Slipped Disc in the Neck in Depth AKA: Cervical Disc Prolapse

Slipped Disc in the Neck Injury Explained

A slipped disc in the neck can be a cause of neck and arm pain. Medically, a slipped disc in the neck is known as a ‘Cervical Disc Prolapse’. This condition tends to be most prevalent in the 30-50 age group and is rare outside this group. A slipped disc is less common in the neck than in the lower back.

Between each vertebra (the bones which make up the spinal column) there are inter vertebral discs. There are 7 vertebra in the neck with discs in between, that are called C1 to C7 in descending order. The most common levels for a slipped disc in the neck are between C5 – C6 and C6 – C7, due to the greater movement at these levels and exposure to injury.

The discs consist of a tough outer fibrous layer that surrounds a gel-like nucleus. Repeated stress and overuse during neck movements, for example in machine operators and keyboard users, can lead to degeneration of the outer layer of the disc. If this degeneration is sufficient the nucleus material is liable to ‘prolapse’ out of the disc.

If the direction of the disc prolapse is back and to the side, it may press on what is called a nerve root, causing pain down one of the arms. This can produce pain in the shoulder and down the arm. Depending on the level, a sensation of pins and needles in the hands is also sometimes present with a slipped disc in the neck. Neck movements may produce pain down the arm in what is called a dermatomal pattern. This is because the nerve roots at each level of the cervical spine supply the skin sensation to known areas of the arm.

Slipped Disc in the Neck Signs & Symptoms

Patients with a slipped disc in the neck will experience severe pain, which can be present in the neck, shoulder and down the arm. This pain can be exacerbated by neck movements and even by coughing or sneezing. The pain can be so severe it may stop the person from sleeping. Muscle spasm in the neck is common. Symptoms of pins and needles, numbness or burning may also be felt radiating down the arm.

Classic patterns of pain are often observed with a slipped disc in the neck. Sometimes there is no neck pain and the symptoms are felt in the arm, or the opposite may be true, with neck pain only. In addition to pain, there may be muscle weakness in the upper limb.

Once the patient’s history of severe neck pain with associated arm pain has been established, diagnosis is relatively straightforward, although in some cases further tests may be necessary. An MRI scan may be helpful in the diagnosis of a slipped disc in the neck, although the findings of these scans are not 100% reliable.

Slipped Disc in the Neck Treatment

When the symptoms appear, the patient should rest and take pain-relieving medication. Anti inflammatory medication prescribed by a doctor is usually very effective. A Neck Collar (a soft collar which supports the neck and prevents movement) can be very helpful in the early stages of this injury. It removes stresses on the neck and restricts any painful movements. Similarly a Neck Pain Pillow can be helpful to get the correct neck alignment and avoid neck pain when lying in bed.

Physiotherapy treatment can be very effective for a slipped disc in the neck. Heat Packs and gentle massage are used for neck pain relief and to relieve muscle spasm. Manual therapy techniques gently mobilise the vertebra to help restore normal neck movement and address imbalances where some vertebra may be moving more than others. Restoring balance by massage and mobilisations will help reduce the likelihood of injury in the future.

‘Traction’ is a very effective treatment for neck and arm pain due slipped disc in the neck. It refers to an upward pulling force, which lengthens the neck and relieves pressure on the discs in the neck. Although evidence on Traction is inconclusive, the mechanism works by relieving pressure on the discs as it helps create a small suction or vacuum, causing the prolapsed disc material to shrink back into the body of the disc. This removes pressure on the nerve roots and alleviates the neck and arm symptoms in over 70% of patients.

Traction can be applied manually by a physiotherapist, or there are traction machines that can be used in a physiotherapy clinic.

Once the pain resolves, a gradual return to normal activity should be encouraged, as should exercises to restore the normal range of neck movement. If the symptoms do not resolve with conservative treatment it may be necessary to see an Orthopaedic Consultant . Surgery should be considered in cases where there is intractable pain that is affecting quality of life.