In the healthy neck, there is a disc filled with fluid between each bony element of the spine (vertebra). Each disc has a strong outer ring (annulus fibrosus). The outer ring helps keep the disc’s soft center (nucleus pulposus) in place.
What is Disc Herniation?
When a disc degenerates (breaks down), the disc’s outer ring may form tiny tears or cracks. If the outer ring of the disc fully tears or splits, the gel-like center can squeeze out. Disc herniation, also called a disc bulge or a ruptured disc, shrinks the space between the vertebrae.
Causes of Disc Herniation in the Neck
Disc degeneration can start from over-use, an accident, or just the wear and tear of everyday life. Once the outer ring of the disc has degenerated and cracked, everyday activities can cause the disc center to leak out.
Symptoms of Disc Herniation
When the disc center bulges beyond its natural location, the disc may press on a nerve root and/or the spinal cord. Loss of disc height can also cause pressure on nerve roots and the spinal cord. This pressure can cause pain, numbness, and weakness in your neck, shoulders, or arms. The type and location of pain depend on which disc has herniated and how the nerve root and/or spinal cord is pinched (compressed).
Disc Herniation Diagnosis
Using the type and location of pain as a reference, your doctor will perform a physical examination. The exam checks for the range of motion and strength in your neck and arms. Your doctor will also order images of your neck: x-ray, MRI, or CT scan. An MRI will show the location of the herniated disc and any pinched nerves.
Disc Herniation Treatment
Unless a nerve is severely pinched, conservative treatment can be the first choice in the care of disc herniation. Your doctor may suggest: physical therapy, rest, anti-inflammatory medications, and lifestyle changes. If conservative care does not help, if a nerve is pinched, or if pain is severe, your doctor may recommend surgery. Some patients have worsening weakness in the arms, where having surgery sooner can be beneficial. In some cases, if there is no surgical intervention, permanent nerve damage can occur.
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