The neck or cervical spine is made up of 7 bones or vertebrae. Excluding the top level, in between each of the bones of the neck lies a disc. The disc is made up of tough con-centric outer layers of tissue known as the annulus and a soft jelly like substance in the middle. Due to the structure of the spine and the nature of the way we move, it is almost always the back part of the disc that becomes injured.
What is it
Injury to the cervical disc will generally fall into one of the 3 following categories of increasing severity:
Annular strain
This is where the back portion of the disc becomes inflamed due to sustained or repetitive bending of theneck or as a result of a sudden unexpected force on the neck or arms.
Disc bulge
This generally tends to occur gradually over a period of time, although onset of symptoms may be quite sudden. With this injury, as a result of repetitive stress on the back of the annulus, it becomes stretched and begins to bulge, generally backwards, towards the nerves and spinal cord.
Disc herniation
This will generally occur in a chronically bulged cervical disc, where the tissue at the back of the disc fails and the jelly like substance in the middle of the disc leaks out.
Symptoms of Cervical Disc injury
- Pain generally on one side of the neck.
- Painful restriction of movements of the neck, especially dropping the head forward.
- Pain is often relieved after a period of extension or having the head leaning back while supported.
- Muscle spasm in the neck and top of the shoulders.
- A disc bulge and disc herniation, commonly cause compression or irritation of the nerves from the neck into the arms, resulting in pain, pins and needles, numbness or weakness in the arm.
Management
The cervical disc is generally irritated by dropping the head forward. Avoiding forward head positions and slouched posture are essential in allowing the disc to settle. Heat and anti inflamatories are quite useful in settle muscle spasm and inflammation of the disc and surrounding nerves.
Your physio will generally use gentle techniques to decrease muscle spasm and restore normal joint mechanics. Occasionally taping the neck and shoulder can be useful in offloading the painful disc. Often you will be prescribed exercises to settle the disc and increase range of motion.
Identification of contributing factors to the injury, such as postural issues and or weakness of the stability muscles of the neck and shoulder girdle is essential in prevention of re-occurrence of the injury. Your physio is able to provide you with a range of corrective rehab exercises to overcome these issues and keep you pain free.
