Medical management and specialized targeted physiotherapy at PCI gives quick relief to the patients. Sometimes Injections therapies like cervical epidural steroid injections, facet joint or its nerve block, radiofrequency ablation, Prolotherapy, Provocative discography, Cervical Nucleoplasty and disc removal Surgery for pain are the treatment options.
The cervical spine in your neck is made up of seven bones called vertebrae, which are separated by discs filled with a cushioning gel-like substance. Your cervical discs both stabilize your neck and allow it to turn smoothly from side to side and bend forward to back. "Without discs, the spine would be very stiff." Discs allow our body to move in the way that we want. They also provide cushion for the body, acting as a shock absorber.
Aging causes these shock absorbers to wear & tear. The space between the vertebrae narrows and nerve roots become pinched. This process is known as cervical degenerative disc disease. The pressure causes tingling & numbness. Pain is caused only when there is inflammation of nerves. Research finds that about 25% of people without symptoms under age 40, and 60% over age 40 have some degree of degenerative disc disease. As degenerative disc disease progresses, the neck becomes less flexible, and you may feel neck pain and stiffness, especially towards the end of the day.
When the disc breaks open or bulges out, putting pressure on the spinal cord or nerve roots, it is known as a herniated disc or "slipped disc". Although cervical disc disease is generally a slow process, a herniated disc sometimes can occur quickly after an injury or trauma to the neck.
The most common and obvious symptoms of cervical degenerative disc disease are neck pain and a stiff neck. When one of these conditions presses on one or more of the many nerves running through the spinal cord, you also can develop pain, numbness, or weakness radiating down your shoulder, arm, and hand.
To diagnose your cervical disc disease, your doctor will first take a medical history to find out when your symptoms started, how severe they are, and what causes them to improve or worsen. You'll likely have a neurological exam to test your strength, reflexes, and the sensation in your arm and hand, if they are affected.
Imaging tests such as X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans can help your doctor visualize your spinal cord to pinpoint the source of your neck pain.
Even if you have degenerative disc disease or a slipped disc, chances are good that you'll be able to treat it without surgery. The first line in treatment for cervical disc disease is pain medications, including Paracetamol, and nonsteroidal anti-inflammatory medications such as ibuprofen; acetaminophen and naproxen. These medications can help reduce pain and inflammation. Some muscle relaxant, antidepressant medicines may be added for chronic neck pain.
Physical therapy is another treatment option for cervical spine pain. The therapist at PCI can use Interferrential therapy (IFT), US (Ultrasound), cervical traction, or gently manipulate your muscles and joints to reduce your pain and stiffness. The physical therapist can also help you increase your range of motion and show you exercises and correct postures to help improve your neck pain.
Your neck pain should improve with these conservative treatments. If you also have continued pain & disability or significant numbness or weakness, contact pain specialists at PCI right away. You and your doctor will need to consider the next step in your treatment. The next step is Epidural cortisone injection under x-ray control.
Other non-surgical treatment options are transforaminal selective nerve root injection, pulsed RF, discography, >95% of moderate to severe neck pain do respond to these therapies.
The main surgery for degenerative disc disease is called a discectomy. During this procedure, the surgeon removes the deteriorating disc. Discectomy is often followed up by artificial disc replacement, in which a metal disc is inserted in place of the disc that was removed. Discectomy may also be followed by cervical fusion, in which a small piece of bone is implanted in the space between the vertebrae. As the bone heals, it fuses with the vertebrae above and below it.
Cervical Nucleoplasty
Radiofrequency Rhizotomy for Facet joint Pain causing Neck Pain
Even though degenerative disc disease is most often due to age, it can also be influenced by lifestyle factors. To make sure you keep your spine as healthy as possible, eat a balanced diet and exercise regularly. Don't smoke, because, aside from its other affects on your health, smoking is a risk factor for cervical disc disease. Also watch your posture, always keeping your neck straight and your back well supported.
Although neck pain from cervical disc disease can return, you'll lower the chances if you take good care of your neck and the rest of your body. Most people don't have constant neck problems throughout their lives. Usually it comes and goes. "If you have a problem with your neck now, the odds are it won't last forever."
