Neck (cervical disc) hernia is the condition where the disc material (cushions) located between the cervical vertebrae ruptures, breaks and is displaced into the canal as a result of aging or trauma, and causes compression to the spinal cord and nerve roots.
Who has a neck hernia?
Almost all adults experience severe neck pain or stiffness at least once in their lives. Not every neck pain means neck hernia. Neck hernia is a condition commonly seen in middle-aged adults. It is important to know the risk factors that increase the incidence of neck hernia.
What are the risk factors?
Disruption of discs depending on age.
Trauma caused by traffic accident and impact.
Lifting heavy things.
Continuous working in inappropriate neck position (eg continuous computer use) and inactivity.
How one can avoid neck hernia? What are risky positions and movements?
The majority of neck pain is caused by the weakness of the neck muscles or the disruption of joints and bones. In most cases, shoulder pain may be confused with neck hernia. Strengthening of neck muscles plays an important role in the prevention of neck hernia. It is possible to strengthen the neck muscles with a few exercises. In addition, if there is no heart problem during sleep, it would be beneficial to use medium or soft pillows which are not too high. The neck should lie flush with the shoulders when lying on your back and excessive bending of the neck to forward and back should be avoided. Using the monitors at the head level can reduce pain when using a continuous computer.
What are the symptoms of Neck Hernia?
Only one of the following symptoms may be seen, or multiple symptoms may coexist.
Neck or shoulder pain (the pain may not make you sleep at night).
Pain from the neck to the head.
Unrest in one or two arms.
Severe pain, tingling in one or both arms.
Weakness in one or both arms or hands. For example, dropping objects such as cups being handled.
Numbness or felting in one or two arms.
There are signs of impaired urinary or defecation control.
Dizziness, imbalance while walking.
How is Neck Hernia Diagnosed?
Magnetic resonance imaging (MRI), which is one of the modern diagnostic methods, can easily diagnose the neck hernia and determine its degree. EMG (Nerve Measurement Test) is also required in some cases. Computed tomography (CT) is very good for demonstrating the structure of the neck spine bones. However, the most important criteria in the diagnosis of neck hernia are clinical examination and the physician’s observation experience.
What are the treatment methods of neck hernia?
The treatment of neck hernia depends on the degree of herniation, that is, the pressure of the elastic material we call the disc on the nerves leading to the arm and the spinal cord. If only a reasonable degree of the neck or arm pain is present, and there is no numbness, loss of strength, and limitation of movement, this means that the neck hernia is in its initial stage. In this case, analgesics, non-steroidal anti-inflammatory drugs, and muscle relaxants may be given to the patient. It is recommended to avoid bed resting and movements that will force the neck. Recommendations to the patient are:
The patient should not lift weights exceeding five or six pounds
Should use a short-term neck collar
If there is no heart disease, should use a low and soft pillow in bed
Should do exercises daily to strengthen neck muscles
The patient should always keep his neck warm and do not stand in front of open windows or ventilation
Patients with neck and arm pain should and must avoid stress. Stress can increase the pain as well as the progression of the neck hernia.
Should not stand improperly at computer or television for long periods of time.
If Neck Hernia Advances
If the patient’s complaints persist despite the above recommendations, rest and muscle relaxants, physical therapy may be administered. Physical therapy must be supervised by an expert. There may be an increase in pain during the first few days of physical therapy, but the patient should continue to the treatment for the duration recommended by the physical therapist.
Conditions that Need Surgery
In spite of physical therapy, if the patient’s pain persists or if there is loss of strength, sensory loss and numbness, surgical intervention is the solution.
How surgical treatment is done?
Today, the most commonly used surgical method is microscopic disc surgery performed from the anterior aspect of the neck. Depending on the patient’s situation and the condition of the disease, special cages to replace the discharged hernia can be used, sometimes plate screws or prostheses can be used. Surgery can also be performed from the back of the neck depending on the location of the hernia. The diagnosis of the disease, the degree of the disease, how it affects the daily life of the patient and their needs, the physician’s approach and experience are important in the choice of treatment.
Expectations after surgery
Most patients benefit quickly from neck hernia surgery. Neck and arm pain are expected to resolve after surgery. There may be a slight pain in the operation area and it is controlled by painkillers.