Neck Pain – Bulging Disc of the Cervical Spine
A slipped disc in the cervical spine can cause severe pain into the neck and down along the arm. To understand the injury we need to first to understand what a spinal Disc actually is. A disc can be pictured as a Jam donut with a gel interior surface surrounded by a harder outer surface that sits between the vertebrae blocks of the cervical spine. Poor forward bending of the neck can force the internal gel in the spinal disc to push outwards against its surrounding fibrous surface; this is akin to squeezing a jam donut on one side thus forcing the jam to squeeze out to the opposite end of the donut. A similar dysfunction arises in the discs of the lower spine. If the protruding disc is excessively pushed outwards to one side it can press against the nerve roots causing shooting pain locally into the neck and also down along the arm.
How does the Injury Occur?
Sudden forceful forward movements such as Whiplash during a car crash or trauma to the neck on the field of sport. In this situation the symptoms of severe neck pain may not appear until hours or even days after the accident occurred.
Alternatively the disc prolapsed can occur more gradually when degenerative changes slowly begin to occur in the cervical spine due to periods of prolonged forward neck bending e.g. Office Workers & Mechanics
Signs & Symptoms
Sharp neck Pain when coughing or sneezing
A sharp aching pain in the neck & shoulder blades and possibly radiating down both arms
Neck pain is aggravated by sudden neck movement
Pins & Needles and possible weakness into the arm and hand
Stiffness into the neck and reduced neck movement
Patients are commonly awoken at night with pain
Treatment & Management
Initial treatment for an acute stage disc prolapsed is bed rest with the head and neck held in a neutral position on a comfortable surface. All aggravating neck straining activities should be avoided. The use of ice treatment of the inflamed muscle tissue behind the neck can help. When Patients attend my clinic with the symptoms of Cervical Disc bulging I regularly use gentle graded traction techniques to relieve pressure on the compressed disc. As improvement occurs further advanced mobilisation techniques coupled with light muscle stretching are added to the treatment process in order to improve neck motion. Finally the neck muscles must be strengthened in order to prevent injury re-occurrence.
Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.
Contact Number: 0504 26672
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