A common source of back or neck pain is a herniated disk. Sometimes called a “slipped” or “ruptured” disc, this condition most often occurs in the lower back, as well as the smaller discs in the neck.
Although a herniated disk can sometimes be very painful, most people feel much better with just a few months of simple, nonsurgical treatments.
As with pain in the lower back, neck pain is also common. When pressure is placed on a nerve in the neck, it causes pain in the muscles between your neck and shoulder (trapezius muscles). The pain may shoot down the arm. Other symptoms include:
- Weakness in one arm
- Tingling (a "pins-and-needles" sensation) or numbness in one arm
- Burning pain in the shoulders, neck, or arm
Nonsurgical treatment is effective in treating the symptoms of herniated discs in the majority of patients. Most neck pain will resolve gradually with simple measures.
- Rest and over-the-counter pain relievers may be all that is needed.
- Muscle relaxers, Compound Topical Creams, analgesics, and anti-inflammatory medications are also helpful.
- Cold compresses or ice can also be applied several times a day for no more than 20 minutes at a time.
- After any spasms settle, gentle heat applications may be used.
A physiotherapist should be involved in your care and progression. Any physical activity should be slow and controlled, especially bending forward and lifting. This can help ensure that symptoms do not return, as can taking short walks and avoiding sitting for long periods. For the neck, exercises and traction may be helpful. To help avoid future episodes of pain, it is essential that you learn how to properly stand, sit, and lift.
Injections can be very helpful for this condition and they may include:
- Cortisone (Corticosteroid)
- Platelet Rich Plasma (PRP)
- Trigger Point Injections
Only a small percentage of patients with disc herniations require surgery. Spine surgery is typically recommended only after a period of nonsurgical treatment has not relieved painful symptoms.
- Lumbar microdiscectomy: Microdiscectomy involves removing the herniated part of the disc and any fragments that are putting pressure on the spinal nerve.
- Cervical discectomy and fusion. Cervical discectomy is a procedure for the herniated disc in the neck. To relieve pressure, the entire herniated disc is removed. Bone is placed in the disc space and a metal plate may be used to help support the spine.