The cervical spine is the upper part of the spine comprising of the first 7 vertebrae. The vertebrae are separated from one another by shock absorbing pads called intervertebral discs. Over time, these natural shock absorbers wear out and degenerate due to aging, trauma or injury. As a result, the space between the vertebrae narrows and nerve roots can get compressed resulting in neck pain. This is also known as cervical degenerative disc disease (DDD).
Traumatic injury, postural strain, repetitive movements, overuse, changes in posture or poor body mechanics and being overweight may alter the structure of the disc. All of these structural changes can place abnormal stress to the cervical spinal roots resulting in pain.
The cartilaginous disc is made up of an outer fibrous layer called the annulus fibrosa, which surrounds an inner gelatinous core called the nucleus pulposus. The nucleus pulposus is well hydrated and acts as a shock absorber. Over time, the nucleus pulposus begins to dehydrate and become stiffer, losing its functionality as a shock absorber. This also results in a reduction in the height of the disc and increased stress and damage to the surrounding annulus fibrosis. This can cause causing cervical spine instability and pain.
In some individuals cervical DDD may be asymptomatic and may be notified of the condition on being examined for some other health problem, or during a routine checkup. Cervical DDD is a progressive condition, this means that the symptoms often develop gradually and the condition may deteriorate over time. Cervical radiculopathy is characterized by pain originating in the neck and radiating to the shoulders and arms. Other symptoms include moderate to severe pain, pain aggravated by movements, problems with gait and balance, numbness, tingling and weakness radiating to your shoulder, arm, and hand, and rarely bladder and bowel problems.
Your physician will diagnose cervical degenerative disc disease based on your symptoms, medical history as well as physical and neurological examination. In neurological examination, your reflexes are tested to identify any muscle weakness, loss of sensation or other signs of neurological injury. Imaging tests such as X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans can help to confirm the diagnosis. X-rays are used to identify the collapsed disc space. Computed tomography (CT) scans and magnetic resonance imaging (MRI) scans may be used to reveal disc and endplate changes.
Sometimes, discography may be performed to confirm the diagnosis. A discogram is a diagnostic procedure used to precisely locate which spinal discs are injured and causing the neck pain.
Treatment of cervical degenerative disc disease comprises of non-surgical and surgical treatment options. Non-surgical treatment of cervical degenerative disc disease can help reduce pain and the associated symptoms. The non –surgical treatment options include anti-inflammatory and pain medications, muscle relaxants, physical therapy, spinal injections, certain types of braces, and acupuncture. Your doctor may combine two or more therapies to increase the chances for successful treatment.
Surgery is usually recommended if you have spine instability or neurological dysfunction and the pain is persistent and not responding to conservative treatment. Spinal stabilization and fusion will be performed to help alleviate your pain and stabilize the spine.
Consult your doctor for any concerns or queries about cervical degenerative disc disease. Your doctor is a reliable resource to answer all your queries and help you understand the condition better.