Neck pain is a problem that 1 in 3 people face at some point in their lives. Some of the neck pain may be caused by a herniated disc, as well as poor posture and inappropriate pillow selection.
Our spine is a structure that carries the weight of our body and also protects the nerves that leave the brain and go to the whole body. The neck (cervical) part of our spine consists of 7 bones called vertebrae, arranged one above the other. There are pads called discs between the vertebrae. Again, there are joints called facets between the vertebrae and the connective tissue that holds them firmly.
The discs consist of an inner jelly-like layer (nucleus pulposus) and a strong band (annulus fibrosus) surrounding this jelly-like layer. The task of the discs is to absorb the load from the upper side and transmit it equally to the lower vertebra, and also to provide the movement of the vertebrae together with the joint called facet. As a result of this outer band layer being damaged for any reason, the inner jelly-like part overflows into the region of the nerves that are inside the spine and disperse throughout our body. In this way, it both compresses the nerves and has an irritating effect on the nerves with the chemical effect of the jelly-like layer. Neck pain may occur due to the irritating effect of the chemicals released, and numbness, tingling and loss of strength may occur in the arms as a result of the compression of the nerves. This disease picture that occurs is called “neck hernia”, that is, “cervical disc herniation”.
When patients apply to the doctor with these and similar complaints, the doctor first takes the history of the disease, performs a detailed physical examination including the strength of the muscles in the arms, sensation and reflexes. Then, X-ray (X-Ray), computed tomography (CT) and magnetic resonance (MR) examinations are performed, among the radiological evaluations deemed appropriate by the physician. X-ray (X-Ray) shows bone structures in the neck, while tomography examines these bones in more detail. MRI (magnetic resonance) shows the discs and nerves between the vertebrae in the neck in detail. MRI gives us the most valuable information in neck hernias. EMG, which is also one of the electrophysiological examinations, can show us where the nerves are compressed.
Patients with neck hernia are primarily treated with conservative methods, called non-operative methods, according to the degree of hernia. These methods include drug therapy, a collar that can be used for a short time, and physical therapy. The aim of drug treatment is to relieve pain and increase the quality of life in this way. The neck brace can only be used for a short time as the doctor deems appropriate, and in this way, the spasms in the neck muscles, which is a reaction of the body due to hernia, can be relieved. Long-term use of the neck brace will weaken these muscles and cause harm rather than benefit. Again, physical therapy strengthens the muscles and tissues around the neck and ensures a stable spine. In addition, needles (Spinal injections) applied to the hernia area in the neck are also a non-surgical treatment method that can be applied to reduce the chemical effect caused by the hernia.
Surgical treatment can be applied to people for whom non-surgical treatments are insufficient or who have severe numbness, tingling, and loss of strength in the hands and arms. In the surgical treatment, the disc material that overflows into the spinal canal or compresses the nerves going out from this canal to the arms is cleaned. Then, depending on the amount of the protruding and removed disc, in large discs, the two vertebrae below and above the disc can be attached to each other so that that region does not remain unsupported, or a disc prosthesis can be placed in order to restore movement. Small discs may not need to do anything extra. These types of surgical treatment may vary depending on the age of the patient, the shape and location of the hernia. Patients can usually be discharged on the same day after the surgery, and with the rehabilitation program to be applied afterwards, they can return to their normal daily life as soon as possible.