Ask the Expert: Dr. Andrew Sama, Orthopedic Spine Surgeon, Answers Your Questions on Cervical Disc Herniations
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.
Dr. Andrew Sama specializes in the evaluation and surgical management of all traumatic, degenerative, and deformity-related conditions of the cervical, thoracic, and lumbosacral spine. Board certified in orthopedic surgery, he believes in a team approach to patient care. He is an active member of many spine societies, academic committees, and editorial review boards. He is a Fellow of the American Academy of Orthopedic Surgeons and a Diplomat of the American Board of Orthopedic Surgeons.