Cervical herniated disc

The neck is made up of bones called cervical vertebrae. Between the cervical vertebrae lie the intervertebral discs. A cervical herniated disc is a bulge of one of these intervertebral discs. When the bulge presses against a nerve, symptoms can arise in the area where this nerve runs, for example in the neck, shoulder, arm, and/or hand.

Specialists also refer to a cervical radiculopathy when they talk about a cervical herniated disc.

What causes a cervical herniated disc?

The most common cause of a cervical herniated disc is degeneration of the intervertebral disc. It is also possible for the intervertebral disc to bulge after an accident, for example after a car accident or a fall.

The diagnosis of a cervical herniated disc is made regularly. This condition occurs most often in people between 35 and 65 years of age. From the age of 65, the chance of a herniated disc actually decreases.

How can a cervical herniated disc be recognized?

Common symptoms of a cervical herniated disc include pain in the neck, shoulder, arm, and/or hand. The pain sometimes feels like an 'electric shock' that suddenly shoots from the neck down the arm. The pain may also be experienced when coughing, sneezing, or straining (bowel movement).

Due to pressure on the nerve, symptoms can occur in the corresponding area supplied by that nerve. This can lead to tingling, a numb or prickling sensation, or loss of strength in the arm and/or hand.

How is a cervical herniated disc diagnosed?

A cervical herniated disc can be diagnosed based on the patient's history and the accompanying physical examination. If a cervical herniated disc is suspected, imaging—such as an MRI scan—should provide clarity.

On an MRI scan, a bulge of the intervertebral disc is usually clearly visible. A CT scan of the neck can also be chosen. This gives the specialist more information about the influence of the bones on the symptoms. This is useful when deciding whether or not to operate.

The neck consists of seven cervical vertebrae. The most common cervical herniated discs are seen between the fifth and sixth cervical vertebrae or between the sixth and seventh cervical vertebrae. These vertebrae are located more in the lower part of the neck.

How is a cervical herniated disc treated?

After assessing the imaging, a decision will be made to treat the cervical herniated disc surgically or non-surgically (conservatively). In 80 to 90 percent of cases, a cervical herniated disc heals on its own. That is why a conservative treatment is usually chosen initially.

Conservative treatment consists of a combination of 1) medication aimed at pain reduction and 2) exercise therapy under the guidance of a physical therapist. The treatment focuses on the mobility (range of motion) of the neck and training the stability of the neck muscles.

In surgical treatment of a cervical herniated disc, a small incision is made in the front of the neck on the right or left side. Then the 'affected' intervertebral disc, including the bulge, is removed. To replace this intervertebral disc, a plastic cage is placed, and the overlying and underlying vertebrae are fixed to this cage. 

Even after surgery, exercise therapy for neck mobility and stability of the neck muscles is of great value.

Do the self-check

With the online self-check, you can assess whether your symptoms match the most common complaints of a cervical herniated disc. Answer a number of questions and view the result.