What is a cervical herniated disc?
Each disc has a firm outer ring around a softer center. When the outer ring tears, some of that inner material can push out and press on a nearby nerve root or, less often, on the spinal cord itself. In the neck this happens most frequently at the lower levels, between C4 and C7, where motion is greatest.
Symptoms
What you feel depends on what the disc is pressing against:
- Neck pain and stiffness, sometimes with muscle spasm
- Pain, tingling, or weakness travelling into one shoulder, arm, or hand
- Symptoms that sharpen when looking up or turning the head
- Less commonly, clumsiness in both hands or a change in walking, when the cord is involved
Urgent
Come in promptly if you develop clumsiness in both hands, unsteady walking, or worsening weakness, and seek urgent care for any loss of bowel or bladder control.
How it is diagnosed
The examination establishes which nerve is affected and whether the cord is involved, which is the distinction that drives everything else. MRI shows the herniation, its direction, and what it is contacting. X-rays add information about alignment and motion. Findings on imaging are common in people without symptoms, so the two are read together.
Non-surgical treatment
A fair trial of non-operative care is appropriate for most people: activity modification, anti-inflammatory medication where safe, and physical therapy once the acute pain settles. A selective injection may relieve symptoms and help confirm the level. Improvement is often gradual rather than sudden.
When surgery is considered
Surgery is discussed when arm pain is severe and persistent despite appropriate care, when weakness is progressing, or when the disc is compressing the spinal cord. The approach depends on the level, the direction of the herniation, and the alignment of the neck, including motion-preserving options such as disc replacement where the anatomy allows.