What is a disc prolaps of the neck?
If you have a disc prolaps (also known as a slipped disc or hernia nuclei pulposi), part of an intervertebral disc protrudes from the spine. This occurs most frequently in the lower back (lumbar vertebrae) or in the neck (cervical vertebrae). The protruding part presses against a nerve root. This can irritate the nerve, and it may even get trapped, causing complaints in the part of the body supplied by this nerve, with pain radiating to an arm.
Intervertebral discs may start to protrude as a person gets older. They may even tear, and then its contents can be pushed towards the spinal canal, just where the nerve root is located. This type of ageing of the intervertebral disc is a normal process and can happen to all people. This means that anyone can get a herniated cervical disc, though it does tend to occur more frequently in some families. Smoking also appears to have an influence, especially on the severity of the problem.
Signs and symptoms
The main complaint among patients with a herniated cervical disc is a pain that radiates to their arm. This pain usually starts before the pain in the neck, or at the same time. The pain often increases when patients cough, sneeze or push. But tilting the head backwards and/or turning it sideways can also increase the pain in the patient's arm, often resulting in a sharp, stabbing pain. Patients may also feel tingling and/or numbness, or their muscles may weaken.
How is disc prolaps of the neck diagnosed?
If you visit our clinic with pain radiating to your arm, which becomes worse when you cough, sneeze or push, it is very likely that you have a herniated cervical disc. This can be confirmed by certain tests that are part of the neurological examination you will get. In addition, the doctor will test the mobility of your neck and shoulder, to see whether certain movements are restricted or painful. The doctor will also feel your neck to see whether pressing on any of the vertebrae causes pain.
Do I need additional examinations?
- Diagnostic examination for other non-physical factors important for your pain, have already been done by yourself trough filling out your pain questionnaires.
- Since the neurological examination usually confirms the diagnosis, further examinations are not always necessary. What is important to know is that many people who do not have any complaints are still found to have a protruding cervical disc when they are examined with an MRI-scan. On the other hand, a scan may reveal no herniated cervical disc even if the doctor suspected one because the patient has pain radiating to their arm.
- An MRI-scan only needs to be made if there is doubt about the diagnosis or when the doctor is considering an operation. An MRI scan may reveal the herniated cervical disc or other possible causes of the pain.
- A CT scan is usually not useful, as it only shows clear images of the bones.
- Sometimes an examination of the patient's muscles (EMG) is done, to check which nerve root in the neck is causing the pain in their arm.
- Nerve root test blocks can also be used to check which nerve root in the neck is causing the pain in the arm.
What are my treatment possibilities?
Depending on the cause of your pain, your pain specialist will decide whether or not to embark on physical treatment. Based on the results of the completed pain questionnaire, additional examinations can be carried out and, apart from physical treatment, other methods of treatment will be suggested.
If the results of your pain questionnaire are abnormal, your pain specialist will offer you one of the non-physical treatments listed below:
Interventional Pain Treatments