Cervical Disc Injury & Herniated Disc Treatment

What Is a Cervical Disc Injury?

The cervical spine is made up of seven vertebrae in the neck. Between most of these vertebrae are intervertebral discs that help distribute load and allow movement between the bones of the spine.

Each disc has a tougher outer layer, called the annulus fibrosus, surrounding a softer central region called the nucleus pulposus.

Changes within a disc can sometimes cause it to bulge or herniate. If this affects a nearby spinal nerve root, it may cause symptoms extending from the neck into the shoulder, arm or hand.

What Is the Difference Between a Bulging Disc and a Herniated Disc?

The terms “disc bulge”, “disc protrusion” and “disc herniation” are sometimes used interchangeably, but they describe different appearances of the disc.

A disc bulge generally describes a broader extension of the disc beyond its usual boundary. A disc herniation describes a more localised displacement of disc material.

You may also hear the term “slipped disc”, although a disc does not literally slip out of position.

Most importantly, the appearance of a disc on an MRI does not by itself tell us how much pain someone will have. Imaging findings need to be interpreted alongside the person’s symptoms and clinical examination.

What Symptoms Can a Cervical Disc Problem Cause?

A cervical disc problem may cause neck pain, but symptoms can also occur further away from the neck.

Depending on whether a spinal nerve is affected, symptoms may include:

• Neck pain or stiffness
• Pain around the shoulder blade
• Pain travelling into the shoulder or arm
• Tingling or pins and needles in the arm, hand or fingers
• Numbness or altered sensation
• Weakness in particular muscles of the arm or hand

The exact pattern depends partly on which nerve root is affected.

What Is Cervical Radiculopathy?

Cervical radiculopathy describes symptoms caused by dysfunction or irritation of a spinal nerve root in the neck.

It can produce pain travelling into the arm together with sensory changes such as tingling or numbness and, in some cases, weakness.

A cervical disc herniation is one possible cause of radiculopathy. Narrowing of the space through which a nerve leaves the spine can also cause similar symptoms.

Not every pain in the shoulder or arm is cervical radiculopathy. Problems involving the shoulder, muscles, joints and peripheral nerves can sometimes produce similar symptoms, which is why examination is important.

What Causes a Cervical Disc Herniation?

Disc problems do not always have one identifiable cause.

Changes can develop gradually as the discs change with age, while some symptoms begin following an injury or particular movement.

Factors such as previous injury, repeated loading and individual anatomy may also contribute.

It is therefore usually more useful to understand how a disc is affecting the surrounding structures than to try to identify one single movement that “damaged” it.

How Do We Assess a Suspected Cervical Disc Problem?

Your assessment begins with a detailed history of your symptoms, including where the pain travels, whether you have tingling or numbness, whether you have noticed weakness and what makes the symptoms better or worse.

The examination may include:

• Neck movement
• Strength testing
• Reflexes
• Sensation
• Neurological examination
• Clinical tests that may reproduce or relieve nerve-related symptoms
• Assessment of the shoulder and other areas where appropriate

The purpose is not simply to establish whether your neck hurts, but to determine whether there is evidence that a particular spinal nerve may be involved and whether further investigation is required.

Do I Need an MRI for a Cervical Disc Problem?

Not everyone with neck or arm pain requires an MRI.

In many cases, the history and clinical examination provide enough information to begin appropriate conservative management.

An MRI may be considered where symptoms are severe or persistent, neurological function is deteriorating, the diagnosis remains uncertain, spinal cord involvement is suspected or imaging is likely to change management.

MRI is particularly useful for showing the discs, spinal nerves, spinal cord and other soft tissues.

Importantly, disc bulges and other degenerative changes can also be seen on scans of people without symptoms. The scan therefore needs to be interpreted alongside the clinical findings.

Will an X-Ray Show a Herniated Disc?

An X-ray does not directly show a disc herniation because discs and nerves are soft tissues.

However, X-rays can provide information about the bones, alignment and degenerative changes in the cervical spine and may sometimes be useful when clinically indicated.

If direct assessment of the discs, nerves or spinal cord is required, MRI is generally the more appropriate investigation.

Can Chiropractic Care Help With Cervical Radiculopathy?

Many cases of cervical radiculopathy are initially managed conservatively, provided there are no clinical findings suggesting that urgent medical or surgical assessment is required.

Depending on the individual assessment, conservative care may include exercise, advice about activity, rehabilitation and appropriate manual therapy.

Research suggests that manual therapy can improve pain and disability in some people with cervical radiculopathy, particularly as part of a broader conservative treatment approach. However, the research does not establish that one particular manual treatment technique is best for every patient.

At Isis Chiropractic Centres, treatment is therefore based on the clinical findings rather than automatically manipulating a neck because a scan shows a disc problem.

Does Treatment Always Involve Neck Manipulation?

No. A cervical disc problem does not automatically mean that neck manipulation should be performed.

Depending on the findings and the individual patient, treatment may involve:

• Joint mobilisation or appropriate manual therapy
• Exercise and rehabilitation
• Advice about movement and activity
• Soft tissue treatment where appropriate
• Strategies to help manage nerve-related symptoms
• Referral or further investigation when required

The treatment plan should reflect the diagnosis, neurological findings, patient preference and response to care.

Can a Cervical Disc Herniation Improve Without Surgery?

Yes. Many people with cervical radiculopathy can be managed without surgery, particularly where symptoms are stable and there is no evidence of progressive neurological or spinal cord dysfunction.

Recovery varies between individuals. Pain may improve before tingling, numbness or weakness fully resolves because neurological symptoms can take longer to recover.

Surgery may be considered when symptoms remain severe or disabling despite appropriate conservative management, or when neurological findings indicate that surgical assessment is appropriate.

Should I Keep Moving With a Cervical Disc Problem?

In most uncomplicated cases, completely avoiding movement is not necessary.

It is usually helpful to remain active within tolerable limits while temporarily modifying movements or activities that significantly aggravate arm or nerve symptoms.

As symptoms settle, rehabilitation can be progressed gradually to restore movement, strength and confidence.

What Is the Difference Between Cervical Radiculopathy and Cervical Myelopathy?

This is an important distinction.

Cervical radiculopathy involves a spinal nerve root. Symptoms commonly affect an arm or hand and may include pain, tingling, numbness or weakness.

Cervical myelopathy involves the spinal cord. It can produce more widespread neurological problems and requires medical assessment.

Possible warning signs of spinal cord involvement include:

• Increasing clumsiness or loss of dexterity in the hands
• Difficulty with buttons, handwriting or other fine hand movements
• Weakness affecting the arms or legs
• Changes in walking or balance
• Unusually brisk reflexes
• New bladder or bowel disturbance

If the history or examination suggests spinal cord involvement, the priority is appropriate investigation or referral rather than routine conservative treatment.

When Should Neck and Arm Symptoms Be Assessed Urgently?

Most neck and arm symptoms are not caused by a medical emergency. However, some neurological changes require prompt assessment.

Seek urgent medical advice if you develop:

• Rapidly increasing weakness in an arm or hand
• Weakness or altered sensation affecting both arms or the legs
• New difficulty walking or significant problems with balance
• Increasing clumsiness or loss of coordination in the hands
• New bladder or bowel disturbance associated with neurological symptoms
• Severe symptoms following significant trauma
• Neck pain accompanied by severe illness or other concerning systemic symptoms

These symptoms do not necessarily mean that there is spinal cord compression, but they require appropriate medical assessment.

Other Problems That Can Cause Similar Symptoms

Neck, shoulder and arm symptoms are not always caused by a cervical disc problem.

Other possible explanations include problems involving the cervical facet joints, narrowing around a spinal nerve, shoulder conditions and irritation or compression of peripheral nerves elsewhere in the arm.

This is why the diagnosis should be based on the overall pattern of symptoms and examination findings rather than on one symptom or scan finding alone.

Cervical Disc Treatment Near You

Milton Keynes

Our Milton Keynes clinic provides assessment, chiropractic treatment and rehabilitation for neck pain and cervical disc-related symptoms, with on-site X-ray facilities where clinically indicated.

Northampton

Our Northampton clinic assesses neck pain, arm symptoms and suspected cervical disc problems, with chiropractic care, rehabilitation and on-site X-ray facilities where appropriate.

Aylesbury

Our Aylesbury clinic provides assessment and treatment for neck pain and cervical disc-related symptoms, with on-site X-ray facilities where clinically indicated.

Frequently Asked Questions About Cervical Disc Problems

Is a slipped disc the same as a herniated disc?

“Slipped disc” is a commonly used term, but the disc does not literally slip out of place. Disc herniation is a more accurate description of localised displacement of disc material.

Can a cervical disc problem cause pain in my hand?

Yes. If a cervical nerve root is irritated, symptoms can travel into the arm, hand or fingers. The distribution can sometimes help identify which nerve may be involved.

Can a cervical disc herniation cause numbness or weakness?

Yes. Nerve-root involvement can cause altered sensation, numbness and weakness as well as pain. Progressive weakness requires careful assessment.

Do all cervical disc herniations need an MRI?

No. Imaging is not automatically required for every person with neck or arm symptoms. MRI is particularly useful when neurological symptoms are significant or progressing, the diagnosis is uncertain or the result is likely to change management.

Will I need surgery?

Not necessarily. Many people with cervical radiculopathy are initially managed conservatively. Surgical assessment becomes more important when symptoms remain severe or disabling or when neurological function is deteriorating.

Can chiropractic treatment make a herniated disc go back in?

It would be misleading to describe chiropractic treatment as physically “putting a disc back in”. The aim of conservative care is to help manage symptoms, restore function and movement and support recovery where appropriate.

Start by Understanding What Is Causing Your Neck and Arm Symptoms

Neck pain, arm pain, tingling or numbness can have several possible causes. A careful assessment can help distinguish a cervical disc problem from other conditions and identify whether conservative treatment, rehabilitation or further investigation is appropriate.