HERNIATED NECK DISC: SYMPTOMS, CAUSES, TREATMENT, EXERCISES AND PREVENTION

Updated 27 September 2023

If you are experiencing debilitating neck pain, you might be suffering from a herniated disc in the neck. A herniated neck disc refers to a condition where the nucleus of the intervertebral disc within one of the neck’s vertebrae, bulges out between the vertebrae. It may place pressure on spinal nerves or the spine’s blood supply, which can give rise to symptoms such as pain, numbness, or loss of coordination. This can knock one back for several weeks at a time and may result in needing time off work.

Unfortunately, there are no shortcuts to a speedy recovery. It is vital to know the signs and symptoms of a herniated neck disc in order to seek swift treatment. Recovery involves taking special precautions to minimize neck strain, managing symptoms, and building strong neck muscles, all of which are covered in the article below, alongside causes and treatment options.

Symptoms of a Herniated Neck Disc

Neck pain is typically the chief complaint in cases of neck disc herniation. This occurs when a nerve is impinged by the bulging or ruptured disc. As the herniated disc tends to compress the blood supply or other nerves traveling from the neck, it can also affect the muscles of the shoulders, arms, and hands. In addition, it may promote headaches and poor coordination by affecting the blood flow to the head.

Aside from neck pain, other common symptoms of a slipped neck disc include:

• Neck stiffness
• Pain that radiates or shoots through the shoulders or down the arms
• Arms, hands, or fingers experiencing tingling, numbness, or weakness
• Diminished reflexes and physical coordination in the hands and arms
• Clumsiness
• Headaches and migraines
• Muscle spasms in the neck and shoulders
• Eye or ear pain

Symptoms may intensify with certain movements, such as rotating or contracting the neck. Caution is advised when attempting to exercise the area.

Severe cases may result in swelling of the neck and place pressure on the heart or brain due to constriction of major arteries or veins. If experiencing severe symptoms, it is crucial to consult a doctor immediately.

Common Causes and Risk Factors

Also known as cervical disc herniation, a ruptured disc, or a slipped disc, this condition is fairly common and is known to affect up to 2% of the population annually. It typically results from a vertebral injury or age-related wear and tear. It mostly affects individuals over the age of 30, with those aged 50-60 being the most vulnerable.^[1]

Ruptured neck discs are known to affect women more than men, constituting up to 60% of all cases. This is likely due to the use of high heels and the hormonal changes that occur during menopause, which impact bone density.

Inflammatory conditions may also increase the risk due to placing pressure on surrounding structures, detracting from bone density, and promoting the vertebrae’s susceptibility to damage.

Treatment Options

Most cases of neck disc herniation resolve spontaneously within 4-6 weeks. Treatment is still essential for aiding the recovery process and to make sure it does not happen again or become a chronic ailment. In chronic cases, patients may need to opt for more intensive therapies or surgery.

Some of the main treatment options available are discussed below.

• Painkillers and Anti-Inflammatories. Depending on the cause of pain, one may require the use of painkillers, anti-inflammatories, or both when dealing with a herniated neck disc. NSAIDs are often a good first option as they can reduce inflammation. Your doctor may prescribe you a stronger painkiller if the pain is persistent.
• Neck Immobilization. Some patients benefit from wearing a neck brace or collar for the first week after symptoms appear. This holds the neck in one position, preventing further neck strain and nerve compression until the acute inflammation subsides and the patient is ready to exercise the area. A physician may insist on neck immobilization for patients with severe neck injuries.
• Physical Therapy and Exercises. After initial inflammation has gone down and the pain lessens, it is vital to exercise the neck. Gentle stretches that improve the neck’s range of motion and daily neck strengthening exercises are par for the course. These ought to be tweaked by a physiotherapist. Your doctor could also suggest various remedies you might try at home, such as heat or ice packs. Ultrasound therapy or electrical stimulation of the spine may speed up the recovery process and help lower pain.
• Traction. This is another form of physical therapy that involves decompressing the neck vertebrae. It often provides pain relief for some patients by removing pressure off the nerves. During traction, the head is lifted up at a slight angle, allowing for the spine to stretch out.
• Cervical Manipulation. A step up from traction would be cervical manipulation at the chiropractor’s office. Through a careful series of neck manipulations, a chiropractor may be able to take pressure off the neck and improve its posture. This is known to work best after residual inflammation has subsided and is only recommended if the neck is out of alignment due to a slipped disc. Some patients do not benefit from manipulation, while others report a reduction in headaches and pain in response to treatment.

The above treatment options are conservative and aim to aid recovery. They typically improve symptoms in 75-90% of patients. Roughly 25-30% of patients go on to experience recurrent or chronic symptoms.^[2]

If conservative treatment fails to alleviate symptoms after 6 weeks, the patient is advised to consult a doctor for more intensive treatment options, such as:

• Injections for Pain Management. Epidural corticosteroid injections are a preferred alternative to surgery in patients with a chronic herniated disc. Injecting steroids into the epidural area allows for pain and inflammation to be blunted. It is used to help patients continue with physical therapy in an effort to repair the problem. The effects are often cited as lasting for 3 months or more, yet some studies have reported the average duration to be over a year.^[3]
• Surgery. If the patient does not experience relief through epidural injections and fails to heal, they may prefer to have the problem surgically resolved. For many years, Anterior Cervical Discectomy with Fusion was the gold standard for treating a herniated disc in the neck. This procedure demands removing the diseased disc and fusing the surrounding vertebrae together with a bone graft. It greatly restricts the patient’s ability to move their neck after recovery, yet it is known to reduce chronic pain.^[4]
• Total Disc Replacement is a more recent surgical option that is starting to become more popular than discectomy. In total disc replacement, the disc is replaced with an artificial one. The surgery allows for the patient to retain their neck’s mobility and may reduce residual pain. Follow-up studies have shown that after 5 and 10 years, patients had a higher life quality and were more satisfied on average with total disc replacement than with discectomy.^{[5] [6]}

Recovery, Prevention, and The Role of Building Muscle

In the past, bed rest was the go-to protocol recommended by doctors for treating neck disc herniation. While bed rest may be helpful for coping with pain, it ultimately promotes muscle weakness, which slows recovery and can even exacerbate symptoms in the long run. ^[7]

These days, exercise is understood to be vital for building neck muscle, speeding up the healing process, and ensuring the problem does not persist in the future.

A few benefits of exercising the neck for those with a herniated cervical disc include:

• Pain Relief. The neck and spine are critical for the transmission or inhibition of pain. This is one reason that a herniated disc in the neck can be exceedingly sore. Exercise is known for its ability to balance signals of pain that pass through the spine to the brain, thereby encouraging pain relief, especially in those with severe neck pain.^[8]
• Improved posture and spinal stability. Impaired neck alignment can affect one’s posture, sense of balance, and the stability of the spine when bearing weight during daily activities. Exercises that work to improve overall balance and postural control have been shown to enhance mobility and stability in patients with cervical disc herniation^[9]. Proper posturing of the neck helps to keep the discs healthy as well and is linked to slower degeneration during aging. These exercises help increase blood flow in the area, which can also improve other symptoms, such as headaches and tingling sensations.
• Better Protection and Vertebral Support. Building muscle regulates the growth of nearby bone and cartilage. In the neck, this can improve the strength of the cartilaginous cervical discs and the vertebrae so as to prevent displacement.
• Enhanced Range of Motion. Exercising the muscles regularly helps to keep them loose and does away with stiffness. In some cases, this can enhance the neck’s range of motion and flexibility within a matter of days. Moving the neck muscles and getting the heart rate up slightly also stimulates the lymphatic system, which can improve lymphatic drainage of the area and contribute towards lowered swelling and stiffness.
• Reduced Pressure on the Herniated Disc. Larger muscles are well-known to act as extra shock absorbers for jarring impacts, effectively doubling up on the role of cartilage in spinal cord and disc protection. In this respect, neck muscle can be especially useful for taking strain off the neck and limiting unnecessary pain during recovery (particularly pertinent for those prone to clumsiness).

Recommended Exercises for Building Muscle in the Neck

Knowing where to begin can seem daunting when attempting to improve the neck’s strength and flexibility while dealing with the pain. Thankfully, it is best to take it slow, as too much exertion is bound to worsen the problem, yet doing nothing will not show any improvements.

Essentially, one needs to increase blood flow through the neck and build stronger spinal muscles. This involves stretching the area gradually every day, as well as engaging in activities that strengthen the core spinal muscles, improve balance, and get the heart rate up slightly.

The following exercises are known to be safe and effective for building cervical muscles:

Neck Flexion-Extension Exercises. These refer to exercises that either bend the neck forward (neck flexion) or backward (extension). Looking from side to side, bending the neck from side to side while looking forward, rotating the head, and rolling the neck forward are all examples of neck flexion exercises. Tilting the head back or straightening the neck are examples of extension exercises. Doing a handful of each of these helps to work the neck muscles, loosen up the neck, and enhance its range of motion. It may be easier to perform extension exercises before being able to do flexion without pain, yet flexion exercises are known to yield the best results.

Shoulder Shrugs and Rolls. Loosening up the shoulders can take the strain off the neck and enhance circulation between the two, which is often affected by a slipped disc. This can be achieved with several sets of shoulder shrugs, rolls, and moving the arms in wide arches in both clockwise and counterclockwise directions. It may be useful to start with shoulder exercises first if the neck is too stiff to stretch.

Core-Strengthening Exercises. These exercises strengthen the core muscles, including the pelvic, back, and abdominal muscles. The core muscles are used for postural control, mobility, and spinal support. Any exercise that works these muscles will improve overall core strength and support the neck. Some of the best examples include planks, bridges, and alternating leg and arm lifts. Modified versions of these could be done until fit enough to perform them properly.^[10]

Low-Impact Aerobics. Physical activity that gets the heart rate up and boosts blood flow completes any physical recovery regimen, with neck disc herniation being no different. Some of the best exercises for this include walking and swimming. These work muscles away from the neck and offer great benefits for minimal exertion. Studies have proven that patients with hernias benefit from walking, experiencing pain relief from the activity even after undergoing surgery.^[11]

While these exercises can help to get you started, it is vital to speak to a qualified physician about exercising the area and what else you can do to aid recovery.

When to Seek Professional Help

It is not always easy to know what is causing your neck pain. As the causes can vary considerably, seeking professional help is vital. A physician can confirm the diagnosis, ensuring that the condition is localized to the spine and not the result of another health problem, such as an infection or an underlying disease. This can also avoid the common mistake of making the problem worse in an attempt to resolve it on one’s own.

At the first appointment, the practitioner will conduct a thorough medical examination and take a full medical history. They may also perform an x-ray to confirm the ruptured disc and to make sure it is not the result of an underlying condition. If another condition is suspected or the symptoms are more severe than usual, the doctor may perform a CT scan, MRI, or nerve conduction test to acquire an optimal diagnosis. The patient may need to go for blood testing.

Once diagnosed, your physician may provide you with prescription medications. The physician can then recommend treatments such as traction and work with you or your physiotherapist to design an optimal exercise program that serves to strengthen the neck and regenerate the area. Unlike online resources, a professional can guide you through essential exercises and correct your technique. This ensures that the muscles grow back properly and the neck remains in an optimal alignment. Your physician may also suggest other helpful strategies to cope.

If a herniated disc is confirmed and the problem does not resolve within 4-6 weeks despite one’s best attempts, the physician will need to be consulted again, and further testing may be warranted. The doctor will need to ascertain whether the problem is still an acute one or whether it has progressed into a chronic condition. If chronic, they may recommend more advanced treatment options such as corticosteroid injections or surgery as a last resort.

Conclusion

Whether the result of injury or aging, a herniated disc in the neck is an exceedingly painful condition that can detract substantially from your daily routine. Understanding the symptoms of cervical disc herniation can help one to receive swift treatment and greatly enhance recovery. Treatment is aimed at reducing pain and physically strengthening the problem area. Exercising can go a long way towards recovery through speeding disc regeneration, taking the strain off the neck, and managing pain. If conservative treatment fails to yield results, surgery may be required to prevent chronic neck pain.

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