PAIN AND ORTHOPAEDICS · Health guide
What Is a Cervical Disc Herniation? Symptoms and the Treatment Approach
Arm pain and numbness in cervical disc herniation: neurological examination, rehabilitation options and the symptoms that must be assessed without delay.
Updated: · General information
Definition and assessment
Outward displacement of the disc contents between the cervical vertebrae is termed a cervical disc herniation. Its clinical significance is determined by its relationship to a nerve root or the spinal cord. Imaging findings must be interpreted together with the symptoms and the examination.
Symptoms and diagnosis
There may be pain radiating into the neck, shoulder or arm, numbness in the fingers and reduced strength in the arm and hand. The pattern of radiation is not the same in every patient. History and neurological examination form the basic assessment; MRI and other tests are selected where needed. Any new deterioration in hand dexterity or in walking is of particular importance.
Treatment approach
In suitable patients, non-surgical options such as medication, individually tailored exercise and rehabilitation are considered. The need for surgery is not determined by the number of months elapsed alone; spinal cord involvement, progressive loss of strength and the response to treatment are taken into account. Forceful neck manoeuvres and the unsupervised use of a cervical collar are not appropriate.
Nerve root and spinal cord findings
In some people, changes in a cervical disc affect the nerve root and cause pain radiating into the arm, numbness or reduced strength. Findings such as marked deterioration in hand dexterity and unsteadiness of gait are assessed separately for possible spinal cord involvement. Whether the symptoms arise from the neck or the shoulder is distinguished by examination.
How are treatment goals set?
Difficulties with sleep, desk work, driving and using the arm for everyday tasks are recorded. The intensity of rehabilitation is adjusted according to the neurological findings and the pain. In the event of sudden or progressive loss of strength, a routine review is not awaited; imaging and assessment by the relevant specialist may be required.
Your questions
Patient information
Is it dangerous if a herniation is seen on MRI?
The image alone does not indicate the level of danger. Effects on the nerve and the spinal cord are interpreted together with the examination and the symptoms.
Should a cervical collar be worn continuously?
A cervical collar is not necessary for every patient. If one has been recommended, ask the physician for what purpose and for how long it should be worn; it should not be used for long periods on your own initiative.
