Neck Pain: Cervical Degenerative Disc Disease
Cervical degenerative disc disease at a glance
- Neck pain can be caused by cervical (neck) disc degeneration.
- The spinal discs act as shock absorbers between the vertebrae, allowing the spine and neck to bend and twist. A fall or injury can cause degeneration of the discs, but the most common cause is wear and tear over time.
- Symptoms most commonly include a stiff or inflexible neck.
- Treatment can range from home remedies to spinal surgery.
Causes of neck pain & cervical degenerative disc disease
As a person ages, the discs in the spine and neck may begin to break down. This can lead to degenerative disc disease, which is a term used to describe the normal changes in your spinal discs as you age.
Disc degeneration is more likely in people who smoke, are obese or do heavy physical lifting.
Over time, wear and tear can lead to changes such as:
- Loss of fluid in the discs. Loss of fluid affects a disc’s ability to act as a shock absorber, and makes the discs less flexible. It also narrows the distance between the vertebrae.
- Small cracks in the outer layer of the disc may appear, allowing the jellylike material inside to be forced out through the cracks. This may cause the disc to bulge or even rupture.
Sudden injuries may also initiate the degeneration process.
Symptoms of neck pain & cervical degenerative disc disease
Many patients with cervical disc degeneration complain of a stiff or inflexible neck. Others have severe heck pain, numbness, tingling or weakness in the neck, shoulders and arms as the nerves in the neck become pinched or irritated. The pain usually worsens with movements such as bending or turning the neck.
If you have mild neck pain for more than a week or sudden onset of severe neck pain, see your health care provider. Your physician will review your medical history and perform a physical exam to measure neck extension and flexibility. You may be asked to perform certain movements and determine whether or not neck pain increases or decreases with the movements.
Your doctor may order imaging tests such as X-Ray, MRI or a CT scan if the physical exam warrants further investigation. Diagnostic images can determine if and where degeneration is occurring, or whether other conditions are the cause of your symptoms.
Treatment for neck pain & cervical degenerative disc disease
Treatment usually begins with conservative measures (non-surgical), and surgery is only recommended if other care fails to provide adequate pain relief or if the patient’s daily activities are inhibited. Conservative treatment options include:
- Applying ice or heat for relief
- Medication: Using over-the-counter medications such as acetaminophen and non-steroidal anti-inflamatories. Your doctor may also prescribe medications such as muscle relaxants, oral steroids and narcotic pain medications. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
- Exercise: Daily exercise is essential in maintaining flexibility in the neck, and can help relieve chronic neck stiffness. Your health care provider may develop an exercise plan for you. Here are a few helpful exercises:
- Slowly turn your neck from left to right and back again several times.
- Try several chin-to-chest stretches. This will stretch the back of the neck.
- Lift your chin upward and look up. This will stretch the front of the neck and upper thoracic area.
- Move your neck in an ear-to-shoulder stretch, in order to extend the sides of the neck as much as possible. You can assist this move by gently placing a hand on the head, but don’t pull or push your head to the shoulder.
- Physical therapy may provide some relief. Chronic manipulation can help to increase, at least for a time, the disc space in the affected area.
- Neck traction or a cervical collar may be helpful by stabilizing the neck. This may improve neck alignment so that disc compression does not worsen during everyday activities.
- Surgery: If pain is not relieved after six months of conservative care, or if daily motion becomes too difficult, your doctor may recommend surgery. Fusion may stop the motion of the affected vertebral segment. It involves removal of the disc, and decompression of the nerve root. A bone graft is then inserted to reestablish the normal disc space and neck alignment. A cervical plate can be used to promote fusion between the two affected vertebrae.