What are the symptons?
Sudden or gradual onset neck pain with stiffness moving down the arm, often to the fingers, with pins and needles and numbness. Movement of the neck may provoke symptoms.
Sometimes pressure on the spinal cord can lead to a loss of balance when walking, difficulty with fine tasks such as writing, doing up buttons, leg weakness, problems with bladder and bowels and sexual dysfunction.
What is the prognosis and are the treatment options?
Most patients will improve over 4-6 weeks as the disc herniation resorbs (‘shrivels up’). Conservative treatment is based around activity modification, regular simple analgesia particularly an anti-inflammatory painkiller, such as ibuprofen, taken maximally and continuously, if tolerated,over 1-2 weeks. Gentle stretching exercises led by a physiotherapist can be helpful, but manipulative treatments on the neck by an osteopath or chiropractor are potentially dangerous and should be avoided.
If symptoms are intrusive and not improving after a few weeks then referral to the clinic is appropriate. The correct imaging will be arranged to make the diagnosis.
Appropriate stretching exercises will be arranged through the clinic, if not already in place.
A cervical nerve root block is a relatively straightforward and excellent first treatment option often, with rapid relief of symptoms and may avoid surgery.
If symptoms remain intrusive beyond 4-6 weeks then surgery is a reliable option. This typically involves an operation through the front of the neck to remove the disc and either a traditional anterior cervical fusion or cervical disc replacement.