Intervertebral disc lesion

The ‘slipped disc’ is commonly used but is incorrect. The disc is firmly attached on either side to the vertebral body.

 

What is it?

  • A bulge in the intervertebral disc, the spongy bit between the bony vertebrae of the neck occurs due to the outer fibres of the disc being damaged.
  • The bulge is postero-lateral, causing unilateral nerve root impingement and thus sharp neck and arm pain.  The most common level is C5/6 ie. C6 root involvement.
  • Incidence of cervical disc prolapse = 5.5 per 100,000
  • Males tend to get more cervical spine disc bulges. more than females

What are the causes?

  • Occupational relationship with static posture and repetitive arm/hand activity eg hairdressers.
  • Acute cervical disc: 80% associated with initiating trauma
  • Chronic cervical disc: more common in older patients and associated often with repetitive micro-trauma

What are the symptoms?

  • Local neck pain with sharp radiation to arm unilaterally => usually dermatomal pattern
  • Must shake arm to decrease symptoms
  • Sleep often disturbed by night pain
  • Decreased neck mobility
  • Rotation toward lesion side may reproduce symptoms
  • Antalgic posture with neck flexion and lateral flexion
  • Often unable to lie face down due to pain

 

 

 

 

 Degree of Herniation      Pain and associated symptoms 
 Mild Neck and tip of scapula pain 
 Moderate  Neck and arm pain
 Severe  Neck and arm pain and weakness   

Neck Pain