Ask the Expert: Dr. Andrew Sama, Orthopedic Spine Surgeon, Answers Your Questions on Cervical Disc Herniations

by Dr. Andrew Sama
Dr. Andrew Sama, Orthopedic Spine Surgeon

Q1: What are the best non surgical or surgical options for a 41 year old male suffering from a cervical disc herniation? How long is recovery from both options?  

Most non surgical treatment for cervical disc herniation is centered around decreasing inflammation and pain and maintaining or improving range of motion and stability. This usually includes physical therapy, massage, sometimes traction and anti-inflammatory medications or muscle relaxants. If pain persists or if there is any weakness or progressive neurologic issue, then sometimes it is necessary to consider surgery. Surgery is typically done through the front of the neck to decompress the nerves and fuse the spine segment in question. Some newer techniques for stabilizing the spine with a disc replacement that preserves motion can be considered on a case by case basis.

Q2: If an index finger has been numb for many years from the herniation C-5-6, stenosis C-6-7, can epidural or surgery help get the feeling back? I have been told after a few years the nerve can be dead.  

Surgery can sometimes help regain lost function but in some cases permanent nerve damage may have occurred.  A neurologist can perform a test called an EMG to see if there has been permanent nerve damage before considering surgery.

Q3: Are there any exercises that can help prevent cervical disc herniations?  

I am not familiar with specific exercises that can prevent disc herniation but we know that maintaining a general level of fitness, good cervical muscle tone and flexibility is good for overall spine health.

Q4: I’ve heard that stretches and exercise can make a cervical disc herniation worse but I have also heard that remaining inactive is the worst thing you can do. What’s the best thing to do?  

Aggressive stretching or manipulation of the neck can sometime cause herniations to worsen and inactivity can make muscles stiff leading to increased pain. I usually recommend that patients maintain a good level of basic fitness, be mindful to strengthen their core and avoid high impact activities that may predispose one to cervical injuries.

Q5: Is surgery the only way to treat a cervical disc herniation?  

No, in fact, most disc herniations are treated non-surgically with good results. Physical therapy, anti-inflammatory medications and time usually result in improvement and the body can absorb the herniation. It is only if there is progressive neurologic deterioration or persistent or worsening of pain that we recommend surgery.

Q6: What is the most common cause of cervical disc herniation?  

Herniations can occur for a variety of reasons some of which may be related to an accident or direct injury while others are less obvious and may be the result of daily activity.

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The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

Comments

M Jerome says:

I read your articles about cervical disc herniation, can surgery be perform in the front of the neck instead of the back c3, c4, and c7

Thank You

HSS on the Move says:

Hello, thank you for your question. Dr. Andrew Sama, Orthopedic Spine Surgeon, says: “Depending on the reason for the surgery and the location of the problem being treated, decompression and fusion surgery can often be performed from the front of the neck. Your surgeon should review your condition and imaging studies and can advise you on the safest and most effective approach for your case.” If you are interested in care at HSS, please check with our Physician Referral Service at 877-606-1555.

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