Pain, weakness, numbness and limitation of movement radiating from the neck to the arm are among the symptoms of neck hernia. Prof. Dr. Engin Çakar gave information about cervical hernia and non-surgical treatment methods.
Consisting of seven vertebrae, the neck is the most mobile part of the spine. There are jelly-like cushions called discs between the vertebrae. The discs ensure that the load on the body is transmitted to the lower body parts in a balanced way. Nerves to the spinal cord and arms pass through the spine in the neck. Hernia occurs when the gel-like structure in the inner layer of the disc overflows, creating edema and pressure in the surrounding tissues.
Large hernias cause nerve compression
As a result of hernia, there may be a sharp and stabbing pain radiating from the neck to the arm due to the compression of the nerves leading to the arms. Neck and shoulder pain may also be accompanied by pain in the back, radiating towards the inner side of the shoulder blade. The patient cannot turn his / her head to the opposite side of the aching side and cannot bend it to the same side. Large hernias can cause compression in the nerves passing through the spinal cord. In addition to neck and arm pain, numbness and weakness may occur in the arm and hand. Sensory changes such as numbness, tingling, electrification and loss of sensation can be seen in the arm and fingers depending on the nerve root that is compressed in cervical hernias.
Neck hernias are most common between the C5-6 and C6-7 vertebrae
If the C-5 nerve root is compressed, the pain spreads from the neck to the top of the shoulder, there may be a decrease in the sensation of the side of the shoulder and weakness in the shoulder opening sideways, and may cause left shoulder and right shoulder pain. If the C-6 nerve root is compressed, the pain spreads from the neck to the back region and downwards to the thumb and index finger, there may be a decrease in the sensation of the same fingers and weakness in lifting the wrist upward. If the C-7 nerve root is compressed, the pain spreads from the neck to the middle finger, there may be a decrease in the sensation of the same finger and weakness in the extension of the elbow to the outside. All these findings in the detection of cervical hernia are revealed as a result of the examination of the physical therapist. MRI is the most useful test in diagnosis in patients with compatible clinical findings. An EMG test can be performed when necessary to detect if nerve damage is suspected.
There are many treatment options for cervical disc hernia.
Surgical options are preferred in advanced cases. However, the majority of neck hernias can be eliminated by non-surgical physical therapy methods. These can be listed as follows:
1. Medication: Various muscle relaxants and painkillers can be used in the treatment to relieve muscle spasm, reduce edema and pain.
2. Physical treatment methods: Hot-cold applications, electric currents, vacuum interference, ultrasound, laser, magnetic field are among the treatment methods applied.
3. Dry needle treatment: One of the most important reasons that increase pain in cervical disc hernia is muscle spasm. The spasm causes an increase in herniation and a painful spine by compressing the discs between the vertebrae. It causes coldness, numbness, chills and edema in the arms and legs by compressing the veins. Dry needle therapy is an important and effective treatment method used in pain due to muscle spasm.
4. Regenerative methods: Injection methods such as prolotherapy, PRP, proloPRP, neural therapy increase the blood flow of the applied area and allow the area to repair itself. These methods activate the body’s natural healing process. Injections are usually made at intervals of a few weeks, depending on the size of the hernia and the severity of the accompanying spasm.
5. Needle treatment from the spine (Spinal injections): Needle treatment from the spine is applied to reduce pain and heal hernia in cases such as waist and neck hernia, narrow spinal canal. It provides patients with non-surgical treatment in cervical hernia. By applying the drug mixture between the vertebrae, the shrinkage of the hernia can be achieved without surgery. After the intervention, 1-3 hours of rest may be required, there is no need to stay in the hospital. Depending on the disease, facet, caudal spinal, foraminal spinal, sacroiliac injection methods can be applied.