Cervical Disc Degeneration, Disc Herniation and Nerve Impingement
Cervical Disc Degeneration is an upper spine condition that can cause pain and numbness in the neck, shoulders, arms, and even hands.
As we age, the discs in our cervical spine (neck) begin to flatten and wear down. When a disc flattens, it forces the vertebrae closer together, which can put added stress not only on the disc itself, but also on the surrounding joints, muscles, and nerves. This process is called Cervical Disc Degeneration, and can lead to several painful conditions some of which are discussed below:
Herniated Disc: A Herniated Disc, known as a Herniated Nucleus Pulposus (HNP), occurs when the outer layer of the disc (the annulus fibrosus) tears or ruptures due to stress from the surrounding vertebrae.
Normal cervical intervertebral disc
Ruptured disc and Impinged nerve
These tears can cause the disc`s soft central core (the nucleus pulposus) to bulge out or even detach completely, putting pressure on the nearby nerves or spinal cord. This nerve pressure can cause symptoms of pain or weakness in specific parts of the body, depending on which nerves are being compressed.
Bone Spurs (Osteophytes): Bone spurs, also called osteophytes, are small bony ridges that form on vertebrae as a result of increased stress on these bones. Usually, these spurs cause nothing more than an occasional stiff or sore neck. However, as with a HNP, bone spurs may press against nearby nerves or the spinal cord, causing symptoms of pain or weakness in specific parts of the body.
Symptoms of Cervical Disc Degeneration
Although many people experience Cervical Disc Degeneration as a result of aging, few people experience severe symptoms. Typically, Cervical Disc Degeneration symptoms are mild such as aches or stiffness in the neck and shoulder, as well as occasional headaches. However, Cervical Disc Degeneration symptoms can become severe when nerves are pinched due to a herniated disc or bone spurs. This can lead to painful conditions known as Cervical Radiculopathy and Cervical Myelopathy.
Cervical Radiculopathy - When spinal nerves are pinched, it can lead to pain, weakness, or numbness in the neck, shoulder, arms, and hands. Oftentimes, this feels like a shooting pain traveling down the arm.
Cervical Myelopathy - Occasionally, the spinal cord itself is pinched, which can lead to severe pain or weakness in the arms and legs. This pain can cause difficulty walking as well as trouble using the hands.
Your physician will conduct a history and physical examination to understand your symptoms and to determine if you have any nerve or spinal cord impairment caused by conditions related to Cervical Disc Degeneration.
Your posture, neck motion, reflexes, muscle strength and areas of pain are all evaluated during the examination. If Cervical Disc Degeneration is suspected, your doctor may order an X-ray or MRI to evaluate your discs, nerves and spinal cord and to help outline a course of treatment.
For many patients, non-surgical or conservative treatments will effectively relieve symptoms of Cervical Disc Degeneration. These treatments may include a combination of rest, physical therapy, or the use of painkillers or anti-inflammatory medications. If pain or numbness persists despite these treatments, surgical treatment options are considered. Both conservative and surgical treatments are designed to relieve your pain symptoms. Your doctor will determine the best treatment based on the severity of your degenerative disorders.
Surgical treatment involves removing the herniated disc, osteophytes, and bone spurs causing your symptoms; a process called decompression. Together, cervical spine decompression and cervical spine discectomy (removal of part or the entire intervertebral disc) surgeries are used to remove the damaged cervical disc and relieve pressure from the impinged nerve.
The following video demonstrates the surgery to treat cervical disc degeneration:
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