What is a Cervical Herniation? Causes, Symptoms, and Treatment

Cervical herniation occurs when one of the discs in the cervical spine (neck vertebrae) protrudes or leaks a gel-like substance outside of the disc. This usually happens when the inner part of the disc pushes outward through the outer part. Cervical herniation can lead to various types of pain in individuals' bodies. However, some patients may not experience any pain. In addition to pain symptoms, numbness or weakness in the arm and hand may also occur. Cervical herniation can result from muscle weakness, trauma, or neck injuries. Treatment methods include rest, exercise, physical therapy, and pain-relief medications. However, in more severe cases, surgical intervention may be necessary.

What is a Cervical Herniation?

Cervical herniation is a spinal injury that occurs in individuals. The spine consists of a series of bones that extend from the base of the skull to the tailbone. Between the vertebrae are spinal discs. Inside each disc is a soft, jelly-like substance known as the nucleus. The primary function of the discs is to act as cushions between the bones. Thanks to these discs, a person can bend and move comfortably. Cervical herniation occurs when one of the discs in the neck region tears or leaks. A herniated disc occurs when part of the nucleus pushes out through any tear.

What are the Causes of Cervical Herniation?

The discs between the spinal bones have soft, jelly-like centers and a tougher outer layer. Over time, or due to traumatic injuries, the outer layer can weaken and crack. The leaking nucleus fluid from the weakened or cracked area can put pressure on the spinal nerves. Some causes of cervical herniation include:

• Aging: During the aging process, the fluid content of the discs in the spine decreases, and they lose their elasticity. Loss of fluid and elasticity in the discs can lead to damage.
• Overexertion: Situations such as lifting heavy loads for extended periods, performing repetitive movements, or working in poor posture can strain and damage the discs in the neck.
• Trauma and accidents: Traumatic injuries to the neck area, such as falls after accidents or car accidents, can cause damage to the discs.
• Abnormal posture: Irregularities in neck and back positions maintained for extended periods, poor posture habits, or habits of constantly slouching or leaning can strain and damage the discs.
• Obesity: Obesity can be a contributing factor in cervical herniation. Being overweight increases pressure on the spine, potentially leading to herniation in the neck area over time.

What are the Symptoms of Cervical Herniation?

Symptoms of cervical herniation vary depending on the location of the herniation. The severity and location of pain can differ for each patient. In cervical herniation, pain can radiate down the arm and, in some cases, to the hand. Pain is often felt in the shoulders and neck, especially when turning or bending the head. Some symptoms of cervical herniation include:

• Neck pain: The most common symptom in individuals with cervical herniation is pain felt in the neck area. This pain typically starts in the lower neck or shoulders and can radiate to the arm or hand.
• Shoulder and arm pain: Nerve compression caused by cervical herniation can lead to pain, burning, or tingling sensations in the shoulders or arms. In addition to pain, weakness or loss of strength in the arm and hand may also be observed.
• Headaches: Headaches are one of the prominent symptoms associated with cervical herniation. The pain often starts from the neck and can radiate to the back of the head or temples.
• Numbness and tingling: A herniated disc in the neck can put pressure on the spinal nerves. This pressure can lead to numbness and tingling sensations in the arm, hand, or fingers.
• Weakness in the arm and hand: Cervical herniation can cause weakness by affecting the muscles of the arm and hand. This can lead to difficulties in gripping or holding objects.
• Stiffness in the neck: Individuals with cervical herniation may experience stiffness and limited movement in the neck. Pain or stiffness may occur during neck movements.
• Symptoms of nerve compression: If pressure is applied to the nerves, symptoms of cervical herniation may include pain, weakness, or tingling in the back or legs.

How is Cervical Herniation Diagnosed?

To diagnose cervical herniation, a comprehensive examination is conducted by a specialist doctor. During the physical examination, the doctor can assess pain symptoms, muscle reflexes, and muscle strength. The following tests may also be used to confirm the diagnosis:

• Magnetic Resonance Imaging (MRI): MRI is the most common imaging test used to diagnose cervical herniation. This test helps identify herniated discs, conditions that may exert pressure on the spinal canal, and other spinal issues.
• X-rays: X-rays create images of the spine, evaluating the spacing between vertebrae, bone degeneration, and spinal curvature.
• Computed Tomography (CT): CT scans allow the doctor to visualize the bones of the spine. This test provides cross-sectional images of the spine to assess the condition of the discs, narrowing of the spinal canal, and other structural changes.
• Myelogram: A myelogram involves injecting dye into the spine for a CT scan. The injected dye is examined using X-rays, allowing for visualization of any narrowings in the spinal canal.
• Electromyogram (EMG): This test is used to assess the functionality of the nerves and muscles. During the test, small needles are placed into various muscles to determine which nerve is affected.

Cervical Herniation Treatment

In mild cases without serious symptoms, the initial treatment for cervical herniation recommended by a doctor is usually conservative and may include non-steroidal anti-inflammatory drugs and rest. The doctor may also suggest other treatments. Most people who undergo these treatments return to their normal activities. Some individuals may require further treatment. In severe cases, steroid injections or surgery may be necessary. Some methods used in the treatment of cervical herniation include:

• Medication Therapy: Some medications may be prescribed by the doctor to reduce pain and inflammation. These medications may include non-steroidal anti-inflammatory drugs (NSAIDs) or pain relievers.
• Physical Therapy: Physical therapy applications are among the methods used to treat cervical herniation. Physical therapy can be applied to strengthen the patient's neck muscles and increase flexibility in the muscles and tissues.
• Injection Therapies: In some cases, the doctor may recommend injection therapy. Steroid injections or local anesthetics can be directly applied to the nerve roots to help alleviate pain and inflammation.
• Surgical Intervention: In severe cases of cervical herniation that show intense symptoms, the doctor may prefer surgical intervention. This decision can be made through mutual discussion between the patient and the doctor. Surgical options include procedures such as discectomy (removal of the herniated disc), microdiscectomy (minimally invasive disc surgery), disc decompression, and cervical fusion.

Frequently Asked Questions

Cervical herniation can often be observed due to reasons such as aging, damage to the cervical region, and prolonged incorrect posture. If left untreated, it can cause discomfort to individuals and symptoms may worsen.

What are the Possible Complications of Cervical Herniation?

Cervical herniation can lead to potential complications that may cause serious issues. Some of these complication risks include:

• Long-term back pain or leg pain
• Loss of movement or sensation in the legs or feet
• Headaches and neck stiffness
• Rarely, permanent spinal cord injury

Does Cervical Herniation Recur?

Cervical herniation can recur under certain conditions. Symptoms may reappear if herniated discs again put pressure on the spinal nerves.

Cervical herniation is a condition that negatively affects individuals' daily lives. If not diagnosed and treated, symptoms may worsen over time. If symptoms of cervical herniation are observed, individuals can start treatment by making an appointment at the general surgery clinic of hospitals.