A neck herniated disc may cause problems with symptoms from a sore area to sharp pain

Depending on the extent the disc is herniated and the location in the neck, the symptoms may be a local sore neck confined to a small area or a sharp pain that may travel down the arm and even into the fingers.

The disc is a type of joint cartilage that connects and cushions the bones in your neck. Each disc attaches to the bone above and below it. This provides the proper spacing for nerve roots to exit from the spinal cord from between each joint. It is sandwiched between each neck bone and allows normal turning and bending.

Each disc has a "ball bearing" like inner portion which is red in the diagram and an outer part colored blue. The disc is kind of like a jelly doughnut with the inner part being the jelly and the outer the doughnut.

A healthy disc in the neck provides flexibility, normal turning and bending which produces a pumping action that supplies proper disc nutrition and waste removal.

Problems arise when the disc is damaged by arthritis or injury. Like a blister, disc tissue can bulge. As the soft inner part is compressed, it pushes outward where it can cause neck symptoms ranging from a sore area to sharp traveling pain, numbness and/or tingling. The symptoms can also involve muscle twitching and weakness. Muscles usually go into spasm to protect and splint the joint.

In the diagram we can see a bird's eye view of the disc and how a herniated inner part can extrude and come in contact with the sensitive nerves. The herniated part may move back and/or to the side and cause a pinched nerve in the neck.

Because the disc is so close to the spinal cord and nerves, it is often involved with neck pain. The disc may not completely herniate but weaken and slightly push out or protrude which may cause a more local pain reaction.

Disc problems are not a normal result of aging but more likely the result of years of neglect. Many neck problems do not cause symptoms until the advanced stages of degenerative disc disease.

A disc herniation may require surgery, anti-inflammatory medications or other therapeutic measures to get past the acute stage depending on how much of the inner part has herniated out and the extent of pressure it puts on the sensitive nerve tissue in the neck.

The disc is sensitive to pain. In the image above (left) you can see the results of stimulating the disc and the areas of pain that it refers to at each spinal level. The image above (right) shows the types of disc herniations; Bulging, Protrusion and Extrusion.

For a technical note on the nerves as related to the disc level involved; A C4-C5 disc herniation will compress the C5 nerve root A C5-C6 disc herniation will compress the C6 nerve root A C6-C7 disc herniation will compress the C7 nerve root A C7-T1 disc herniation will compress the C8 nerve root A T1-T2 disc herniation will compress the T1 nerve root In the example of the MRI picture, the C5-C6 disc is herniated leaving an impression on the spinal cord which may cause myelopathy. The nerve involved would be the C6 nerve. The C6-C7 disc may cause pressure on the C7 nerve root which may cause chest pain in addition to arm pain. This is often called "cervical angina" or "pseudoangina" and can be quite frightening. It may be precipitated by fatigue, incorrect posture or movement of the involved segments and is often dull and aching in character and punctuated by brief sharp twinges of pain. It may be intensified by coughing and sneezing, and the pain may last for hours. Relief may be obtained through rest, analgesics, postural change, manual treatment, local heat or cold.

Injuries to the disc may evoke pain by the activation of sensory nociceptors. Injury of the annulus can lead to release of significant amounts of inflammatory chemicals that may in turn irritate or sensitize the annulus and adjacent structures in the spinal canal and intervertebral foramina. Inflammatory and immunological reaction to herniated disc material is well recognized as a pain generating mechanism.

The shoulder abduction test is often used to test for compression on a nerve. The pain of a herniated disc may be relieved by placing the hand of the affected side on top of the head. In some instances it may increase the pain depending on how the disc herniates and places pressure on the nerve. A disc may herniate medially, in which case the shoulder abduction test will cause relief while the pain is made worse when the arm hangs or is tractioned downward. In a laterally herniated disc, the pain is made worse when placing the hand on the head and relief is obtained by hanging or tractioning the arm downward.

Fortunately, most often a neck herniated disc will dry up and shrink over time taking pressure off the nerves. The long term consequences result from the altered biomechanics which disrupt normal motion and thus nutrition and waste removal of the disc which can cause an advanced degeneration of the joints.

It is important to get a proper neck examination if you think you have a herniated disc. An x-ray will not show the disc, only the disc space. Usually a MRI is taken to get a clear view.

For long term management, restoration of normal motion is important. The use of heat for neck pain relief is important to reduce muscle spasm. Additionally, a tens unit can be used for pain relief to avoid prolonged dependence on medications. To promote early mobilization with a passive motion, the neck massager is a wonderful therapy to use before active neck exercises can be performed. Often, a home neck traction unit can begin to restore normal biomechanical relationships and ease nerve tension. Chiropractic adjustments can provide additional relief and biomechanical support although I do recommend gentle, low force techniques for any confirmed neck herniated disc.