to perform all the activities he/she wishes without pain.
Occasionally there are some complications that make life difficult for the sufferer:
- Prolonged back pain
- Pain in the leg
- Loss of movement or sensation in the foot or legs.
- Loss of bladder and bowel control
- Permanent spinal cord injury
Symptoms of cervical disc herniation
Symptomatology and signs of disc herniation vary from person to person, as there are cases where a person has a herniated disc and does not know it, as there are no symptoms.
Medical tests for cervical disc herniation
When the patient comes for consultation, the specialist will perform a physical examination of the back to look for tender points and determine the cause of the pain. The physician may perform a neurological examination to check reflexes, muscle strength and the ability to feel bumps or pinches.
In most cases, the examination and a medical history are enough to make the diagnosis, although if it is suspected that there may be another problem or want to know which nerves have been affected, the following tests will be performed:
- X-rays: although they do not detect hernias, the presence of other back problems is ruled out.
- Computed tomography (CT) scan: a series of X-rays are taken from different points and then combined to create cross-sectional images of the spine and its structures.
- MRI: radio waves and a magnetic field are used to reproduce the internal structures. It can confirm the location of the herniation and check which nerves are affected.
- Myelography: through the injection of a dye into the cerebrospinal fluid, the pressure on the spinal cord or nerves is shown.
What are the causes of cervical disc herniation?
Herniated discs are the result of disc wear and tear over time and as the individual ages. Over the years, the vertebral discs lose some of the fluid they contain, becoming less flexible and easier to rupture or tear, even with minimal effort.
For the most part, herniated disc sufferers cannot explain the source of their problem. Occasionally, using back muscles instead of legs or arms to lift heavy objects can cause a herniated disk, as can bending or twisting while the individual is carrying weight.
Occasionally, a herniated disc is caused by trauma, such as a fall or a blow to the back, although these causes are less common.
The easiest way to avoid cervical disc herniation is to avoid risk factors, such as being overweight or maintaining good posture.
Can cervical disc herniation be prevented?
The best way to avoid cervical disc herniation is to avoid risk factors and lead a healthy lifestyle. Some recommendations are the following:
- Exercise: regular exercise strengthens the trunk muscles and helps stabilize the spine.
- Maintain correct posture: proper posture reduces pressure on the spine and discs. Keeping the back aligned when the individual is sitting for long periods of time is the best option.
- Maintain a healthy weight: excess weight on the spine generates pressure on the spine and discs, making them more prone to suffer a hernia.
At the same time, one should try to avoid risk factors as much as possible:
- Weight: avoid being overweight
- Occupation: physically demanding jobs are more likely to cause back problems.
- Genetics
Treatment for cervical disc herniation
There are various ways of dealing with the treatment of a herniated disc. The first of these is conservative treatment, which may be accompanied by physiotherapy. Subsequently, there are options that require surgical intervention and alternative remedies.
- Conservative treatment: consists mainly of avoiding painful positions and following previously agreed exercises, accompanied by analgesics such as over-the-counter painkillers, narcotics, anticonvulsants, cortisone or muscle relaxants.
- Therapy: if the pain does not disappear after several weeks, the specialist may recommend the assistance of physiotherapists.
- Surgery: this procedure is performed in patients in whom conservative treatments do not work and especially if the patient continues to feel weakness, difficulty in standing and a loss of sphincter control. The possibilities are to remove the external part of the disc, the entire disc, to fuse vertebrae with metal elements to give stability to the spine or, in very isolated cases, to implant an artificial disc.
- Alternative medicine: include chiropractic, massage, yoga or acupuncture.
Which specialist treats cervical disc herniation?
There are several specialists who can diagnose and treat cervical disc herniation problems. The main ones would be specialists in Traumatology, as well as Neurosurgeons, specialists in Pain Unit and Ozone Therapy. Specialists in Physiotherapy, Acupuncture or Osteopathy can also play an important role in recovery.