A cervical disc bulge in the neck occurs when the outer walls of a disc in the cervical (upper) spine become weak and bulge outward between the vertebrae. There are various terms that may be used to describe a cervical disc bulge, such as a bulging disc or herniated disc. Generally, a cervical disc bulge isn’t necessarily a sign of a serious spine problem. However, a bulging disc can happen in both young adults and older people. Therefore, it’s often considered a normal part of the aging process, caused by wear and tear and degeneration of the intervertebral disc. It may also occur as a result of a sudden fall or trauma from repetitive stress injuries.
Additionally, if you have a cervical disc bulge, you may feel the pain that radiates down your arm and possibly into your hand. You may also feel pain on or near your shoulder blade, and neck pain when turning your head or bending your neck. Oftentimes, you may have muscle spasms (which indicates that the muscles tighten uncontrollably). In most severe cases, sometimes the herniation is so severe that a free fragment occurs, meaning a piece has broken completely free from the disc and is in the spinal canal.
You may first notice pain when you wake up, without any traumatic event that might have caused the injury. Some patients find relief by holding their arm in an elevated position behind their head because this position relieves pressure on the nerve.
Causes & Symptoms
The spine is made up of a variety of several interconnected bones. These bones are called vertebrae, which protect the soft tissues, the spinal cord, and the nerves that run through the spine. When the spin bends or rotates, the spinal discs change in size to support the movement and prevent friction in between the bones. It is possible for spinal discs to dislodge. This is one of the most common causes in the lower spine. However, it can also occur in the upper portion of the spine, and it can cause a bulge into the spinal canal. In more severe cases, it can lead to a cervical disc bulge.
Each disc contains a soft inner substance with a surrounding outer layer, which maintains the structure of the disc. A bulging disc occurs when damage to the outer layer causes the inner substance to leak out of the disc. The causes of bulging or herniated discs include sudden or long-term trauma.
Other causes linked to cervical disc bulge include strain or injuries in the neck area, poor posture, and inactivity for a long period of time.
Overall, spinal discs weaken over time and become more vulnerable to injury. This means that aging increases the risk of a bulging / herniated disc. This depends on what starts to degenerate first.
It may be a possibility for a bulging disc to happen without any present symptoms. In other cases, however, the disc presses on a nerve in the neck. These symptoms can cause:
- Pain when moving your neck.
- Pain in the shoulders and back.
- Numbness in the shoulders, arms, or fingers.
- A reduced range of motion.
The severity of the symptoms will depend on how much pressure there is on the nerve. These symptoms mentioned above often worsen during activity and improve when you rest.
Who gets Cervical Disc Bulge?
As mentioned, cervical disc bulges can affect both young adults and elders of all ages – this is due to the aging process and the wear and tear caused by disc degeneration. As the body ages, the vertebral discs lose part of their water content, which makes them less flexible and more prone to tear or rupture, even with a minimum effort or turn.
In addition, most studies have shown that men are at a higher risk for a cervical disc bulge rather than women. However, recently, there have been more cases of women experiencing bulging discs compared to men.
A sedentary lifestyle is another important factor since the loss of the muscle component weakens the complex structure of the vertebral column. The posture at work is also related to this; a patient who works stationary (such as sitting in the office for a long period of time) often sit with his / her back slightly arched forward and with the head bent, which loads the intervertebral discs even more. Another risk factor is exerting unusual forces on the column (such as exercising or sports not well-controlled, efforts at work or at home).
Other risk factors linked to cervical disc bulge include:
- Obesity – Excess body weight causes extra stress on the cervical discs.
- Smoking – Smoking lessens the oxygen supply to the disk, causing it to break down much more rapidly.
- Genetics – Some people inherit a predisposition to developing a bulging disc.
How Does it Affect You? How Serious is it?
In rare cases, a sign for a cervical disc bulge and its symptoms may gradually worsen rather than eventually stabilizing and resolving on its own. If a cervical nerve root remains pinched or inflamed, tingling, numbness, and / or weakness may progress in the arm.
Similarly, if the spinal cord is compressed or inflamed by a cervical disc bulge, problems with walking, coordination, and / or reduced bladder or bowel control may be present. These types of neurological deficits require immediate medical attention to prevent them from worsening or becoming permanent.
Generally, most disc bulges can be treated without surgery, which is preferable in cases where it is possible. However, it is relatively more likely for a cervical disc bulge to require surgery because the location of the bulge sometimes makes the condition more urgent.
For instance, in some cases, patients experience progressive muscle weakness or tingling, which could potentially lead to paralysis if left untreated. Your doctor will make the decision on what type of treatment to administer based on the severity of your symptoms and how you have responded to any previous treatment.
Recommended Treatment & Rehabilitation
During a diagnosis, to rule out a cervical disc bulge, your doctor will typically involve a 3-step process diagnosis, including the following below:
- Medical history – The patient’s medical history is reviewed, including any chronic conditions, past injuries, or history of back or neck pain. Information about the current symptoms is also gathered.
- Physical examination – Then neck may be palpated for any affected areas that indicate swelling, tenderness, or pain. The doctor also checks the neck’s range of motion, as well as for any signs of neurological deficits in the arms, such as issues with reflexes, numbness, and / or weakness.
- Imaging study – An imaging study can show whether a disc has started to flatten out or move beyond its normal location. A Magnetic Resonance Imaging (MRI) scan is the preferred method for viewing a cervical disc bulge due to its high-quality view of soft tissues. If an MRI is not an available option, a CT scan or CT myelogram may be used.
In some cases, enough information can be gathered during the patient history and physical examination to begin treatment, so an imaging study is not always requested right away. However, to diagnose a cervical disc bulge as the cause of pain usually requires comparing the medical history, physical exam, imaging study, and an X-ray-guided, contrast-enhanced diagnostic injection.
During a physiotherapy session, strengthening and stretching the neck may help it to become more resistant to pain. Some exercises may also help the head and neck to maintain better posture. Weakened neck muscles are more likely to lead to forwarding head posture and neck pain. When the head is instead held in neutral alignment with the ears directly above the shoulders, less stress is placed on the cervical spine and its discs. A physiotherapist can design a physiotherapy program to meet the patient’s specific needs. For example, some exercises or stretches may need to be modified to reduce pain or target certain muscles. In time, most patients are able to continue neck exercises and stretching methods at home to help maintain neck strength and flexibility over the long term.
The following exercises may improve your neck pain from a cervical disc bulge. The goal of these exercises is to push the disc back, away from the nerve root:
First, sit or stand against a wall with your arm by your side. Then, bend your elbows to 90 degrees as you bring your shoulders down and back and push the back of your arms toward the wall, squeezing your shoulder blades together. Repeat this exercise 3 times a day.
Begin by sitting up tall while relaxing your shoulders. Next, put your hand on your forehead, pressing your head into your hand without moving your head. Hold this position for 5-15 seconds before repeating this method 15 times a day.
Lie on your back on a table or bed with the bottom of your neck in line with the edge. Afterwards, slowly and gently lower your h ear backward and let it hang. Hold this position for 1 minute, then repeat 5-15 times a day.
Lie on your back with your head on the bed and hands by your side. Tuck your chin in toward your chest, making a double chin. Hold this position for 5-10 seconds, then repeat this exercise 15-20 times.
Head lift including a neck extension
Lie on your stomach on a table or bed with your arms by your side and head hanging off the structure. Next, slowly and gently raise your head up, extending your neck against the cavity. Finally, hold this position for 5-10 seconds before repeating 15-20 times a day.
Sit up tall and relax your shoulders. Next, gently turn your head to the side. Do not over-rotate your head behind you and avoid twisting your neck. Slowly turn your head to the other side, then hold each position for 30 seconds before repeating 3-5 times a day.
Pain from cervical disc bulge symptoms can usually be managed with non-surgical treatments. The following treatments include the following:
Non-steroidal anti-inflammatory drugs (NSAIDs) help to reduce inflammation in the body, since some of the worst pain caused by a cervical disc bulge comes from inflammation of nerve roots and other tissues. Over-the-counter NSAIDs (such as ibuprofen or naproxen) are commonly the first medications recommended.
If oral medications do not provide enough pain relief for a cervical disc bulge, therapeutic injections may be considered. Most injections for neck pain are performed using fluoroscopy and contrast dye to visualize the needle’s exact placement in the spine. Two common injections for a cervical disc bulge include cervical epidural steroid injection and selective nerve root injection.
Alternative & Homeopathic Treatment
Many alternative and homeopathic treatments may provide relief from a cervical disc bulge, such as:
- Massage – A gentle massage may provide some relief by helping to loosen muscles, increase blood flow, and promote relaxation.
- Ice/heat application – Applying ice for 15-20 minutes at a time may help reduce inflammation and alleviate pain. Some patients may find applying heat for 15-20 minutes at a time also offers great relief.
- Cervical traction device – A mechanical device is strapped to the head and used to gently lift upward and stretch the cervical spine. The ultimate goal is to reduce pressure on the discs and nerve roots.
- Cervical pillow – A proper cervical pillow will not only help improve your quality of sleep, but also aid in giving your neck the support it is needed to ease symptoms linked to a cervical disc bulge.