Severe Neck Pain From a Herniated Disc: What are Your Treatment Options?
Posted Nov 21 2008 2:01pm
You have neck pain that radiates into your right arm causing weakness at the same time. A Cervical MRI shows that there is a herniated disc at C4-C5 level. There are many treatments beside neck surgery available to you:
Ice Therapy For immediate pain relief, ice should be applied to the neck and upper back area. The ice pack should be placed over the area of disc herniation (in this case C4-5), not over the area of severe pain. It is important to apply the ice for 30 minutes to allow for penetration of the cold therapy into the area of the herniation. Wait one hour and then re apply the ice pack for another 30 minutes. Ice helps to decrease inflammation and gives you pain relief.
Muscle Spasm Therapy A T.E.N.S unit also works well, although the pain relief may be temporary- Tens works by blocking pain signals. You also use an analgesic gel called Biofreeze which works extremely well for muscle spasm and soreness in the neck.
Chiropractic treatment is very important for a disc herniation: A chiropractor can determine if there is a misalignment in the cervical spine and correct that with manual manipulation and gentle mobilization techniques. Numerous studies have shown that chiropractic manipulation is a safe and effective treatment for herniated disc. BenEliyahu 1,2 demonstrated the safety and effectiveness of including manipulation in the treatment of cervical radiculopathy caused by a herniated disc. He studied 27 patients (11 had a cervical radiculopathy). The patients were treated with manipulation, traction, therapeutic modalities, ice and home exercise. 22 of the 27 patients had a good outcome. 9 out of the 11 cervical patients were able to return to their normal occupations. Most importantly it was noticed that there were no side effects.
Cervical Traction is another therapy that can be used to treat herniated disc in the neck. A study that was completed by Zylbergold 3 that examined 3 types of traction in patients. Static, intermittent, and manual traction were compared to no traction. The study revealed that all patients had relief of symptoms but the intermittent traction group had significant results in terms of decreased pain and increased range of motion in the cervical spine. There are many traction units available on the market today. The gold standard for neck traction is the Pronex Pnuematic traction unit. This traction unit comes in 3 sizes, is very comfortable to use and gives traction in the anterior (front part) and posterior part (back part) of the disc. The Pronex has one section that stabilizes the occiput, while the other exerts counterforce against a patient's shoulders. The special design of the Pronex supports the natural curvature of the cervical spine during treatment. There is a single-hand pump inflation – which allows you to control the Pronex traction device easily while maintaining muscle relaxation during treatment. Another positive is that Pronex will not aggravate or put pressure on the on the temporomandibular joint (TMJ).
Cervical Support Neck Pillow A good cervical support neck pillow will also help patients who experience pain due to a herniated disc. The Cervical Traction neck pillow is a traction pillow that not only does traction in the neck but also gives good cervical support. This neck pillow allows its users to have a proper c-curve when sleeping- taking pressure off of the nerves and making sure your head and neck are properly aligned while sleeping.
Non Surgical Spinal Decompression There is a newer treatment called non surgical spinal decompression for the cervical spine that might be beneficial if you are a candidate. If you google "Drx9000C" you may be able to find a doctor near you. This treatment is safe and effective for patients who suffer from disc herniations. It is very important that you have an exam (orthopedic +neurological) to see if you are a candidate. You Dr will also look at your MRI's to see what level is affected. The treatment is called Non surgical spinal decompression and most often it is offered in a chiropractor’s office. Unfortunately the treatment is not covered by most insurance companies. Each session can run about $170-$225 dollars depending on the office and location in the United States. Most people go for about 20 sessions- but each case is different. Treatment is often following by ice therapy and electrical stimulation. *** note that this is available for disc herniations in the lower back + Neck.
Pain Medications and Pain Management may provide a temporary relief for severe neck pain but also introduce new side effects that must be monitored by your Doctor. I am not a big favor of pain management because you are just treating the symptoms, not the cause of the disc herniation. Yes, some people get relief, but it means you are putting a lot of meds into your body and for how long will you have pain management and what will be the side effects?
Surgery - Only in extreme cases should surgery be considered. Surgery may be an option if severe neurological deficits occur, persistent pain, bowel or bladder dysfunction occur or severe motor weakness.** Always seek conservative non surgical treatment options before thinking about surgery as an option for treatment.
BenEliyahu DJ. Magnetic resonance imaging and clinical follow-up: Study of 27 patients receiving chiropractic care for cervical and lumbar disc herniation. Journal of Manipulative and Physiological Therapeutics; 1996;19(9):597-606
BenEliyahu DJ. Chiropractic management and manipulative therapy for MRI documented cervical disk herniation Journal of Manipulative and Physiological Therapeutics 1994; 17(3):177-185
Zylbergold RS, Piper MC. Cervical spine disorders: A Comparison of three types of traction. Spine 1985; 10(10):867-871