Cervical Disc Prolapse
Cervical disc prolapse is the bulging or the breaking of the nucleus pulposus through the annulus of the disc. This typically results from sudden trauma such as whiplash injuries from a road traffic accident or repetitive injuries. Individuals who spend a lot of time in front of the computer with bad posture may also fall victim to this disorder as they constantly put load on the neck and cause excessive pressure on the discs. Cervical disc prolapse occurs most frequently at the C5/6 and C6/7 levels† of the cervical neck, the same levels that are shown to have the most movements with any arm movement.
Tingling Sensations and Numbness
Cervical disc prolapse commonly results in radiating symptoms due to the compression or ‘pinching’ of the nerve exiting the spine by the disc. Patients usually complain about radiating symptoms down the arm such as tingling sensations, pins and needles, as well as numbness. Occasionally, a loss of muscle power can also be present. In severe cases, the pathway that the spinal cord runs, also known as the spinal canal, may be narrowed if the disc bulges into the spinal canal. These would cause diffused radiating symptoms, instead of a having radiating symptoms in a certain pattern that is supplied by a specific nerve that is impinged.
“What should I look out for?”
- Gradual or sudden onset of pain in the neck
- Any numbness, tingling or pins and needles in the arm that goes down to the finger tips
- Catches of pain when moving your neck in a certain direction
- Experiencing severe pain in the morning (The disc typically rehydrates in the night, resulting in the worst pain in the morning)
- When specific directions of movement, such as bending your head forward, results in the most pain.
Radiating symptoms can also indicate a degenerative problem in the neck. Therefore, experiencing these symptoms may not absolutely indicate a slipped disc. The only way to confirm a cervical disc prolapse is by MRI imaging.
80% of Function Restored in 4-6 weeks
Patients with cervical disc prolapse require at least 4-6 weeks of rehabilitation for 80% of function to be restored. The initial phases of the injury will consist of mainly pain modulation and restoring as much range of movement as possible in the neck. At this stage, gentle joint mobilization and muscle releases will be done to facilitate normal movements. Electrotherapeutic modalities such as ultrasound and TENS may also be used when required.
The second phase of rehabilitation will include a motor control program that involves the retraining of the baby muscles in the neck that are responsible for stability. This is to ensure adequate muscle balance in the neck, preventing any excessive compression on the joints by the large muscle groups surrounding the neck.
† – C5/C6 refers the level between the 5th and 6th Cervical Vertebrae in the Neck.