Dr. M.J. Bazos MD, Patient Handout

About Your Diagnosis
The neck (cervical) portion of your spinal column is made of seven vertebrae separated by cartilaginous disks. These disks are the “shock absorbers” of the head and neck. They act as a cushion between the bones and allow some of the bending movements of the head and neck. Degenerative changes or trauma may rupture the annulus fibrosus, the tough band of cartilage surrounding each disk, and disk material may bulge or herniate into the spinal
canal or nerve root canal. The herniated or bulging piece of the disk or degenerative bone spur may compress the spinal cord or nerve root, causing pain in the neck or “tingling and numbness” that may radiate to the shoulder, upper back, arm, or hand. Some patients also have weakness, clumsiness, and
difficulty walking.

Living With Your Diagnosis
The pain from a bulging or herniated disc is worse on movement and may be worsened by coughing, laughing, or straining when having a bowel movement. Degenerative changes in the disks are a normal process as we age. Tobacco abuse, poor posture, and strenuous work with poor lifting technique may accelerate the degenerative changes. The disks gradually become worn, less plump, and eventually flattened. When the disk space becomes narrow enough that the vertebrae rub one another, then wear and tear changes develop at the edges of the vertebrae. This wear and tear causes bone spurs to develop that may begin to press on the spinal cord or nerve root. As the nerve becomes irritated, it may cause pain, tingling, numbness, or weakness.

If your physician suspects that you have a cervical disk that is causing a problem, one or more of the following tests may be ordered: computed tomography (CT) scan (special x-ray pictures of the neck); magnetic resonance imaging (MRI: special non–x-ray pictures of the neck); myelogram/CT (xray of the spinal canal and nerve roots); or an electromyogram/ nerve conduction velocity test (EMG/ NCV: an electrical test of the nerves and muscles). Conservative treatments such as physical therapy, localized heat, cervical traction, and special exercises are usually performed by a trained physical therapist. Injection of steroids and an anesthetic medication into the cervical spinal canal is usually performed by anesthesiologists with special training in pain control. Generally, surgery is the final option if conservative treatments have failed to relieve the symptoms. Your surgeon will discuss the risks and benefits of surgery.

The DOs
• Perform gentle stretching and bending of your neck.
• Maintain good posture while sitting and walking.
• Always wear a seat belt when traveling in a motor vehicle.
• Place a pillow under your head and neck when lying in bed.
• Participate in a daily exercise program approved by your physician.

The DON’Ts
• Don’t use tobacco. This causes cumulative injury to your spine by damaging the normal repair process in the disks and vertebrae.
• Don’t make a habit of “popping” your neck.
• Don’t slouch in a chair or bed.
• Don’t return to work without clearance from your physician.
• Don’t engage in any strenuous activities until cleared with your physician.
• Don’t resume driving until pain free without pain medication.

When to Call Your Doctor
• If you have any problems associated with your medications.
• If your symptoms become much worse or if you have new weakness.
• If you have difficulty walking, have weakness or inability to move your limbs, or have loss of control of your bowels or bladder.