How to Treat Cervical Disc Disease : Controlling Neck Pain at Home
Cervical is caused by an abnormality in one or more discs, the cushions that lie between the neck bones (vertebrae). When a disc is damaged, usually due to wear or tear (degeneration) or to disc herniation, it can lead to neck pain from inflammation or muscle spasms.
Cervical disc disease may be the most common cause of neck pain. It's caused by an abnormality in one or more discs, the cushions that lie between the neck bones (vertebrae). When a disc is damaged, usually due to wear or tear (degeneration) or to disc herniation, it can lead to neck pain from inflammation or muscle spasms. In severe cases, pain and numbness can occur in the arms from nerve irritation or damage from pinching a nerve.
While pain relievers, physical therapy, Exercises, neck traction, and as a last resort, surgery, can help ease neck pain from cervical disc disease, there are also home remedies you can use to help relieve pain and speed the healing process.
We have also touched the topic of Herniated Cervical Disc Problem
Cervical Treatment
We have also touched the topic of Herniated Cervical Disc Problem
Cervical Treatment
Neck Pain Tip 1: Take It Easy
If you're like most people, you probably live a busy, hectic life. But if you're living with cervical disc disease and have increased neck pain, it's important to temporarily ease back on intense activities. While you are resting, find a comfortable position -- one that causes you the least amount of neck pain. You can place a rolled up towel or a pillow under your neck to help keep your neck in a neutral position. Resting doesn't mean crawling into bed and remaining perfectly still, however. Staying immobile for more than a day or two actually can be harmful because it can decondition the muscles that support your neck and actually increase neck pain in the long run. While your neck is healing, adjust your activity level to what you can comfortably handle. As you improve, gradually increase your activity level back to normal.
Neck Pain Tip 2: Apply Cold/Heat
People often face the hot/cold conundrum: Which one should you use? Generally, the recommendation is to use ice for the first 24 to 48 hours after an injury to reduce swelling, followed by heat to loosen muscles and improve stiffness. But with cervical disc disease, neither heat nor cold is going to penetrate deeply enough to actually relieve the inflammation, so use whichever feels best. Regardless of whether you choose cold or heat, keep it on for only about 20 minutes at a time and then leave it off for at least 40 minutes. Wrap the ice or heat source in a towel -- never put it directly against your skin or you could wind up with a nasty burn.
Neck Pain Tip 3: Stretch Exercises
Once you are feeling well enough and your doctor gives permission, practice stretching exercises to both relieve neck pain and improve your flexibility.
It's best to perform these exercises after warming up muscles with a warm shower, bath, or towel.
Here are a few simple stretch Exercises for cervical disc disease that you can do at home:
1. Slowly turn your head to the left. With your left hand, apply very light tension on your chin so that your head turns slightly more. Hold for 20 seconds and return your head slowly to center. Repeat on the right side.
2. Tilt your head to the left and try to touch your left ear to your shoulder. With your left hand, apply light pressure on your temple. Hold for 20 seconds and repeat on the right side.
3. Bend your head forward and try to touch your chin to your chest. Relax the shoulders as you do this. Hold for 20 seconds and repeat.
4. Lie on your back with your knees bent and a pillow under your head and neck for support. Nod your head forward gently, as though you were saying "yes." Hold the position for 10 seconds and then relax. Repeat 10 times.
Neck/Shoulder Exercises
1. Bend your neck so your right ear approaches your right shoulder, then switch sides.
2. Gently rotate your head as far as comfortable to the left, then the right.
3. Circle your shoulders forward, then back.
4. Pull your shoulders down and back.
5. Gradually raise your shoulders toward your ears and hold for a few seconds before relaxing.
Neck/Shoulder Exercises
1. Bend your neck so your right ear approaches your right shoulder, then switch sides.
2. Gently rotate your head as far as comfortable to the left, then the right.
3. Circle your shoulders forward, then back.
4. Pull your shoulders down and back.
5. Gradually raise your shoulders toward your ears and hold for a few seconds before relaxing.
If you feel significant discomfort with any of these stretches, stop immediately.
Move It
Research is showing that exercise is an effective way to treat neck pain. According to a study in the Journal of the American Medical Association, women with chronic neck pain who performed strength and endurance exercises using resistance bands and light weights significantly reduced their neck pain and disability. It's also important to keep active in general. Thirty minutes of aerobic exercise (walking, biking, swimming) every day can keep your back muscles strong. And improved blood flow from exercise can nourish your spine help to keep it healthy. Talk to your doctor, physical therapist, or a personal trainer with expertise in working with people with neck pain to determine the right exercises for you.
Get Out of Your Slump
Bad posture is a major contributor to neck pain. Think about your posture every time you are sitting, standing, or lifting. Always try to keep your head and neck straight and make sure your back is supported. When you sit at your desk, for example, your computer should be at eye level and your chair should be right up against your back (in other words, don't press your nose against the computer screen). Your mouse should be positioned low enough so that you don't have to continually reach for it. When you go to pick something up, don't lean forward. Instead, bend from your knees and keep your back straight, which will also help protect against low back pain.
Get Out of Your Slump
Bad posture is a major contributor to neck pain. Think about your posture every time you are sitting, standing, or lifting. Always try to keep your head and neck straight and make sure your back is supported. When you sit at your desk, for example, your computer should be at eye level and your chair should be right up against your back (in other words, don't press your nose against the computer screen). Your mouse should be positioned low enough so that you don't have to continually reach for it. When you go to pick something up, don't lean forward. Instead, bend from your knees and keep your back straight, which will also help protect against low back pain.
Exercises: Neck Stretches
Herniated cervical disc
Overview
A herniated disc occurs when the gel-like center of a spinal disc ruptures through a weak area in the tough outer wall, similar to the filling being squeezed out of a jelly doughnut. Neck or arm pain, numbness or tingling may result when the disc material touches or compresses a spinal nerve. Treatment with rest, pain medication, spinal injections, and physical therapy is the first step to recovery. Most people improve in 6 weeks and return to normal activity. If symptoms continue, surgery may be recommended.
Anatomy of the discs
Your spine is made of 24 moveable bones called vertebrae. The cervical (neck) section of the spine supports the weight of your head (approximately 10 pounds) and allows you to bend your head forward and backward, from side to side, and rotate 180 degrees. There are 7 cervical vertebrae numbered C1 to C7. The vertebrae are separated by discs, which act as shock absorbers preventing the vertebrae from rubbing together. The outer ring of the disc is called the annulus. It has fibrous bands that attach between the bodies of each vertebra. Each disc has a gel-filled center called the nucleus. At each disc level, a pair of spinal nerves exit from the spinal cord and branch out to your body. Your spinal cord and the spinal nerves act as a "telephone," allowing messages, or impulses, to travel back and forth between your brain and body to relay sensation and control movement (see Anatomy of the Spine).
What is a herniated cervical disc?
A herniated disc occurs when the gel-like center of your disc ruptures out through a tear in the tough disc wall (annulus) (Fig. 1). The gel material is irritating to your spinal nerves, causing something like a chemical irritation. The pain is a result of spinal nerve inflammation and swelling caused by the pressure of the herniated disc. Over time, the herniation tends to shrink and you may experience partial or complete pain relief. In most cases, if neck and/or arm pain is going to resolve it will do so in about 6 weeks.
What treatments are available?
Conservative nonsurgical treatment is the first step to recovery and may include medication, rest, massage, physical therapy, home exercises, hydrotherapy, chiropractic care, and pain management. Over 95% of people with arm pain due to a herniated disc improve in about six weeks and return to normal activity. If you don't respond to conservative treatment or your symptoms get worse, your doctor may recommend surgery.
Nonsurgical treatments
Self care: In most cases, the pain from a herniated disc will get better within a couple days and completely resolve in 4 to 6 weeks. Restricting your activity, ice/heat therapy, and taking over the counter medications will help your recovery
Medication: Your doctor may prescribe pain relievers, nonsteroidal anti-inflammatory medications (NSAIDs), and steroids. Sometimes muscle relaxers are prescribed for muscle spasms.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen (Alleve, Naprosyn), ibuprofen (Motrin, Nuprin, Advil), and celecoxib (Celebrex), are examples of nonsteroidal anti-inflammatory drugs used to reduce inflammation and relieve pain.
Analgesics, such as acetaminophen (Tylenol), can relieve pain but don't have the anti-inflammatory effects of NSAIDs. Long-term use of analgesics and NSAIDs may cause stomach ulcers as well as kidney and liver problems.
Muscle relaxants, such as methocarbamol (Robaxin), carisoprodol (Soma) and cyclobenzaprine (Flexeril), may be prescribed to control muscle spasms.
Steroids may be prescribed to reduce the swelling and inflammation of the nerves. They are taken orally (as a Medrol dose pack) in a tapering dosage over a five-day period. It has the advantage of providing almost immediate pain relief within a 24-hour period.
Steroid injections: The procedure is done under x-ray fluoroscopy and involves an injection of steroids and a numbing agent into the epidural space of the spine. The medicine is delivered next to the painful area to reduce the swelling and inflammation of the nerves. About 50% of patients will notice relief after an epidural injection, although the results tend to be temporary. Repeat injections may be given to achieve the full effect. Duration of pain relief varies, lasting for weeks or years. Injections are done in conjunction with a physical therapy and/or home exercise program.
Physical therapy: The goal of physical therapy is to help you return to full activity as soon as possible and prevent re-injury. Physical therapists can instruct you on proper posture, lifting, and walking techniques, and they’ll work with you to strengthen and stretch your neck, shoulder, and arm muscles. They’ll also encourage you to stretch and increase the flexibility of your spine and arms. Exercise and strengthening exercises are key elements to your treatment and should become part of your life-long fitness.
Holistic therapies: Some patients find acupuncture, acupressure, yoga, nutrition / diet changes, meditation and biofeedback helpful in managing pain as well as improving overall health.
Surgical treatments
When symptoms progress or do not resolve with conservative treatment, surgery may be an option. Factors such as patient age, how long the problem has persisted, other medical problems, previous neck operations, and expected outcome are considered in planning surgery.
The most common approach to cervical disc surgery is anterior (front of the neck). A posterior (from the back) approach may be performed if you require decompression for other conditions such as stenosis.
Anterior cervical discectomy & fusion (ACDF): The surgeon makes a small incision in the front of your neck. The neck muscles, vessels and nerves are moved aside to expose the bony vertebra and disc. The portion of the ruptured disc that is pressing on the nerve is removed. After removing the herniated material, the disc space may be filled with a bone graft or cage to create a fusion
(Fig. 3). Fusion is the process of joining two or more bones. Over time the graft will fuse to the vertebra above and below to make one solid piece of bone. Metal plates and screws may be used to provide stability during fusion and possibly a better fusion rate.
Figure 3. In spinal fusion, a metal plate and screws are used to hold the bone graft between the vertebrae. In 3 to 6 months new bone fills the space making one solid piece of bone.
Artificial disc replacement: During anterior discectomy a moveable device that mimics a disc’s natural motion is inserted into the damaged joint space. An artificial disc preserves motion, whereas fusion eliminates motion. Made of metal and plastic, they are similar to hip and knee joint implants. Outcomes for artificial disc compared to ACDF (the gold standard) are similar, but cervical disc replacement preserves motion and perhaps avoids adjacent level disease, but this still remains a hypothesis and is not yet proven.
Minimally invasive microendoscopic discectomy: The surgeon makes a tiny incision in the back of the neck. Small tubes called dilators are used with increasing diameter to enlarge a tunnel to the vertebra. A portion of the bone is removed to expose the nerve root and disc. The surgeon uses either an endoscope or a microscope to remove the ruptured disc. This technique causes less muscle injury than a traditional discectomy.
Posterior cervical discectomy: The surgeon makes a 1-2 inch incision in the back of your neck. To reach the damaged disc, the spinal muscles are dissected and moved aside to expose the bony vertebra. A section of the bony arch is removed to reach the nerve root and disc space. The portion of the ruptured disc that is compressing the spinal nerve is carefully removed. The spaces through which the nerve roots exit the spine are usually enlarged to prevent future pinching.
Clinical trials
Clinical trials are research studies in which new treatments—drugs, diagnostics, procedures, and other therapies—are tested in people to see if they are safe and effective. Research is always being conducted to improve the standard of medical care. Information about current clinical trials, including eligibility, protocol, and locations, are found on the Web. Studies can be sponsored by the National Institutes of Health (see clinicaltrials.gov) as well as private industry and pharmaceutical companies (see www.centerwatch.com).
Recovery & prevention
Back pain affects 8 of 10 people at some time in their lives, and usually resolves within 6 weeks. A positive mental attitude, regular activity, and a prompt return to work are all very important elements of recovery. If your regular job cannot be done initially, it is in the patient's best interest to return to some kind of modified (light or restricted) duty. Your physician can give prescriptions for such activity for limited periods of time.
The key to avoiding recurrence is prevention:
Proper lifting techniques (see Self Care for Neck & Back Pain)
Good posture during sitting, standing, moving, and sleeping
Appropriate exercise program to strengthen weak abdominal muscles and prevent re-injury
An ergonomic work area
Healthy weight and lean body mass
A positive attitude and stress management
No smoking
Mayfield Brain & Spine
Exercises: Neck Stretches
1.
Upper Trapezius Stretch: Sit up tall with good posture keeping shoulders down. Grasp the bottom of the seat with one hand. Slightly turn your ear to your shoulder until a comfortable stretch is felt on the opposite side of the neck. Hold that position for 20 seconds. Repeat to each side 3 times. Perform this exercise 2 times per day.
2.Levator Scapular Stretch: Sit up tall with good posture keeping shoulders down. Grasp the bottom of the seat with one hand. Slightly turn your chin toward your armpit until a comfortable stretch is felt on the opposite side of the neck. Hold that position for 20 seconds. Repeat to each side 3 times. Perform this exercise 2 times per day.
3.Neck Rotation: Rotate head gently and slowly from side to side. Do not turn head completely to either side, keep motion small. Keep chin level with ground without letting chin drop to chest. Repeat 10 times. Perform this exercise 2 times per day.
4.
Doorway Stretch: Stand in a doorway with hands and arms out to the side as shown in picture. Keep forearms flat on door frame. Take one step forward with one leg to feel a comfortable stretch in chest region. Hold that position for 10-20 seconds. Repeat 3 times. Perform this exercise 2 times per day.
Exercises: Neck Strengthening
1.Shoulder Scapular Squeeze: Squeeze your shoulder blades together as shown in the picture. Hold 5 seconds. Repeat 10 times. Only squeeze hard enough to encourage good posture, not to create pain or discomfort. Perform this exercise 2 times per day
2.
Wall Push Up: Start with feet approximately shoulder width apart. Place hands against wall slightly below shoulder level and elbows straight as shown in the picture. Bend elbows while keeping head in a neutral position. Repeat 10 times with 1-2 sets. Perform this exercise 2 times per day.
3.
Theraband™ Rows: Place Theraband around a doorknob, or tie a knot in the Theraband and close it in the door. Anchor the band at chest level. Stand tall with each end of Theraband in your hands, knees slightly bent, abdominal muscles tight. Maintaining tight trunk muscles, pull arms back while squeezing shoulder blades together. Focus on squeezing the shoulder blades without shrugging the shoulders up towards the ears. Return to starting position. Do not lean back. Repeat 20 times. Perform 2 times per day.
4.
Prone Rows: Lie on your stomach with your arms dangling off the side of the bed (try angling your body so your head is facing the corner of your bed). Use a pillow under your stomach for comfort. Begin by pulling arms back while bending elbows and squeezing shoulders blades together then slowly return to starting position. Do not lift head up while pulling arms back. Repeat 20 times. Perform 2 times per day.
Herniated cervical disc
A herniated disc occurs when the gel-like center of a spinal disc ruptures through a weak area in the tough outer wall, similar to the filling being squeezed out of a jelly doughnut. Neck or arm pain, numbness or tingling may result when the disc material touches or compresses a spinal nerve. Treatment with rest, pain medication, spinal injections, and physical therapy is the first step to recovery. Most people improve in 6 weeks and return to normal activity. If symptoms continue, surgery may be recommended.
Anatomy of the discs
Your spine is made of 24 moveable bones called vertebrae. The cervical (neck) section of the spine supports the weight of your head (approximately 10 pounds) and allows you to bend your head forward and backward, from side to side, and rotate 180 degrees. There are 7 cervical vertebrae numbered C1 to C7. The vertebrae are separated by discs, which act as shock absorbers preventing the vertebrae from rubbing together. The outer ring of the disc is called the annulus. It has fibrous bands that attach between the bodies of each vertebra. Each disc has a gel-filled center called the nucleus. At each disc level, a pair of spinal nerves exit from the spinal cord and branch out to your body. Your spinal cord and the spinal nerves act as a "telephone," allowing messages, or impulses, to travel back and forth between your brain and body to relay sensation and control movement (see Anatomy of the Spine).
What is a herniated cervical disc?
A herniated disc occurs when the gel-like center of your disc ruptures out through a tear in the tough disc wall (annulus) (Fig. 1). The gel material is irritating to your spinal nerves, causing something like a chemical irritation. The pain is a result of spinal nerve inflammation and swelling caused by the pressure of the herniated disc. Over time, the herniation tends to shrink and you may experience partial or complete pain relief. In most cases, if neck and/or arm pain is going to resolve it will do so in about 6 weeks.
Different terms may be used to describe a herniated disc. A bulging disc (protrusion) occurs when the disc annulus remains intact, but forms an outpouching that can press against the nerves. A true herniated disc (also called a ruptured or slipped disc) occurs when the disc annulus cracks or ruptures, allowing the gel-filled center to squeeze out. Sometimes the herniation is so severe that a free fragment occurs, meaning a piece has broken completely free from the disc and is in the spinal canal.
Conservative nonsurgical treatment is the first step to recovery and may include medication, rest, massage, physical therapy, home exercises, hydrotherapy, chiropractic care, and pain management. Over 95% of people with arm pain due to a herniated disc improve in about six weeks and return to normal activity. If you don't respond to conservative treatment or your symptoms get worse, your doctor may recommend surgery.
Nonsurgical treatments
Self care: In most cases, the pain from a herniated disc will get better within a couple days and completely resolve in 4 to 6 weeks. Restricting your activity, ice/heat therapy, and taking over the counter medications will help your recovery
Medication: Your doctor may prescribe pain relievers, nonsteroidal anti-inflammatory medications (NSAIDs), and steroids. Sometimes muscle relaxers are prescribed for muscle spasms.
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen (Alleve, Naprosyn), ibuprofen (Motrin, Nuprin, Advil), and celecoxib (Celebrex), are examples of nonsteroidal anti-inflammatory drugs used to reduce inflammation and relieve pain.
Analgesics, such as acetaminophen (Tylenol), can relieve pain but don't have the anti-inflammatory effects of NSAIDs. Long-term use of analgesics and NSAIDs may cause stomach ulcers as well as kidney and liver problems.
Muscle relaxants, such as methocarbamol (Robaxin), carisoprodol (Soma) and cyclobenzaprine (Flexeril), may be prescribed to control muscle spasms.
Steroids may be prescribed to reduce the swelling and inflammation of the nerves. They are taken orally (as a Medrol dose pack) in a tapering dosage over a five-day period. It has the advantage of providing almost immediate pain relief within a 24-hour period.
Steroid injections: The procedure is done under x-ray fluoroscopy and involves an injection of steroids and a numbing agent into the epidural space of the spine. The medicine is delivered next to the painful area to reduce the swelling and inflammation of the nerves. About 50% of patients will notice relief after an epidural injection, although the results tend to be temporary. Repeat injections may be given to achieve the full effect. Duration of pain relief varies, lasting for weeks or years. Injections are done in conjunction with a physical therapy and/or home exercise program.
Physical therapy: The goal of physical therapy is to help you return to full activity as soon as possible and prevent re-injury. Physical therapists can instruct you on proper posture, lifting, and walking techniques, and they’ll work with you to strengthen and stretch your neck, shoulder, and arm muscles. They’ll also encourage you to stretch and increase the flexibility of your spine and arms. Exercise and strengthening exercises are key elements to your treatment and should become part of your life-long fitness.
Holistic therapies: Some patients find acupuncture, acupressure, yoga, nutrition / diet changes, meditation and biofeedback helpful in managing pain as well as improving overall health.
Surgical treatments
When symptoms progress or do not resolve with conservative treatment, surgery may be an option. Factors such as patient age, how long the problem has persisted, other medical problems, previous neck operations, and expected outcome are considered in planning surgery.
The most common approach to cervical disc surgery is anterior (front of the neck). A posterior (from the back) approach may be performed if you require decompression for other conditions such as stenosis.
Anterior cervical discectomy & fusion (ACDF): The surgeon makes a small incision in the front of your neck. The neck muscles, vessels and nerves are moved aside to expose the bony vertebra and disc. The portion of the ruptured disc that is pressing on the nerve is removed. After removing the herniated material, the disc space may be filled with a bone graft or cage to create a fusion
Figure 3. In spinal fusion, a metal plate and screws are used to hold the bone graft between the vertebrae. In 3 to 6 months new bone fills the space making one solid piece of bone.
Artificial disc replacement: During anterior discectomy a moveable device that mimics a disc’s natural motion is inserted into the damaged joint space. An artificial disc preserves motion, whereas fusion eliminates motion. Made of metal and plastic, they are similar to hip and knee joint implants. Outcomes for artificial disc compared to ACDF (the gold standard) are similar, but cervical disc replacement preserves motion and perhaps avoids adjacent level disease, but this still remains a hypothesis and is not yet proven.
Minimally invasive microendoscopic discectomy: The surgeon makes a tiny incision in the back of the neck. Small tubes called dilators are used with increasing diameter to enlarge a tunnel to the vertebra. A portion of the bone is removed to expose the nerve root and disc. The surgeon uses either an endoscope or a microscope to remove the ruptured disc. This technique causes less muscle injury than a traditional discectomy.
Posterior cervical discectomy: The surgeon makes a 1-2 inch incision in the back of your neck. To reach the damaged disc, the spinal muscles are dissected and moved aside to expose the bony vertebra. A section of the bony arch is removed to reach the nerve root and disc space. The portion of the ruptured disc that is compressing the spinal nerve is carefully removed. The spaces through which the nerve roots exit the spine are usually enlarged to prevent future pinching.
Clinical trials
Clinical trials are research studies in which new treatments—drugs, diagnostics, procedures, and other therapies—are tested in people to see if they are safe and effective. Research is always being conducted to improve the standard of medical care. Information about current clinical trials, including eligibility, protocol, and locations, are found on the Web. Studies can be sponsored by the National Institutes of Health (see clinicaltrials.gov) as well as private industry and pharmaceutical companies (see www.centerwatch.com).
Recovery & prevention
Back pain affects 8 of 10 people at some time in their lives, and usually resolves within 6 weeks. A positive mental attitude, regular activity, and a prompt return to work are all very important elements of recovery. If your regular job cannot be done initially, it is in the patient's best interest to return to some kind of modified (light or restricted) duty. Your physician can give prescriptions for such activity for limited periods of time.
The key to avoiding recurrence is prevention:
Proper lifting techniques (see Self Care for Neck & Back Pain)
Good posture during sitting, standing, moving, and sleeping
Appropriate exercise program to strengthen weak abdominal muscles and prevent re-injury
An ergonomic work area
Healthy weight and lean body mass
A positive attitude and stress management
No smoking
Mayfield Brain & Spine
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